A study on the relationship between serum CX3CL1,CCL17 and lung function and prognosis in patients with rheu-matoid arthritis associated interstitial lung disease
Objective To analyze the relationship between serum C-X3-C motif chemokine ligand 1(CX3CL1)and C-C motif chemokine ligand 17(CCL17)with lung function and prognosis in patients with rheumatoid arthritis associated in-terstitial lung disease(RA-ILD).Methods 295 RA patients admitted to the Rheumatology Department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2017 to January 2018 were selected.They were divided into ILD group(115 cases)and non ILD group(180 cases)based on the presence of ILD.RA-ILD patients were divided into poor prognosis subgroup and good prognosis subgroup based on their prognosis.Detect serum levels of CX3CL1 and CCL17,as well as lung function indicators[forced expiratory volume at 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,and lung carbon monoxide diffusion(DLCO)].Pearson correlation analysis was used to examine the corre-lation between serum CX3CL1 and CCL17 levels and lung function indicators in RA-ILD patients.Multivariate logistic re-gression analysis was used to identify the factors influencing poor prognosis in RA-ILD patients.Receiver Operating Char-acteristic(ROC)curve analysis was used to assess the value of serum CX3CL1 and CCL17 levels in predicting poor progno-sis in RA-ILD patients.Results Compared with the non ILD group,the serum levels of CX3CL1 and CCL17 in the ILD group increased,while FEV1,FVC,FEV1/FVC,and DLCO decreased(t/P=14.359/<0.001,13.855/<0.001,12.015/<0.001,2.732/0.007,14.749/<0.001,14.010/<0.001).Pearson correlation analysis showed that serum CX3CL1 and CCL17 levels in RA-ILD patients were negatively correlated with FEV1,FVC,FEV1/FVC,and DLCO(r=-0.762,-0.711,-0.577,-0.534,-0.707,-0.692,-0.735,-0.672,all P<0.001).During a 5-year follow-up,the incidence of poor prognosis in 115 RA-ILD patients was 46.96%.Multivariate logistic regression analysis showed that common type interstitial pneumonia,high-resolu-tion computed tomography(HRCT)score,CX3CL1,and elevated CCL17 were independent risk factors for poor prognosis in RA-ILD patients[OR(95%CI)=3.745(1.245-11.264),1.051(1.008-1.095),1.008(1.003-1.012),1.037(1.012-1.062)],FEV1,FEV1/FVC Elevated DLCO is an independent protective factor[OR(95%CI)=0.952(0.896-0.988),0.892(0.867-0.981),0.857(0.789-0.949)].ROC curve analysis showed that the area under the curve for predicting poor prognosis in RA-ILD patients with serum CX3CL1 and CCL17 levels combined was 0.875,which was greater than the 0.783 and 0.788 predicted by CX3CL1 and CCL17 alone(Z=2.807,2.698,P=0.005,0.007).Conclusion Elevated serum levels of CX3CL1 and CCL17 in RA-ILD patients are associated with decreased lung function and poor prognosis.The combined detection of serum levels of CX3CL1 and CCL17 has high predictive value for the prognosis of RA-ILD patients.
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