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류마티스 관절염 환자에서 혈청 TRAIL 농도의 임상적 의의
송정수 ( Jung Soo Song ),최종원 ( Jong Weon Choi ),박보형 ( Bo Hyoung Park ),이훈재 ( Hun Jae Lee ),박원 ( Won Park ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.2
Objective: TNF-α related apoptosis inducing ligand (TRAIL) is a member of TNF superfamily that promotes apoptosis by binding to the transmembrane receptors. The effects of TRAIL in patients with rhematoid arthritis (RA) are still debatable. This study was performed to evaluate the effects of TRAIL on RA by measuring serum concentration of TRAIL in patients with RA and assessing relationships between the TRAIL concentration and various clinical parameters of RA. Methods: A total of 105 patients with RA, 34 patients with osteoarthritis (OA), and 35 age- and gender-matched healthy controls were enrolled in this study. Data from the RA patients included subject`s age, duration of disease, daily steroid doses, ESR, CRP, rheumatoid factor, leukocyte count, lymphocyte count, tender joint count, swollen joint count, and serum TRAIL concentration. Serum TRAIL concentration was measured by enzyme immunoassay (EIA) method. The serum concentration of TRAIL in RA patients was compared to those of OA patients and healthy controls. Relationships of TRAIL concentration with various clinical parameters were evaluated. Results: Serum concentration of TRAIL in patients with RA was significantly decreased compared to that in healthy controls (RA: 42.60±26.39 pg/mL, control: 57.21±19.49 pg/mL, p=0.029). Serum concentration of TRAIL in patients with OA (50.79±15.92 pg/mL) was not different from that in normal controls (p=0.115). There were no significant differences in serum TRAIL concentration between patients with RA and those with OA (p=0.360). In patients with RA, serum TRAIL concentration showed no difference between high- and normal ESR subgroups, as well as high- and normal CRP subgroups. Serum TRAIL concentration correlated significantly with ESR (r=0.406, p<0.001). However, other clinical parameters, such as subject`s age, duration of disease, daily steroid doses, CRP, leukocyte count, lymphocyte count, tender joint count, swollen joint count revealed no significant correlation with serum TRAIL concentration. Conclusion: Serum concentrations of TRAIL in RA patients were significantly lower than those in healthy controls, suggesting that apoptotic ability is decreased in the patients with RA. Serum TRAIL concentration does not seem to reflect disease activity of RA.
류마티스 관절염에 동반된 빈혈에서 혈청 Transferrin 수용체 측정의 유용성: 골수 저장철과의 비교
김성수 ( Sung Soo Kim ),박원 ( Won Park ),배성권 ( Sung Kwon Bae ),이용환 ( Yong Hwan Lee ),송정수 ( Jung Soo Song ),최종원 ( Jong Weon Choi ),김순기 ( Sun Ki Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: This study was aimed at investigating the usefulness of serum transferrin receptor (sTfR) in anemic patients with rheumatoid arthritis (RA) compared with bone marrow storage iron and other tests for anemia. Methods: Fifty-five anemic RA patients were undergone anemia study including hematologic indices, iron panel, and sTfR. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. Eighteen patients performed marrow iron stain. The sTfR and serum ferritin levels were compared with bone marrow iron store, hematologic values, iron batteries, and markers of the disease activity. Results: 1) Mean sTfR concentration was 2.68±1.29mg/L in all patients. 2) sTfR correlated significantly with hemoglobin concentration (r=-0.491; p<0.001), hematocrit (r=-0.348; p=0.009), MCV (r=-0.597; p<0.001), RDW (r=0.696; p<0.001), serum iron (r=-0.389; p=0.003), and transferrin saturation (r=-0.451; p=0.001) 3) Ferritin did not correlated significantly with hemoglobin, hematocrit, serum iron/TIBC, MCV and RDW, except reticulocyte count (r=0.295; p=0.032) and total iron binding capacity (TIBC) (r=-0.503; p<0.001). 4) sTfR showed no significant correlation with ESR and CRP, whereas ferritin correlated with CRP (r=0.342; p=0.019). 5) Among the patients who performed iron staining from bone marrow, sTfR was higher in iron-depleted group compared with iron replete group (p=0.040). Conclusion: This study suggests that measurement of sTfR may be useful assay for anemia and the possible substitute for invasive bone marrow study in differentiating iron deficiency anemia from anemia of chronic diseases in patients with RA.