Objective To make an investigation for autoantibodies detection in China. Method Forty-eight hospitals were included by mail or Email. The items of QC include ANA, anti-ENA antibody, anti-dsDNA antibody, anti-mitochondria antibody and anti-smooth muscle antibody. The distribution of samples and analysis of the testing results was double-blinded. Result The correct rate of ANA, anti-ENA antibody, anti-dsDNA antibody, anti-mitochondria antibody and anti-smooth muscle antibody were 47%, 70%, 46%, 95%and 40% respectively. Conclusion The overall results are not optimistic. The quality of detecting kits is not all good, neither level of technicians. This condition should be changed by selecting better methods and improving understanding.

Tumor necrosis factor alpha(TNF-?) is one of the key proinflammatory factors in driving and attending chronic inflammatory process in rheumatoid arthritis(RA).TNF-? acts on different kinds of cell in synovial membrane,such as synoviocytes,macrophages,osteoclasts and chondrocytes,which can produce metalloproteinase,collagenase,stromelysin and so on,further induce pannus formation,joint inflammation,bone erosion and cartilage degradation. The TNF inhibitors have been proved by a lot of clinical trials to be an important new group of agents that significantly improve symptoms and signs,induce remission,reduce objectively measured damage in chronic inflammatory conditions,such as RA.There are three kinds of TNF inhibitors: Etanercept,Infliximab and Adalimumab.Etanercept is a fusion protein of human IgG and two p75 TNF receptors.Infliximab is an IgG1 monoclonal antibody(a chimera of human constant and mouse variable regions).Adalimumab is a humanized IgG1 monoclonal antibody with fully human constant and variable regions.The side effects include injection site infusion reactions,infection,lymphoproliferative disease,demyelinating disease,and SLE-like syndromes.

Objective:To construct retroveral vectors,containing the expression sequence of vIL-10 and to transfect rabbit synoviocyte in vitro with recombinant retrovirus and detect the expression of target genes.Methods:①The primers with restrictive enzyme were designed spot and/amplify target gene by PCR from plasmid including vIL-10 gene was amplified.②The retroviral vector pLXSN of target gene was cloned,and identify the aquired plasmid by sequencing.③Co-transfecting the packaging cell GP-293 with constructed retroviral vector and assistant plasmid pVSVG by calcium phosphate-DNA co-precipitation.The medium containing recombinant virus was collected and titer of virus was determined.④Rabbit synoviocytes was transfected with acquired virus in vitro.Detect the protein expression by cell immunohistochemistry.Results:①The recombinant retrovirus rRV-vIL-10 was successfully constructed.The viral titer reached 5?106 cfu/ml.②vIL-10 gene were transduced into rabbit synoviocytes by recombinant retrovirus in vitro.The protein expression of genes could be detected by cell immunohistochemistry.Conclusion:①The recombinant retrovirus rRV-vIL-10 was successfully constructed.②vIL-10 gene were transduced successfully into the rabbit synoviocytes by retroviral vector in vitro.The transduced synoviocytes can express vIL-10 protein.

Objective:To establish a local ex-vivo gene transfer method to treat RA through animal experiments in vivo and in vitro using retrovirus(rV) as a vector which carrying rRV-vIL-10 target gene.Methods:①The rabbit RA models were induced by the rabbit synovial fibroblast cell line which could continuously expreesed hIL-1?. ②In vivo, the rabbit synovial fibroblast cell line was transduced with rRV-vIL-10, then adding G418 to pick out the rRV-vIL-10 positive clon and infecting the rabbit synovium through intra-articular injection. ③RT-PCR, IHC methods were performed to prove the success of gene transfer to the rabbit synovium and expressed the target protein. ④The relative cytokins changes were detected by ELISA before and after gene therapy and evaluated treatment efficacy of rRV-vIL-10.Results:①rRV-vIL-10 was a effective vector which could transfect to the rabbit synovium in vivo through RT-PCR and IHC methods. ②Intra-articular local gene therapy could effectly reduce the synovium inflammation level of rabbit joints and expressed mRNA and vIL-10 protein. The level of cytokin such as IL-1? was decline.Conclusion:Retrovirus-mediated transgene of vIL-10 is successfully transfected to the rabbit synovium ex-vivo and can reduce arthritis inflammation levels of the IL-1? induced arthritis.

IL-17 is the cytokine secreted by the subgroup of CD4+T cells named Th17.The differentiation,proliferation and cytokine secretion of Th17 are regulated by TGF-?,IL-6,IL-15 and IL-23.IL-17 modulates the production and secretion of proinflammative factors,CXCs,affecting the transfer of neutrophil,the activation and the absorption of bone.It suggests that IL-17 also plays an important role in the pathogenesis of autoimmune diseases.

Objective To compare the T cell receptor recombination excision cycle (TREC) levels in peripheral blood mononuclear cells (PBMC) of systemic lupus erythematosus (SLE) patients with normal age- and gender- matched controls. To investigate the correlations between TREC levels of SLE patients and their clinical features. Methods We studied TREC levels in peripheral blood mononuclear cells (PBMC) of 21 SLE patients and 22 normal age- and sex- matched controls. TREC concentration was determined by real-time quantitative polymerase chain reaction (real-time qPCR) as the number of TREC copies/1000 PBMCs. The clinical features of the SLE patients such as systemic lupus erythematosus disease activity index (SLEDAI) , ESR, C reaction protein (CRP) , ANA, anti-dsDNA and complement levels and organ involvement were recorded and assessed. Results SLE patients had lower TREC levels [ (9.6 ± 7.5 )copies/1000 PBMC] than controls[ (16.1 ±11.1) copies/1000 PBMC,P = 0.033]. There was an inverse correlation between age and TREC levels in controls (r =- 0. 614, P = 0. 002) but not in SLE patients.There was an inverse correlation between SLEDAI and TREC levels in SLE patients(r =-0. 656, P =0. 001) and TREC levels seemed to have relations to skin lesions ( r = - 0. 620, P = 0. 003 ). No other clinical association was observed between TREC levels and clinical and laboratory SLE manifestations.Conclusion SLE patients had lower TREC levels than normal controls and there is a tendency that TREC level is reversely correlated with disease activity. The decrease PBMC TREC level is indicative of a low proportion of recent thymic emigrant (RTE) in SLE and could be caused by decreased RTE output and/or by increased peripheral T cell proliferation in this disease. The under-representation of RTE in the peripheral T cell pool may play a role in the immune tolerance abnormalities observed in SLE.

BACKGROUND: Rheumatoid arthritis(RA) is a systemic disease mainly characterized by chronic and symmetric polyarthritis. Peripheral neuropathy due to RA, however, is uncommon.OBJECTIVE: To analyze the clinical manifestations and laboratory findings of RA complicated by peripheral neuropathy in 5 cases.DESIGN: A retrospective case analysis based on patients as subjects.SETTING: Department of Rheumatism and Immunity, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.PARTICIPANTS: Totally 567 RA patients were admitted to Peking Union Medical College Hospital from January 1983 to December 2002, including 5 cases of peripheral neuropathy. All the cases met the criteria for RA formulated by American Rheumatism Association(ARA), according to which 5 cases of peripheral neuropathy in the active phase were confirmed due to RA. The laboratory indexes in 5 cases accorded with the active core indexes of RA.METHODS: Clinical data of 5 cases of RA were analyzed, and symptoms of peripheral neuropathy, as well as the indexes recorded electrophysiologically and in laboratory were recorded and assessed MAIN OUTCOME MEASURES: Sex, age, course of disease, severity of muscle strength disorder and sensory disorder, electromyography(EMG),biopsy of muscle and nerve, and related laboratory indexes.RESULTS: Five cases were enrolled, including 2 males and 3 females, 42 to 60 years of age(meanly 52 years old), and the course of disease ranged 1 to 14 years, and 5.4 years on the average. Four cases were hospitalized for neurological manifestations, accounting for 80% (4/5), and the other one appeared to have decreased muscle strength and hypoalgesia. Asthenia and numbness of limbs and hypoalgesia of the distal of limbs occurred in 4 cases,paraesthesia in 3 cases, foot drop in 2 cases, carpoptosis in 1 case, myatrophy in 3 cases, decreased muscle strength in 5 cases, and tendon areflexia in 3 cases; joint swelling or pain during the appearance and aggravation of peripheral neuropathy in 4 cases, increased erythrocyte sedimentation, increased level of C-reactive protein, high-titer rheumatoid factor and X-ray changes of joints( i. e., narrowed joint space or erosion and destruction on surface of joint) in 5 cases There were 3 cases complicated by vasculitis, and 2 cases by rheumatoid nodules. EMG showed damages of peripheral nerves in 4 cases. Muscle biopsy and nerve biopsy exhibited neurogenic lesion and chronic moderate axonal neuropathy respectively in 1 case.CONCLUSION: In the present study, the incidence of peripheral polyneuropathy was 1% (5/569), which mainly occurred or was aggravated in the active phase of RA. Among the 5 cases of peripheral neuropathy, 100% (5/5 )developed decreased muscle strength, 60% (3/5) developed myatrophy and 80% (4/5) had symptoms of peripheral neuropathy. The findings are helpful in the early diagnosis of RA.

OBJECTIVE: One possible autoantigen-human cartilage glycoprotein 39(HC gp-39) becomes a hotspot in the researches on the morbidity and the therapy of rheumatoid arthritis(RA) by international rheumatologists in recent years. This exploration would investigate the source, structure, and biochemical significance of HC gp-39 and its effects in RA morbidity.DATA SOURCES: HC gp-39 related articles between January 1990 and January 2004 were searched by the computer on Medline with the searching word of "HC gp-39" and the language of the article was limited in English.STUDY SELECTION: Totally 100 English literatures related with HCgp-39 were selected.DATA EXTRACTION: Related literatures were extracted according to the latest progress of HC gp-39.DATA SYNTHESIS: Summery was summed up according to the source,structure and function of HC gp-39,and the relationship between HC gp-39and disease,especially the relationship between HC gp-39 and RA.CONCLUSION: HC gp-39 can be used as another measurable indicator except the traditional indicators for RA activity. The establishment of serological detection method has certain significance for RA early diagnosis,the judgment of the situation of RA,the improvement of prognosis and transformation. Antigen-specific immunotherapy can be considered.

Objective To detect the expression and activation level of nuclear factor ?B (NF-?B) in synovium of rheumatoid arthritis (RA).Method Forty-six specimens including 17 RA, 24 osteoarthritis (OA) and 5 normal synovial tissues were subjected to RT-PCR to determine the mRNA level of NF-?B p65,p50,inhibitor of NF-?B (I?B),interleukin-1? (IL-1?) and matrix metalloproteinase 9 (MMP-9).Thirty-nine sections including 14 RA,21 OA and 4 normal synovium were subjected to immunohistochemistry to determine the expression level of NF-?B p65.Synoviocytes from 14 synovial specimens including 8 RA and 6 OA were cultured and the nuclear protein was extracted and reserved for western blot.Results The mRNA level of p65,IL-1(,MMP-9 were higher in RA group than that of control (P

Objective To further understand the etiology,definition,clinical manifestation,prognosis and treatment of cutaneous leukocytoclastic vasculitis.Method Retrospective study of23patients with leuko-cytoclastic vasculitis followed up at Peking Union Medical College Hospital from1990to2001.Results Twenty patients were classified as hypersensitive vasculitis,one of whom was diagnosed as Wegeners granulo-matosis2.5years later,two were diagnosed as urticarial vasculitis,and one was systemic lupus erythematosus.Conclusion Cutaneous leukocytoclastic vasculitis,which is usually a benign syndrome,may be caused by in-fection or drugs.Its main clinical manifestaions are skin symptoms.