[Expression of osteopontin in labial glands of patients with primary Sjögren's syndrome].

OBJECTIVE: To investigate the mRNA transcription and protein expression of osteopontin (OPN) and to analyze the possible role of OPN in primary Sjögren's syndrome (pSS). METHODS: In this study, 24 patients with pSS were selected and diagnosed according to the American-European Consensus Group criteria. The control group was composed of 14 subjects. Total RNA from labial glands was extracted. The target gene and ß-actin acted as templates to perform reverse transcript polymerase chain reaction (RT-PCR). Then mRNA expression of the target gene were semi-quantitated by the OD ratio of the target gene to ß-actin bands on gel under densitometry. Immunohistocheical analysis was used to determine the expression of proteins of the target genes in labial glands from patients and healthy control. RESULTS: In contrast to the control group, the mRNA transcription and protein level of the target genes in labial glands in pSS patients were significantly increased statistically (P<0.05). Spearman and Pearson rank correlation coefficients were used for analyzing the correlation of lymphocytes foci-score (LFS) with OPN expressions, the level of the mRNA transcription (0.407, P=0.049) and protein expression of OPN (0.476, P=0.039) was positively correlated with the LFS. Immunohistochemistry detected that OPN protein was not only mainly expressed in intracytoplasm of the gland duct, but also in infiltrated lymphocytes. CONCLUSION: OPN is higher expressed in the basal and surface of labial glands of pSS patients, which may contribute to the destruction of labial glands.

[Characteristics of vascular morphology and vascular endothelial growth factor in patients with osteoarthritis and rheumatoid arthritis].

OBJECTIVE: To study the differences in vascular morphology and vascular endothelial growth factor (VEGF) of early knee osteoarthritis and rheumatoid arthritis and to evaluate whether VEGF mRNA and VEGF protein expression correlate with disease activity and vascular morphology. METHODS: VEGF mRNA and VEGF protein in OA and RA synovium were detected by means of in situ hybridization and immunohistochemistry. Vascular morphology was assessed by arthroscopy. The level of VEGF protein expression of synovium was evaluated to make sure whether it was correlated with disease activity and macroscopic observation by arthroscopy. RESULTS: Significant differences of VEGF mRNA and protein expression were found in synovium lining layer region, perivascular region and sub-lining region between OA and RA. The correlations were found between VEGF expression in sub-lining region and erythrocyte sedimentation rate (ESR) in OA, in synovium lining layer and the counts of platelet in RA, in sub-lining region and C-reaction protein (CRP) in RA. The correlation was found between VEGF expression and synovium lining layer, between VEGF expression and synovial hypertrophy in sub-lining region in OA; The expression of VEGF in synovium lining layer in RA demonstrated its correlation with vascular morphology, tortuous vessels, and vascular density. CONCLUSION: There is differential VEGF mRNA/VEGF protein expression between OA and RA in each layer of synovial membrane. This phenomenon may be responsible for the pathogenic mechanisms of osteoarthritis and rheumatoid arthritis.

[Relationship between oxidative stress and depression in patients with rheumatoid arthritis].

OBJECTIVE: To investigate the relationship between oxidative stress and depression in patients with rheumatoid arthritis (RA). METHODS: In the study, 129 patients with RA were assessed using the Hamilton depression rating scale (HAMD), Zung self-rating depression scale (SDS), Zung self-rating anxiety scale (SAS), symptom checklist 90 (SCL-90), and other multiple item questionnaires. Oxidative-stress-related parameters in sera and indexes of oxidative damage were monitored during a pretreatment period. The patients were divided into depression (group A, HAMD≥20) and nondepression groups (group B,HAMD<20) based on an HAMD score cutoff of 20. In addition, 20 healthy donors were classified as group C. RESULTS: A statistically significant increase in SDS score was observed in group A (59.12±10.18) when compared with group B (39.24±5.02) (t=0.42,P < 0.01). A statistically significant increase was observed in SAS score in group A (59.12±10.18) in comparison with group B (39.24±5.02) (t=1.48,P<0.01). Antisuperoxide anion capacity was significantly decreased in group A (393.76±43.35) in comparison with group B (456.98±93.86) and group C (483.51±30.64) (F=3.95, P=0.03), whereas serum malondialdehyde (MDA) levels of group A (13.84±3.35) were higher than those of group B (9.42±3.52) and group C (7.86±3.21)(F=12.01, P=0.01). Pearson correlation analysis revealed that depression was positively correlated with MDA (r=0.58,P<0.05), but negatively with A-ASC (r =-0.30, P<0.05). CONCLUSION: The oxidative damage occurs in patients with rheumatoid arthritis, and lower antioxidant defences exist in depressive patients. The oxidative stress may promote the development of depression.

Clinical Efficacy of Cortex Daphnes (Zushima) Patch in Patients With Symptomatic Knee Osteoarthritis: A Multicenter Non-Inferiority Randomized Controlled Clinical Trial.

Background: Osteoarthritis (OA) is imposing substantial burdens on individuals and society with the aging population. Cortex Daphnes patch is widely used for symptomatic knee OA in China with a satisfying clinical efficacy; however, there is scant clinical evidence supporting its use. To evaluate its efficacy, we conducted a multicenter, non-inferiority, randomized, parallel-group study comparing Cortex Daphnes patch with topical nonsteroidal anti-inflammatory drugs in patients with knee OA (NCT02770950). Methods: A total of 264 symptomatic knee OA patients were treated with Cortex Daphnes or indomethacin cataplasms applied to affected sites once daily for 2 weeks. The primary outcome was improvement in knee pain on walking as assessed using a visual analog scale (VAS). The non-inferiority margin based on the full analysis population was set as -5 mm on the pain VAS. The secondary outcomes were changes of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, WOMAC scores for pain, function and stiffness, the 36-item Short Form Health Survey (SF-36), and global assessment of knees by the patients. Responder rates for pain VAS, WOMAC total score, and WOMAC pain were also included in the secondary outcomes. Results: The Cortex Daphnes patch was non-inferior to indomethacin cataplasms for the primary outcome with a group difference (Cortex Daphnes patch-indomethacin cataplasm) of 2.1 mm (95% confidence interval: 2.1-6.4); similar results were found in the per-protocol population. For all other outcomes, no significant differences were found in the full analysis set or in the per-protocol analysis set, except the responder rates for WOMAC pain was higher in the Cortex Daphnes patch group than in the indomethacin cataplasm group (78.4 vs. 64.7%, p = 0.022) in the per-protocol analysis set. Overall, 28.8% patients in the Cortex Daphnes patch group and 9.8% in the indomethacin cataplasm group reported treatment-related adverse events, the vast majority of which were mild-to-moderate skin irritation, resulting in only 3.8 and 0.8% of patients dropping out, respectively. Conclusion: The Cortex Daphnes patch, which provides satisfactory analgesic efficacy and enhances the physical function of the knee, as well as improving quality of life, may be a promising alternative to knee OA.

[The role of mannose binding lectin in the pathogenesis of systemic lupus erythematosus].

OBJECTIVE: To detect the serum level of mannose binding lectin (MBL) and its genovariation in systemic lupus erythematosus (SLE) patients and to investigate the role of MBL in the pathogenesis of SLE. METHODS: ELISA was used to measure the serum MBL level of 40 SLE patients and 30 healthy blood donors. Tm genotyping method was used for the first timer in China. Primers and specific fluorophore-labelled hybridization probes for the exon 1 and promoter regions of MBL gene were designed based on the haplotype MBL2(*) LXPA (GenBank X15422). The genotyping of MBL in these two groups were performed using real-time PCR through Light Cycler Instrument. RESULTS: (1) The serum MBL of the SLE patients was 107.2 microg/L, significantly lower than that of the healthy blood donors (290.2 microg/L, P = 0.0002). (2) MBL mutation in exon 1 region was mainly at codon 54, with a mutation rate of 37.1% in the SLE group, significantly higher than that of the control group (13.3%, p = 0.049). (3) Polymorphisms of H/L in MBL gene were present in both SLE patients and controls, and there was no difference in the L allele frequency between the two groups. (4) The serum MBL level of the SLE patients with MBL mutation in codon 54 was 49.8 microg/L, significantly lower than that of the SLE patients without MBL mutation in codon 54 (141.7 microg/L, P = 0.000 27). The SLE disease activity index (SLEDAI) of the SLE patients with MBL mutation in codon 54 was 7.44, significantly lower than that of the SLE patients without MBL mutation in codon 54 (12.87, P = 0.0029). A negative correlation was observed between SLEDAI score and serum MBL (r = -0.48). CONCLUSION: Mutation occurring in MBL exon 1 region at codon 54 may be a predisposing factor of the pathogenesis of SLE. Serum MBL may be a potential biomarker of disease activity in SLE patients.