The Relationship between IL-23/IL-17 Axis in Peripheral Blood and Disease Activity in Patients with Rheumatoid Arthritis and Its Predictive Value for Bone Destruction Progression
Objective:To investigate the relationship between the interleukin-23(IL-23)/interleukin-17(IL-17)axis in the peripheral blood of patients with rheumatoid arthritis(RA)and disease activity,and its predictive value for the progression of bone destruction.Methods:A total of 118 RA patients were enrolled between May 2022 and October 2023.They were divided into mild,moderate,and severe disease activity groups according to the Disease Activity Score 28(DAS28)and received symptomatic treatment based on their condition.Patients were followed up for 6 months,and were further divided into a progression group(27 ca-ses)and a non-progression group(91 cases)based on the presence of bone destruction progression.Fasting venous blood(3 mL)was collected from each patient on the morning after admission,and the levels of IL-23/IL-17 axis factors[IL-23,IL-17,interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necro-sis factor-α(TNF-α)]were measured using enzyme-linked immunosorbent assay(ELISA).The correlation between IL-23/IL-17 axis factors and disease activity was analyzed,and the predictive value of these factors for bone destruction progression was evaluated.Results:The disease course and disease activity in the progres-sion group were significantly higher than those in the non-progression group(P<0.05).The levels of IL-23,IL-17,IL-1β,IL-6,and TNF-α in the peripheral blood of the progression group[(192.38±48.72)pg/mL,(31.13±7.24)pg/mL,(88.71±29.10)pg/mL,(18.59±4.21)pg/mL,(180.31±41.57)ng/L]were higher than those in the non-progression group[(149.07±42.15)pg/mL,(25.04±5.39)pg/mL,(56.92±16.52)pg/mL,(15.16±3.44)pg/mL,(142.59±36.62)ng/L](P<0.05).The levels of IL-23,IL-17,IL-1β,IL-6,and TNF-α in the peripheral blood showed a progressive increase from patients with mild to moderate to severe disease activity(P<0.05).The levels of IL-23,IL-17,IL-1β,IL-6,and TNF-α were positively correlated with disease activity(P<0.05).Partial correlation analysis showed that af-ter excluding the influence of disease course and disease activity,IL-23,IL-17,IL-1β,IL-6,and TNF-α remained significantly correlated with the progression of bone destruction in RA patients(P<0.05).The area under the curve(AUC)values for IL-23,IL-17,IL-1β,IL-6,and TNF-α in predicting the progression of bone destruction in RA patients were 0.807,0.804,0.793,0.792,and 0.794,with sensitivities of 81.48%,74.07%,74.07%,85.19%,and 66.67%,and specificities of 70.33%,75.82%,73.63%,71.43%,and 80.22%,respectively.The combined prediction of bone destruction progression had an AUC of 0.931,with a sensitivity of 85.19%and specificity of 87.91%,which was significantly superior to the individu-al predictions(Z=2.715,2.803,3.026,3.114,2.984,all P<0.001).Conclusion:The IL-23/IL-17 axis in peripheral blood is significantly associated with disease activity in RA patients and has a reliable pre-dictive value for the progression of bone destruction.
Rheumatoid ArthritisIL-23/IL-17 AxisDsease activityCorrelationBone destruc-tion progressionPredictive value
万方数据
维普
