[1]常军英,王 勇,高 伟,等.类风湿关节炎活动期患者血清miR-197、miR-183水平表达与病情及预后的关系研究[J].现代检验医学杂志,2026,41(02):122-127.[doi:10.3969/j.issn.1671-7414.2026.02.021]
　CHANG Junying,WANG Yong,GAO Wei,et al.Study on the Relationship between Serum miR-197 and miR-183 Expression Levels and Disease Severity and Prognosis in Patients with Active Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2026,41(02):122-127.[doi:10.3969/j.issn.1671-7414.2026.02.021]
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类风湿关节炎活动期患者血清miR-197、miR-183水平表达与病情及预后的关系研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年02期
页码:
122-127
栏目:
论著
出版日期:
2026-03-15

文章信息/Info

Title:
Study on the Relationship between Serum miR-197 and miR-183 Expression Levels and Disease Severity and Prognosis in Patients with Active Rheumatoid Arthritis
文章编号:
1671-7414（2026）02-122-06
作者:
常军英，王 勇，高 伟，康 华
邯郸市中医院风湿科，河北邯郸 056002
Author(s):
CHANG Junying，WANG Yong，GAO Wei，KANG Hua
Department of Rheumatology, Handan Traditional Chinese Medicine Hospital, Hebei Handan 056002, China
关键词:
类风湿关节炎; 微小RNA-197; 微小RNA-183; 病情程度; 预后
分类号:
R593.22；R392.11
DOI:
10.3969/j.issn.1671-7414.2026.02.021
文献标志码:
A
摘要:
目的?探究类风湿关节炎(RA)活动期患者血清微小RNA(miR)-197、miR-183水平与病情程度及预后的关系。方法选取2022年2月~2024年3月在邯郸市中医院接受诊治的RA活动期患者为RA组(n=159),体检健康者为对照组(n=159)。RA活动期患者根据入院时28个关节疾病活动度评分(DAS28)分为RA轻度组(n=62)、RA中度组(n=51)和RA重度组(n=46)。收集RA活动期患者入院时临床资料,酶联免疫吸附法(ELISA)测定RA活动期患者血清实验室指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体]水平;实时荧光定量PCR法(RT-qPCR)测定所有受试者血清miR-197、miR-183水平;根据治疗3个月后DAS28评分,将患者分为RA预后良好组(n=107)和RA预后不良组(n=52)。比较对照组和RA组血清miR-197、miR-183水平,不同病情程度RA活动期患者血清miR-197、miR-183水平及入院时DAS28评分,RA预后良好组和RA预后不良组临床资料、实验室指标及血清miR-197、miR-183水平。Pearson法分析RA活动期患者血清miR-197、miR-183及入院时DAS28评分、实验室指标的相关性;Logistic回归分析影响RA活动期患者预后不良的因素;受试者工作特征(ROC)曲线评价血清miR-197、miR-183对RA活动期患者预后不良的预测价值。结果RA组血清miR-197(0.69±0.13)、miR-183(0.54±0.11)水平显著低于对照组(1.00±0.08、1.00±0.05),差异具有统计学意义(t=25.608、48.004,均P<0.05)。与RA轻度组比较,RA中度组和RA重度组血清miR-197、miR-183水平显著降低,入院时DAS28评分显著升高,差异具有统计学意义(t=6.720~26.911,均P<0.05);与RA中度组比较,RA重度组血清miR-197、miR-183水平显著降低,入院时DAS28评分显著升高,差异具有统计学意义(t=6.904、15.812、14.944,均P<0.05)。与RA预后良好组比较,RA预后不良组入院时DAS28评分、血清TNF-α、IL-6、CRP、RF、抗CCP抗体水平显著升高,miR-197、miR-183水平显著降低,差异具有统计学意义(t=14.325~25.639,均P<0.05)。RA活动期患者血清miR-197与miR-183呈正相关(r=0.591,P<0.05),血清miR-197、miR-183与入院时DAS28评分、血清TNF-α、IL-6、CRP、RF、抗CCP抗体呈负相关(r=-0.671~-0.487,均P<0.05)。入院时DAS28评分高、血清高水平TNF-α、IL-6、CRP、RF、抗CCP抗体和低水平miR-197、miR-183是影响RA活动期患者预后不良的独立危险因素(Waldχ2=6.574~12.237,均P<0.05)。血清miR-197、miR-183二者联合预测RA活动期患者预后不良的曲线下面积(AUC)优于miR-197、miR-183各自单独预测,差异具有统计学意义(Z=2.538,2.534,均P<0.05)。结论RA活动期患者血清miR-197、miR-183呈现低水平,且病情越重二者水平越低,miR-197、miR-183联合预测RA活动期患者预后不良有较好的效果。
Abstract:
Objective To investigate the relationship between serum microRNA-197 (miR-197) and microRNA-183 (miR-183) levels and disease severity and prognosis in patients with active rheumatoid arthritis (RA). Methods Patients with active RA diagnosed and treated at Handan Traditional Chinese Medicine Hospital from February 2022 to March 2024 were enrolled in RA group (n=159). Healthy individuals underwent physical examinations served as the control group (n=159). Patients in the RA group were further categorized into mild (n=62), moderate (n=51), and severe (n=46) RA groups according to their disease activi-ty score in 28 joints (DAS28) at admission. Clinical data of active RA patients were collected at admission. Serum levels of labo-ratory indicators [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody] were determined by enzyme-linked immunosorbent assay (ELISA). Realtime fluorescence quantitative PCR (RT-qPCR) was used to measure serum miR-197 and miR-183 levels in all subjects. According to DAS28 score after 3 months of treatment, the patients were divided into the RA favorable prognosis group (107 cases) and the RA unfavorable prognosis group (52 cases). Serum miR-197 miR-183 levels were compared between the control group and the RA group, among RA patients with different disease severity during the active phase, and in relation to the DAS28 score at ad-mission. Clinical data, laboratory indicators, and serum miR-197, miR-183 levels were also compared between the RA group with favorable prognosis and the RA group with poor prognosis. Pearson correlation analysis was performed to assess the rela-tionship between serum miR-197 and miR-183 levels, DAS28 scores at admission, and laboratory indicators in patients with ac-tive RA. Logistic regression analysis was performed to identify factors associated with poor prognosis in patients with active RA. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of serum miR-197 and miR-183 levels for poor prognosis in patients with active RA. Results Serum miR-197 and miR-183 levels in the RA group were significantly lower than those in the control group (0.69 ± 0.13 vs 1.00 ± 0.08, 0.54 ± 0.11 vs 1.00 ± 0.05), and the differences were statis-tically significnat (t=25.608, 48.004, all P<0.05). Compared with the mild RA group, serum miR-197 and miR-183 levels were significantly decreased in the moderate and severe RA groups, while DAS28 scores at admission were significantly increased, and the differences were statistically significant (t=6.720~26.911, all P<0.05). Compared with the moderate RA group, serum miR-197 and miR-183 levels in the severe RA group were significantly decreased, while DAS28 scores at admission were significantly increased (t=6.904, 15.812, 14.944, all P<0.05). Compared with the RA group with favorable prognosis, the DAS28 scores at ad-mission, serum levels of TNF-α, IL-6, CRP, RF and anti-CCP antibody were significantly increased, while the levels of miR-197 and miR-183 were significantly decreased in the RA group with poor prognosis, and the differences were statistically significant (t=14.325~25.639, all P<0.05). Serum miR-197 and miR-183 levels were positively correlated in patients with active RA (r=0.591, P<0.05). Serum miR-197 and miR-183 levels were negatively correlated with DAS28 scores at admission, serum TNF-α, IL-6, CRP, RF and anti-CCP antibody levels (r=-0.671~-0.487, all P<0.05). High DAS28 scores at admission, elevated serum TNF-α, IL-6, CRP, RF, anti-CCP antibody levels, and low miR-197 and miR-183 levels were independent risk factors for poor prognosis in patients with active RA (Wald χ?= 6.574~12.237, all P<0.05). The combined prediction of serum miR-197 and miR-183 for poor prognosis in RA patients during the active phase demonstrated superior area under the curve (AUC) compared to the separate predictions of miR-197 or miR-183 alone, with statistically significant differences (Z=2.538, 2.534, both P<0.05). Conclusions The serum levels of miR-197 and miR-183 are low in patients with active RA, and both levels decrease with dis-ease severity. The combined use of miR-197 and miR-183 demonstrates good efficacy in predicting poor prognosis in patients with active RA.

参考文献/References:

[1] KONZETT V, ALETAHA D. Management strategies in rheumatoid arthritis[J]. Nature Reviews Rheumatology, 2024, 20(12): 760-769.
[2] KATZ J, BARTELS C M. Multimorbidity in rheuma-toid arthritis: literature review and future directions[J]. Current Rheumatology Reports, 2024, 26(1): 24-35.
[3] 陆健,冯萍,吴静,等.类风湿关节炎活动期患者血浆外泌体miRNAs差异表达筛选与生物信息学分析及验证[J].现代检验医学杂志,2024,39(2):62-67. LU J, FENG P, WU J, et al. Bioinformatics analysis and validation of differential expression of miRNAs in plasma exosomes from patients with active rheumatoid arthritis[J]. Journal of Modern Laboratory Medicine, 2024, 39(2): 62-67.
[4] AHMED S F, JASIM S A, PALLATHADKA H, et al. New therapeutic strategies for the inflammatory rheuma-toid arthritis disease: emphasizing mesenchymal stem cells and associated exo-miRNA or exo-lncRNA[J]. Cell Biochemistry and Biophysics, 2024, 82(3): 1599-1611.
[5] PASCUAL-GARC?A S, MART?NEZ-PEINADO P, PUJALTE-SATORRE C, et al. Exosomal osteo-clast-derived miRNA in rheumatoid arthritis: from their pathogenesis in bone erosion to new therapeutic approaches[J]. International Journal of Molecular Sci-ences, 2024, 25(3): 1506.
[6] GAO S J, LIU L, ZHU S B, et al. MicroRNA-197 reg-ulates chondrocyte proliferation, migration, and inflam-mation in pathogenesis of osteoarthritis by targeting EIF-4G2[J]. Bioscience Reports, 2020, 40(9): BSR20192095.
[7] GUPTA N, SOMAYAJULU M, GURDZIEL K, et al. The miR-183/96/182 cluster regulates sensory innerva-tion, resident myeloid cells and functions of the cornea through cell type-specific target genes[J]. Scientific Re-ports, 2024, 14(1): 7676.
[8] 陈光权,王燕涛,李婷,等.血清miR-145、miR-183表达联合预测狼疮性肾炎并发急性肾损伤的价值探讨[J].国际检验医学杂志,2023,44(8):992-997. CHEN G Q, WANG Y T, LI T , et al. Value of combination of serum miR-145 and miR-183 expression in predicting lupus nephritis complicated with acute kidney injury[J]. International Journal of Laboratory Medicine, 2023, 44(8): 992-997.
[9] MIN H K, KIM H R, LEE S H, et al. Time-averaged DAS28 and HAQ predict cardiovascular disease in patients with rheumatoid arthritis: data from KORONA registry[J]. Joint Bone Spine, 2022, 89(5): 105401.
[10] 中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志,2018,57(4):242-251. Chinese Rheumatology Association. 2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis[J]. Chinese Journal of Internal Medicine, 2018, 57(4): 242-251.
[11] O’NEIL L J, ALP?ZAR-RODR?GUEZ D, DEANE K D. Rheumatoid arthritis: the continuum of disease and strat-egies for prediction, early intervention, and prevention[J]. The Journal of Rheumatology, 2024, 51(4): 337-349.
[12] D’ORAZIO A, CIRILLO A L, GRECO G, et al. Patho-genesis of rheumatoid arthritis:one year in review 2024[J]. Clinical and Experimental Rheumatology, 2024, 42(9): 1707-1713.
[13] MART?NEZ-FEITO A, PLASENCIA-RODR?GUEZ C, NOVELLA-NAVARRO M, et al. Influence of rheuma-toid factor on serum drug levels of TNF inhibitors with different structures in rheumatoid arthritis[J]. Clinical and Experimental Rheumatology, 2024, 42(5): 999-1005.
[14] 张旭凤,符起亚,郑根建,等.miR-197在人口腔鳞状细胞癌中的表达及对细胞增殖的作用机制[J].肿瘤药学,2023,13(1):35-42. ZHANG X F, FU Q Y, ZHENG G J, et al. Expression of miR-197 in human oral squamous cell carcinoma and its mechanism of action on cell proliferation[J]. Anti-Tumor Pharmacy, 2023, 13(1): 35-42.
[15] ZHANG Q W, SONG J Y, CAO L J, et al. RNF113A targeted by miR-197 promotes proliferation and inhib-its autophagy via CXCR4/CXCL12/AKT/ERK/Beclin1 axis in cervical cancer[J]. Experimental Cell Research, 2023, 428(1): 113632.
[16] TIAN X, LIU J L, JIA W, et al. MiR-197-3p affects angiogenesis and inflammation of endothelial cells by targeting CXCR2/COX2 axis[J]. American Journal of Translational Research, 2022, 14(7): 4666-4677.
[17] LIU M M, ZHANG Y, CAO X T, et al. MiR-197 par-ticipates in lipopolysaccharide-induced cardiomyocyte injury by modulating SIRT1 [J]. Cardiology Research and Practice, 2022, 2022(Pt.1): 7687154.
[18] MOHAMMADDOUST S, SADEGHIZADEH M. MiR-183 functions as an oncogene via decreasing PTEN in breast cancer cells[J]. Scientific Reports, 2023, 13(1): 8086.
[19] MUHARAM R, BOWOLAKSONO A, MAIDARTI M, et al. Elevated MMP-9, Survivin, TGB1 and downregulated tissue inhibitor of TIMP-1, Caspase-3 activities are inde-pendent of the low levels miR-183 in endometriosis [J]. International Journal of Women’s Health, 2024, 16: 1733.
[20] TAO Z R, ZHOU Y, ZENG B Y, et al. MicroRNA-183 attenuates osteoarthritic pain by inhibiting the TG-Fα-mediated CCL2/ CCR2 signalling axis[J]. Bone &Joint Research, 2021, 10(8): 548-557.
[21] JIANG N Z, JIANG J, WANG Q X, et al. Strategic targeting of miR-183 and β-catenin to enhance BMSC stemness in age-related osteoporosis therapy[J]. Scien-tific Reports, 2024, 14(1): 21489.

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备注/Memo

备注/Memo:
基金项目：河北省中医药管理局科研计划项目（编号：2022651）。
作者简介：常军英（1984-），女，硕士，副主任医师，研究方向：类风湿关节炎的诊治，E-mail：changjunying925@sina.com。
更新日期/Last Update: 2026-03-15