中文摘要：

目的研究类风湿关节炎（RA）患者外周血单核细胞（PBMC）中白介素17（IL-17）、干扰素调节因子4（IRF4）的表达并探讨其临床意义。方法收集四川大学华西医院门诊及住院RA患者30例（RA组），根据疾病活动性评分（DAS28）分为病情活动组16例，病情稳定组14例，另选取健康自愿者20例（健康对照组）。分离外周血得到单核细胞，采用流式细胞术检测IL-17水平，荧光定量PCR（RT—PCR）检测IL-17mRNA、IRF4mRNA表达水平。同时将健康对照组PBMC给予Th17细胞极化条件（CD3／CD28联合IL-6、IL-23、TGF-β，Th17细胞特异刺激组））及对照处理（CD3／CD28，对照组）培养72h后用RT—PCR检测IL-17mRNA、IRF4mRNA表达水平。结果RA病情活动组IL-17水平及IL-17mRNA和IRF4mRNA水平高于病情稳定组（P〈0．01）。病情稳定组IL～17水平及IL-17mRNA和IRF4mRNA表达水平也高于健康对照组（P〈0．05）。健康对照组PBMC在Th17细胞极化条件处理培养72h后Th17细胞特异刺激组组IL-17mRNA、IRF4mRNA水平显著高于对照组（P〈0．05）。结论RA患者中IL-17mRNA与IRF4mRNA表达水平升高，IRF4可能参与Th17细胞增加通过上调IL-17水平参与疾病发生，这可能成为RA治疗的新靶点。

英文摘要：

Objective To investigate the expression and clinical significance of IL-17 and IRF4 in patients with rheumatoid arthritis （RA）. Methods 30 RA patients were divided into active RA patients （16 cases） and stable RA patients （14 cases）. 20 healthy people were taken as the healthy controls （HC）. The peripheral blood monocyte cells （PBMC） from HC and RA patients were collected. The levels of IL- 17 were measured by flow cytometry. The expression levels of IL- 17mRNA and IRF4 mRNA in HC and RA patients were measured by real-time PCR （RT- PCR）. The PBMC from HC were stimulated with anti-CD3/anti-CD28 monoelonal antibodies in the absence or presence of IL-6 ,IL-23 and TGF-IK After co-culture, the levels of IL-17mRNA and IRF4mRNA were analyzed by RT- PCR. Results The levels of IL-17, IL-17mRNA and IRF4 mRNA of RA stable patients were significantly higher than that of active RA patients （P〈0.01）. The levels of IL-17, IL-17mRNA and IRF4 mRNA in RA stable patients were higher than that of HC （P〈 0.05）. Under A-CDa/A-CD28-l-IL-6＋ IL-23 ＋TGF β stimulated PBMC the expression of IL- 17mRNA, IRF4 mRNA were all higher than that of controls （A-CD3/ A-CD28） （P〈0.05）. Conclusion IL- 17mRNA and IRF4 mRNA in RA patients are highly expressed. IRF4 may play an important role in the development of RA. IRF4 may regulate the differ- entiation of Th17 cells, which makes IRF4 to be potential target for RA therapy.