摘要
目的探讨miR-192-5p在非布司他联合依托考昔治疗痛风性关节炎(GA)参与调节炎症和免疫反应机制。方法选取2022年1月至2023年9月南京市江宁医院就诊的144例GA患者,随机数字表法将患者分为单药组和联合组,各72例,单药组采用依托考昔治疗,联合组采用非布司他联合依托考昔治疗,通过实时定量PCR检测治疗前后外周血单个核细胞的miR-192-5p、NLRP3炎症小体和表皮调节蛋白(EREG)表达水平。监测治疗前、7d后血清中的白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)及免疫球蛋白A(IgA)的变化。结构方程模型确定各因子间的依赖关系。结果治疗后,联合组IL-1β、TNF-α、CRP水平均低于单药组(P<0.05);联合组IgA水平在较单药组升高(P<0.05);联合组miR-192-5p、NLRP3 mRNA、EREG mRNA水平低于单药组(P<0.05)。miR-192-5p通过NLRP3和EREG对炎症及免疫因子产生调节,模型具有较高的收敛度(χ2=19.264,P<0.001)和拟合度(NFI=0.996)。结论miR-192-5p通过NLRP3炎症小体、EREG靶向调控炎症和免疫反应,参与非布司他联合依托考昔治疗GA过程,且联合治疗的疗效优于单纯非布司他治疗。
Objective To explore the role of miR-192-5p in regulating gouty arthritis(GA).Methods A total of 144 GA patients admitted to Nanjing Jiangning Hospital from January 2022 to September 2023,and the patients were divided into 72 patients in single agent group and combination group,single agent group was treated with etocoxxi,the combination group was treated with febuxostat combined with etocoxxi.The expression levels of miR-192-5p,NLRP 3 inflammasome,and epidermal regulatory protein(EREG)in peripheral blood mononuclear cells were measured by real-time quantitative PCR before and after treatment.Changes in interleukin 1β(IL-1β),tumor necrosis factorα(TNF-α),C reactive protein(CRP),and immunoglobulin A(IgA)were monitored in serum before treatment and 7 d after treatment.Structural equation model determines the dependence among the factors.Results After treatment,the levels of IL-1β,TNF-α,and CRP in the combination group were lower than those in the monotherapy group(P<0.05).After treatment,the level of IgA in the combination group was higher than that in the monotherapy group(P<0.05).After treatment,the levels of miR-192-5p,NLRP3 mRNA,and EREG mRNA in the combination group were lower than those in the monotherapy group(P<0.05).miR-192-5p regulates inflammatory and immune factors through NLRP3 and EREG,and the model has a high degree of convergence(χ2=19.264,P<0.001)and goodness of fit(NFI=0.996).Conclusions The miR-192-5p regulated inflammatory and immune responses through NLRP 3 inflammasome and EREG,participated in febuxostat combined with etocoxam for GA treatment,and the combination therapy was better than febuxostat alone.
作者
张俊俊
陈堃
陶梦琪
ZHANG Junjun;CHEN Kun;TAO Mengqi(Department of Pharmaceutical,Jiangning Hospital of Nanjing,Nanjing,Jiangsu 211100,China)
出处
《中国医药指南》
2025年第2期49-51,共3页
Guide of China Medicine
