Supplementary Material for: Immunological Profile of Patients with Rheumatoid Arthritis and Asthma

Objectives: The aim of this study was to investigate cytokine profiles in patients with both rheumatoid arthritis (RA) and bronchial asthma (BA). Methods: We studied 25 patients with RA, 25 with BA and 25 with both RA and BA (BARA). A respiratory questionnaire was completed by all the patients, they underwent spirometry and their production patterns of selected T helper (Th)1, Th2 and Th17 cytokines were assessed. Results: BA patients had spirometry findings similar to BARA patients, while RA patients had normal spirometry. BA patients produced significantly higher levels of interleukin (IL)-5 (p = 0.03) and IL-10 (p = 0.03) than patients with RA. Median levels of IL-17A and IL-17F, and interferon (IFN)- were higher (p = 0.001, 0.004 and 0.04) in RA patients than in BA patients. No differences were seen in the levels of cytokines produced by BA patients compared to BARA patients. IL-4 and IL-10 levels were higher (p = 0.04 and 0.03) in BARA patients than in RA patients, while levels of IL-17A and IFN- were higher (p = 0.037 and 0.009 respectively) in RA patients than in BARA patients. Ratios of Th1/Th2 and Th17/Th2 cytokines in most combinations were different between RA and BA, and between RA and BARA, but were similar in BA and BARA. Conclusions: Patients with both BA and RA have a Th2-dominant cytokine profile unlike patients with RA alone. These observations contribute to a better understanding of the immunopathogenesis of these diseases and for the management of patients using cytokine-based therapies.

研究目的：本研究旨在探究同时罹患类风湿关节炎（rheumatoid arthritis, RA）与支气管哮喘（bronchial asthma, BA）患者的细胞因子谱特征。研究方法：本研究纳入25例类风湿关节炎患者、25例支气管哮喘患者及25例类风湿关节炎合并支气管哮喘（BARA）患者。所有受试者均完成呼吸调查问卷，接受肺量测定法（spirometry）检查，并对选定的T辅助（T helper, Th）1型、Th2型及Th17型细胞因子的分泌模式进行检测分析。研究结果：支气管哮喘患者的肺量测定法结果与BARA患者相似，而类风湿关节炎患者的肺功能指标处于正常范围。相较于类风湿关节炎患者，支气管哮喘患者的白细胞介素（interleukin, IL）-5（p=0.03）与IL-10（p=0.03）水平显著升高。类风湿关节炎患者的IL-17A、IL-17F及干扰素（interferon, IFN）-γ的中位水平均高于支气管哮喘患者（p值分别为0.001、0.004与0.04）。支气管哮喘患者与BARA患者的细胞因子水平无显著差异。BARA患者的IL-4（p=0.04）与IL-10（p=0.03）水平高于类风湿关节炎患者，而类风湿关节炎患者的IL-17A（p=0.037）与IFN-γ（p=0.009）水平则高于BARA患者。多数细胞因子比值组合下，Th1/Th2及Th17/Th2的比值在类风湿关节炎与支气管哮喘患者间、类风湿关节炎与BARA患者间存在显著差异，但在支气管哮喘与BARA患者间无明显差异。研究结论：与仅罹患类风湿关节炎的患者不同，同时合并支气管哮喘与类风湿关节炎的患者其细胞因子谱以Th2型为主。本研究结果有助于进一步阐明这两种疾病的免疫发病机制，同时可为采用基于细胞因子的疗法治疗此类患者提供参考依据。