Tissue remodeling

组织重塑
  • 文章类型: Journal Article
    背景:牙周膜干细胞(PDLSCs)是组织工程和临床应用中重要的种子细胞。它们是用于感测各种机械应力的优先受体细胞。Yes相关蛋白(YAP)是公认的机械敏感转录因子。然而,YAP在张力应激(TS)下调节PDLSCs命运的作用及其机制尚不清楚。
    方法:用荧光染色法研究TS对PDLSCs形态和命运的影响,透射电子显微镜,流式细胞术和定量实时聚合酶链反应(qRT-PCR)。然后qRT-PCR,西方印迹,免疫荧光染色和基因敲低实验研究YAP的表达和分布及其与PDLSCs增殖的相关性。随后通过添加细胞骨架抑制剂来探索细胞骨架动力学对YAP核易位的影响。通过qRT-PCR和western印迹证明细胞骨架动力学对LINC复合物表达的影响。腺病毒破坏LINC复合物后,研究了LINC复合物对YAP核易位和PDLSCs增殖的影响.然后进行线粒体相关检测以探索线粒体在YAP核易位中的作用。最后,通过构建Sprague-Dawley大鼠正畸牙齿移动模型对体外结果进行验证。
    结果:TS增强了F-肌动蛋白的聚合和拉伸,上调LINC复合物的表达。这进一步加强了对核弹的拉力,扩大了核孔隙,并促进了YAP的核进入,从而增强增殖相关基因的表达。在这个过程中,线粒体沿着重建的微管运输到细胞核的外围。他们产生ATP以帮助YAP的核易位,并在一定程度上驱动F-肌动蛋白聚合。当LINC复合体被摧毁时,YAP的核易位被抑制,这限制了PDLSCs的增殖,牙周组织改建受阻,阻碍牙齿移动。
    结论:我们的研究证实,适当的TS可以通过机械驱动的F-肌动蛋白/LINC复合物/YAP轴促进PDLSCs增殖和牙周组织重塑,为临床上种子细胞扩增和促进健康有效的牙齿移动提供理论指导。
    BACKGROUND: Periodontal ligament stem cells (PDLSCs) are important seed cells in tissue engineering and clinical applications. They are the priority receptor cells for sensing various mechanical stresses. Yes-associated protein (YAP) is a recognized mechanically sensitive transcription factor. However, the role of YAP in regulating the fate of PDLSCs under tension stress (TS) and its underlying mechanism is still unclear.
    METHODS: The effects of TS on the morphology and fate of PDLSCs were investigated using fluorescence staining, transmission electron microscopy, flow cytometry and quantitative real-time polymerase chain reaction (qRT-PCR). Then qRT-PCR, western blotting, immunofluorescence staining and gene knockdown experiments were performed to investigate the expression and distribution of YAP and its correlation with PDLSCs proliferation. The effects of cytoskeleton dynamics on YAP nuclear translocation were subsequently explored by adding cytoskeleton inhibitors. The effect of cytoskeleton dynamics on the expression of the LINC complex was proved through qRT-PCR and western blotting. After destroying the LINC complex by adenovirus, the effects of the LINC complex on YAP nuclear translocation and PDLSCs proliferation were investigated. Mitochondria-related detections were then performed to explore the role of mitochondria in YAP nuclear translocation. Finally, the in vitro results were verified by constructing orthodontic tooth movement models in Sprague-Dawley rats.
    RESULTS: TS enhanced the polymerization and stretching of F-actin, which upregulated the expression of the LINC complex. This further strengthened the pull on the nuclear envelope, enlarged the nuclear pore, and facilitated YAP\'s nuclear entry, thus enhancing the expression of proliferation-related genes. In this process, mitochondria were transported to the periphery of the nucleus along the reconstructed microtubules. They generated ATP to aid YAP\'s nuclear translocation and drove F-actin polymerization to a certain degree. When the LINC complex was destroyed, the nuclear translocation of YAP was inhibited, which limited PDLSCs proliferation, impeded periodontal tissue remodeling, and hindered tooth movement.
    CONCLUSIONS: Our study confirmed that appropriate TS could promote PDLSCs proliferation and periodontal tissue remodeling through the mechanically driven F-actin/LINC complex/YAP axis, which could provide theoretical guidance for seed cell expansion and for promoting healthy and effective tooth movement in clinical practice.
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  • 文章类型: Journal Article
    目的:研究唇侧倾斜的种植体轴是否会影响上颌骨前部即刻种植体置入和修复(IIPP)的临床结果。
    方法:纳入上颌中切牙或上颌外侧切牙不可挽救的患者。在所有参与者中进行IIPP同时进行结缔组织移植(CTG)。在对照组中,牙槽的长轴与牙齿对齐,这确保了立即植入的目标是切牙边缘或未来修复的扣带。测试组的脊和牙齿的轴之间具有较大的角度。为了避免骨开窗,植入物倾斜放置在唇侧,并从未来修复的唇侧出现。进行口腔内扫描和锥形束计算机断层扫描,以记录基线和1年后的软组织和硬组织轮廓。软组织稳定性,骨重塑,评估并比较两组患者的粉红美学评分(PES)。
    结果:39名参与者(19个测试和20个对照)完成了研究。手术后1年,面部中部牙龈缘迁移为0.85±0.37mm(测试)和0.81±0.33mm(对照),没有显著差异。口腔轮廓改变没有发现差异,线性脊减少,颊骨厚度,或PES分数。试验组比对照组显示出较薄的口腔软组织。
    结论:当出现较大的牙脊角度时,唇侧倾斜的植入物,在IIPP中使用CTG避免颊脊开窗,短期内不会影响临床结局。
    OBJECTIVE: To investigate whether a labially inclined implant axis compromises the clinical outcomes of immediate implant placement and provisionalization (IIPP) in the anterior maxilla.
    METHODS: Patients with unsalvageable central or lateral maxillary incisors were enrolled. IIPP with simultaneous connective tissue graft (CTG) was performed in all participants. In the control group, the alveolar ridge had a long axis aligned with the tooth, which ensured that the immediate implant was aimed at the incisor edge or the cingulum of future restoration. The test group had a large angle between the axes of the ridge and tooth. To avoid bone fenestration, the implants were placed labially inclined and emerged from the labial side of future restoration. Intra-oral scanning and cone-beam computed tomography were performed to record soft and hard tissue profiles at baseline and 1 year later. Soft tissue stability, bone remodeling, and pink esthetic score (PES) were evaluated and compared between two groups.
    RESULTS: Thirty-nine participants (19 tests and 20 controls) completed the study. At 1-year post-surgery, the mid-facial gingival margin migrations were 0.85 ± 0.37 mm (test) and 0.81 ± 0.33 mm (control), without significant differences. No differences were identified in buccal profile alteration, linear ridge reduction, buccal bone thickness, or PES scores. The test group demonstrated thinner buccal soft tissue at the crestal level than the control group.
    CONCLUSIONS: When large tooth-ridge angulation presented, labially inclined implant, avoiding buccal ridge fenestration in IIPP with CTG, did not compromise the clinical outcome in short term.
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  • 文章类型: Journal Article
    与血压和血流模式相关的机械力在血管稳态中起着至关重要的作用。由血液动力学变化引起的血管应力和应变的扰动可能发生在病理条件下。导致血管功能障碍以及人工血管,动静脉分流用于血液透析和机械循环支持。湍流状的血流可以引起血管壁的高频振动,这种刺激最近作为血管病变的潜在贡献者而受到关注,如血液透析动静脉内瘘内膜增生的发展。然而,血管细胞对这种刺激的生物反应仍未完全了解。这篇综述提供了有关高频刺激对血管细胞形态影响的现有文献的分析。函数,和基因表达。形态学和功能研究表明,以高于正常心率的频率刺激的血管细胞表现出细胞形状的改变,对齐,和扩散,可能导致血管重塑。此外,振动调节内皮和平滑肌细胞基因表达,影响与炎症相关的途径,氧化应激,肌肉肥大.了解高频振动对血管细胞的影响对于揭示血管疾病的潜在机制和确定潜在的治疗靶标至关重要。然而,我们对控制这些细胞反应的分子途径的理解仍然存在差距。需要进一步的研究来阐明这些机制及其对血管疾病的治疗意义。
    Mechanical forces related to blood pressure and flow patterns play a crucial role in vascular homeostasis. Perturbations in vascular stresses and strain resulting from changes in hemodynamic may occur in pathological conditions, leading to vascular dysfunction as well as in vascular prosthesis, arteriovenous shunt for hemodialysis and in mechanical circulation support. Turbulent-like blood flows can induce high-frequency vibrations of the vessel wall, and this stimulus has recently gained attention as potential contributors to vascular pathologies, such as development of intimal hyperplasia in arteriovenous fistula for hemodialysis. However, the biological response of vascular cells to this stimulus remains incompletely understood. This review provides an analysis of the existing literature concerning the impact of high-frequency stimuli on vascular cell morphology, function, and gene expression. Morphological and functional investigations reveal that vascular cells stimulated at frequencies higher than the normal heart rate exhibit alterations in cell shape, alignment, and proliferation, potentially leading to vessel remodeling. Furthermore, vibrations modulate endothelial and smooth muscle cells gene expression, affecting pathways related to inflammation, oxidative stress, and muscle hypertrophy. Understanding the effects of high-frequency vibrations on vascular cells is essential for unraveling the mechanisms underlying vascular diseases and identifying potential therapeutic targets. Nevertheless, there are still gaps in our understanding of the molecular pathways governing these cellular responses. Further research is necessary to elucidate these mechanisms and their therapeutic implications for vascular diseases.
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  • 文章类型: Journal Article
    生物药物已被证明可以增强严重哮喘和COPD的治疗。针对特定靶标的单克隆抗体极大地改变了这些病症的管理。虽然哮喘和COPD的炎症途径已经被清楚地概述,替代作用机制仍未被探索。他们可以为这些疾病及其临床管理提供更多见解。因此,已经开发了体内或体外模型来测试替代假设。这项研究描述了复杂的离体模型,模拟人类呼吸道粘膜对疾病触发因素的反应,旨在缩小实验室研究与临床实践之间的差距。这些模型成功地复制了这些疾病的关键方面,比如炎症细胞的存在,细胞因子产生,和组织结构的变化,为调查疾病过程和评估潜在治疗提供动态平台,如单克隆抗体。所提出的模型有可能增强个性化医疗方法和针对患者的治疗,帮助提高对呼吸系统疾病的理解和管理。本文说明了在实验室环境中哮喘和COPD疾病的复制以及该方法的潜在应用。
    Purpose: This article illustrates the replication of asthma and COPD conditions in a laboratory setting and the potential applications of this methodology.
    Introduction: Biologic drugs have been shown to enhance the treatment of severe asthma and COPD. Monoclonal antibodies against specific targets have dramatically changed the management of these conditions. Although the inflammatory pathways of asthma and COPD have already been clearly outlined, alternative mechanisms of action remain mostly unexplored. They could provide additional insights into these diseases and their clinical management.
    Aims: In vivo or in vitro models have thus been developed to test alternative hypotheses. This study describes sophisticated ex vivo models that mimic the response of human respiratory mucosa to disease triggers, aiming to narrow the gap between laboratory studies and clinical practice.
    Results: These models successfully replicate crucial aspects of these diseases, such as inflammatory cell presence, cytokine production, and changes in tissue structure, offering a dynamic platform for investigating disease processes and evaluating potential treatments, such as monoclonal antibodies. The proposed models have the potential to enhance personalized medicine approaches and patient-specific treatments, helping to advance the understanding and management of respiratory diseases.
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  • 文章类型: Journal Article
    先前的研究报道了toll样受体(TLRs)的表达,仅TLR2和TLR4,以及补体片段(C3a,C5b9)在玻璃体视网膜疾病中。除了病原体,TLR可以将组织重塑的内源性产物识别为损伤相关分子模式(DAMPs)。这项研究的目的是确认TLR2和TLR4在患有视网膜前膜(ERMs)的患者的纤维细胞膜和玻璃体液体(可溶性TLRs)中的表达,并评估其与疾病严重程度的关系。补体片段和炎症特征。在玻璃体切除术时收集20个(n=20)ERM和12个(n=12)玻璃体样品。对不同严重程度分期的ERM进行了处理:免疫定位(IF),转录组学(RT-PCR)和蛋白质组学(ELISA,IP/WB,蛋白芯片阵列)分析。调查的目标包括TLR2,TLR4,C3a,C5b9,一些选定的炎症生物标志物(Eotaxin-2,Rantes,血管内皮生长因子(VEGFA),血管内皮生长因子受体(VEGFR2),干扰素-γ(IFNγ),白细胞介素(IL1β,IL12p40/p70))和一组受限的基质酶(基质金属蛋白酶(MMP)/金属蛋白酶组织抑制剂(TIMPs)。观察到作为ERM严重程度的函数的细胞减少。在膜中检测到TLR2、TLR4和myD88转录物/蛋白,并且随着疾病严重程度而降低。可溶性TLR2和TLR4,以及C3a的水平,C5b9Eotaxin-2Rantes,VEGFA,VEGFR2,IFNγ,IL1β,在玻璃体样品中IL12p40/p70、MMP7和TIMP2水平改变。在TLR和补体片段之间以及在TLR和一些炎症介质之间观察到显著的相关性。我们的发现指出TLR2和TLR4在ERM形成的早期过度表达。提示局部免疫反应参与疾病的严重程度。在ERM形成的早期阶段的这些激活表明在纤维细胞膜形成的早期阶段先天性免疫应答的潜在持久性。
    Previous studies reported the expression of toll-like receptors (TLRs), merely TLR2 and TLR4, and complement fragments (C3a, C5b9) in vitreoretinal disorders. Other than pathogens, TLRs can recognize endogenous products of tissue remodeling as damage-associated molecular pattern (DAMPs). The aim of this study was to confirm the expression of TLR2 and TLR4 in the fibrocellular membranes and vitreal fluids (soluble TLRs) of patients suffering of epiretinal membranes (ERMs) and assess their association with disease severity, complement fragments and inflammatory profiles. Twenty (n = 20) ERMs and twelve (n = 12) vitreous samples were collected at the time of the vitrectomy. Different severity-staged ERMs were processed for: immunolocalization (IF), transcriptomic (RT-PCR) and proteomics (ELISA, IP/WB, Protein Chip Array) analysis. The investigation of targets included TLR2, TLR4, C3a, C5b9, a few selected inflammatory biomarkers (Eotaxin-2, Rantes, Vascular Endothelial Growth Factor (VEGFA), Vascular Endothelial Growth Factor receptor (VEGFR2), Interferon-γ (IFNγ), Interleukin (IL1β, IL12p40/p70)) and a restricted panel of matrix enzymes (Matrix metalloproteinases (MMPs)/Tissue Inhibitor of Metallo-Proteinases (TIMPs)). A reduced cellularity was observed as function of ERM severity. TLR2, TLR4 and myD88 transcripts/proteins were detected in membranes and decreased upon disease severity. The levels of soluble TLR2 and TLR4, as well as C3a, C5b9, Eotaxin-2, Rantes, VEGFA, VEGFR2, IFNγ, IL1β, IL12p40/p70, MMP7 and TIMP2 levels were changed in vitreal samples. Significant correlations were observed between TLRs and complement fragments and between TLRs and some inflammatory mediators. Our findings pointed at TLR2 and TLR4 over-expression at early stages of ERM formation, suggesting the participation of the local immune response in the severity of disease. These activations at the early-stage of ERM formation suggest a potential persistence of innate immune response in the early phases of fibrocellular membrane formation.
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  • 文章类型: Journal Article
    胰岛素样生长因子结合蛋白7(IGFBP7)是一种细胞外基质(ECM)糖蛋白,在发育过程中高度富含活化的脉管系统,生理和病理组织重塑。尽管经过几十年的研究,它在组织(再)血管化中的作用是高度模糊的,在不同的组织重塑状态下表现出促血管生成和抗血管生成特性。IGFBP7有多个结合伴侣,包括结构ECM部件,细胞因子,趋化因子,以及几个受体。根据目前的证据,这表明IGFBP7的生物活性强烈依赖于它嵌入的微环境。目前的研究表明,在生理性血管生成过程中,IGFBP7促进内皮细胞附着,发光,血管稳定和成熟。其对血管生成和血管功能的其他阶段的影响仍有待确定。IGFBP7还调节其他信号因子的促血管生成特性,如VEGF-A和IGF,并可能充当生长因子的蓄水池,而其对信号传导因素的实际影响可能取决于IGFBP7嵌入的环境。除了(再)血管化,IGFBP7明显促进祖细胞和干细胞的定型,并可能表现出抗炎和抗纤维化特性。尽管如此,它在炎症中的作用,免疫调节,纤维化和细胞衰老再次可能是环境依赖性的。未来的研究需要进一步阐明IGFBP7的复杂功能。
    Insulin-like Growth Factor-Binding Protein 7 (IGFBP7) is an extracellular matrix (ECM) glycoprotein, highly enriched in activated vasculature during development, physiological and pathological tissue remodeling. Despite decades of research, its role in tissue (re-)vascularization is highly ambiguous, exhibiting pro- and anti-angiogenic properties in different tissue remodeling states. IGFBP7 has multiple binding partners, including structural ECM components, cytokines, chemokines, as well as several receptors. Based on current evidence, it is suggested that IGFBP7\'s bioactivity is strongly dependent on the microenvironment it is embedded in. Current studies indicate that during physiological angiogenesis, IGFBP7 promotes endothelial cell attachment, luminogenesis, vessel stabilization and maturation. Its effects on other stages of angiogenesis and vessel function remain to be determined. IGFBP7 also modulates the pro-angiogenic properties of other signaling factors, such as VEGF-A and IGF, and potentially acts as a growth factor reservoir, while its actual effects on the factors\' signaling may depend on the environment IGFBP7 is embedded in. Besides (re-)vascularization, IGFBP7 clearly promotes progenitor and stem cell commitment and may exhibit anti-inflammatory and anti-fibrotic properties. Nonetheless, its role in inflammation, immunomodulation, fibrosis and cellular senescence is again likely to be context-dependent. Future studies are required to shed more light on the intricate functioning of IGFBP7.
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  • 文章类型: Journal Article
    巨噬细胞在调节损伤后的组织修复和再生中起着至关重要的作用。然而,由于它们复杂的成分异质性和功能可塑性,破译不同巨噬细胞亚群的性质,并揭示它们在修复过程中的动力学和精确作用一直具有挑战性。凭借其独特的优势,斑马鱼(Daniorerio)已成为研究巨噬细胞发育和功能的宝贵模型,特别是在组织修复和再生方面,为我们对健康和疾病中巨噬细胞生物学的理解提供有价值的见解。在这次审查中,我们介绍了目前与巨噬细胞在组织修复和再生中的作用相关的知识和挑战,强调斑马鱼研究的重大贡献。我们讨论了斑马鱼模型的独特优势,包括它的遗传工具,成像技术,和再生能力,这极大地促进了巨噬细胞在这些过程中的研究。此外,我们概述了斑马鱼研究在解决剩余挑战和提高我们对巨噬细胞与组织修复和再生之间复杂相互作用的理解方面的潜力.
    Macrophages play crucial and versatile roles in regulating tissue repair and regeneration upon injury. However, due to their complex compositional heterogeneity and functional plasticity, deciphering the nature of different macrophage subpopulations and unraveling their dynamics and precise roles during the repair process have been challenging. With its distinct advantages, zebrafish (Danio rerio) has emerged as an invaluable model for studying macrophage development and functions, especially in tissue repair and regeneration, providing valuable insights into our understanding of macrophage biology in health and diseases. In this review, we present the current knowledge and challenges associated with the role of macrophages in tissue repair and regeneration, highlighting the significant contributions made by zebrafish studies. We discuss the unique advantages of the zebrafish model, including its genetic tools, imaging techniques, and regenerative capacities, which have greatly facilitated the investigation of macrophages in these processes. Additionally, we outline the potential of zebrafish research in addressing the remaining challenges and advancing our understanding of the intricate interplay between macrophages and tissue repair and regeneration.
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  • 文章类型: Journal Article
    慢性肝损伤诱导肝硬化并促进肝癌发生。然而,这种情况对肝细胞增殖和分化的影响尚不清楚。我们表明,啮齿动物肝细胞在胶原基质中培养时表现出导管表型。该过程涉及转分化而不出现肝母细胞特征,并且至少是部分可逆的。在慢性肝病进行性纤维化的导管反应期间,一些肝细胞,尤其是那些邻近异位导管的,显示导管转分化,但是大多数增加的小导管起源于经历广泛重塑的现有胆管系统。在慢性损伤中,肝细胞增殖较弱但持续,肝硬化中的大多数再生结节由无性系增殖的肝细胞组成,表明一小部分肝细胞在慢性损伤中保持其增殖能力。在小鼠肝癌模型中,肝细胞激活各种胎儿/新生儿基因的表达,表明这些细胞经历去分化。小鼠中各种癌基因的肝细胞特异性体细胞整合表明,肝细胞可能是通过转分化和去分化的广谱肝肿瘤的起源细胞。总之,成熟肝细胞的表型可塑性和异质性对理解慢性肝病和肝肿瘤的发病机制具有重要意义。
    Chronic liver injury induces liver cirrhosis and facilitates hepatocarcinogenesis. However, the effects of this condition on hepatocyte proliferation and differentiation are unclear. We showed that rodent hepatocytes display a ductular phenotype when they are cultured within a collagenous matrix. This process involves transdifferentiation without the emergence of hepatoblastic features and is at least partially reversible. During the ductular reaction in chronic liver diseases with progressive fibrosis, some hepatocytes, especially those adjacent to ectopic ductules, demonstrate ductular transdifferentiation, but the majority of increased ductules originate from the existing bile ductular system that undergoes extensive remodeling. In chronic injury, hepatocyte proliferation is weak but sustained, and most regenerative nodules in liver cirrhosis are composed of clonally proliferating hepatocytes, suggesting that a small fraction of hepatocytes maintain their proliferative capacity in chronic injury. In mouse hepatocarcinogenesis models, hepatocytes activate the expression of various fetal/neonatal genes, indicating that these cells undergo dedifferentiation. Hepatocyte-specific somatic integration of various oncogenes in mice demonstrated that hepatocytes may be the cells of origin for a broad spectrum of liver tumors through transdifferentiation and dedifferentiation. In conclusion, the phenotypic plasticity and heterogeneity of mature hepatocytes are important for understanding the pathogenesis of chronic liver diseases and liver tumors.
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  • 文章类型: Journal Article
    细胞衰老是细胞经历不可逆的细胞周期停滞并获得不同表型的状态。它与各种器官的慢性炎症和纤维化以及个体衰老有关。因此,消除衰老细胞已成为延长健康寿命的潜在目标。细胞衰老在许多生物过程中起着有益的作用,包括胚胎发育,伤口愈合,和组织再生,这是由干细胞的激活介导的。因此,全面了解细胞衰老,包括其有益和有害的影响,对于开发针对衰老细胞的安全有效的治疗策略至关重要。本文综述了细胞衰老的生物学和病理学作用。特别关注其各种角色中的有益或有害功能。
    Cellular senescence is the state in which cells undergo irreversible cell cycle arrest and acquire diverse phenotypes. It has been linked to chronic inflammation and fibrosis in various organs as well as to individual aging. Therefore, eliminating senescent cells has emerged as a potential target for extending healthy lifespans. Cellular senescence plays a beneficial role in many biological processes, including embryonic development, wound healing, and tissue regeneration, which is mediated by the activation of stem cells. Therefore, a comprehensive understanding of cellular senescence, including both its beneficial and detrimental effects, is critical for developing safe and effective treatment strategies to target senescent cells. This review provides an overview of the biological and pathological roles of cellular senescence, with a particular focus on its beneficial or detrimental functions among its various roles.
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  • 文章类型: Journal Article
    背景:银屑病关节炎(PsA)是与银屑病相关的炎性关节炎。PsA疾病涉及耀斑,与关节炎症和组织重塑增加有关。需要鉴定与PsA疾病活动性和耀斑相关的生物标志物以改善PsA患者的管理并减少耀斑。在耀斑期间炎症和纤维增殖过程中发生的组织周转失衡导致细胞外基质(ECM)的降解和/或重组增加,其中增加的蛋白水解起关键作用。因此,蛋白酶介导的炎症和组织重塑成分片段可用作反映PsA患者耀斑的标志物。
    方法:在从经历耀斑(关节急性肿胀[s],PsA-耀斑)。在血清中,在PsA-耀斑患者中评估的生物标志物水平与对照组和未经历耀斑的早期诊断的PsA患者(称为无耀斑的PsA)进行比较.此外,比较了PsA-flare患者SF中评估的生物标志物水平与骨关节炎(OA)患者SF中评估的生物标志物水平.
    结果:在血清中,PRO-C3和C3M的水平,反映间隙基质的形成和降解,与对照组和无耀斑的PsA相比,PsA耀斑显著升高。基底膜的重塑标记,与没有耀斑的PsA相比,PRO-C4在PsA耀斑中显著升高。炎症和免疫细胞活性相关标志物,CRPM,VICM,与对照组和无耀斑的PsA相比,PsA耀斑患者的CPa9-HNE显着升高。此外,VICM(AUC=0.71),CPa9-HNE(AUC=0.89),CRPM(AUC=0.76),和PRO-C3(AUC=0.86)显示出良好的辨别性能,可将PsA-flare与PsA分离而没有flare。在SF中,巨噬细胞活性标记,VICM,显著升高,而II型胶原形成标志物,与OA相比,PRO-C2在PsA-耀斑中显著降低。反映III型和IV型胶原蛋白降解的五种血清标志物(C3M和C4M,分别),III型和VI型胶原形成(分别为PRO-C3和PRO-C6),和中性粒细胞活性(CPa9-HNE)显示出优异的辨别性能(AUC=0.98),可将PsA-耀斑与PsA分离而没有耀斑。
    结论:C3M的血清生物标志物组,C4M,PRO-C3,PRO-C6和CPa9-HNE反射滑膜炎,附着性炎,和中性粒细胞活性可作为定量监测PsA患者耀斑的新工具。
    BACKGROUND: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. PsA disease involves flares, which are associated with increased joint inflammation and tissue remodeling. There is a need for identifying biomarkers related to PsA disease activity and flares to improve the management of PsA patients and decrease flares. The tissue turnover imbalance that occurs during the inflammatory and fibro-proliferative processes during flares leads to an increased degradation and/or reorganization of the extracellular matrix (ECM), where increased proteolysis plays a key role. Hence, protease-mediated fragments of inflammatory and tissue-remodeling components could be used as markers reflecting flares in PsA patients.
    METHODS: A broad panel of protease-mediated biomarkers reflecting inflammation and tissue remodeling was measured in serum and synovial fluid (SF) obtained from PsA patients experiencing flares (acutely swollen joint[s], PsA-flare). In serum, biomarker levels assessed in PsA-flare patients were compared to controls and in early-diagnosed PsA patients not experiencing flares (referred to as PsA without flare). Furthermore, the biomarker levels assessed in SF from PsA-flare patients were compared to the levels in SF of osteoarthritis (OA) patients.
    RESULTS: In serum, levels of the PRO-C3 and C3M, reflecting formation and degradation of the interstitial matrix, were found significantly elevated in PsA-flare compared to controls and PsA without flare. The remodeling marker of the basement membrane, PRO-C4, was significantly elevated in PsA-flare compared to PsA without flare. The inflammation and immune cell activity related markers, CRPM, VICM, and CPa9-HNE were significantly elevated in PsA-flare patients compared to controls and PsA without flare. In addition, VICM (AUC = 0.71), CPa9-HNE (AUC = 0.89), CRPM (AUC = 0.76), and PRO-C3 (AUC = 0.86) showed good discriminatory performance for separating PsA-flare from PsA without flare. In SF, the macrophage activity marker, VICM, was significantly elevated whereas the type II collagen formation marker, PRO-C2, was significantly reduced in the PsA-flare compared to OA. The combination of five serum markers reflecting type III and IV collagen degradation (C3M and C4M, respectively), type III and VI collagen formation (PRO-C3 and PRO-C6, respectively), and neutrophil activity (CPa9-HNE) showed an excellent discriminatory performance (AUC = 0.98) for separating PsA-flare from PsA without flares.
    CONCLUSIONS: The serum biomarker panel of C3M, C4M, PRO-C3, PRO-C6, and CPa9-HNE reflecting synovitis, enthesitis, and neutrophil activity may serve as novel tool for quantitatively monitoring flares in PsA patients.
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