To explore the application of HMGB1, SII, S100A8 / A9 and MCP-1 in the diagnosis, condition monitoring and prognosis of rheumatoid arthritis

Abstract

Objective: To explore the diagnosis and prognosisvalue of high mobility group box1 protein B1(HMGB1), systemic immune inflammatory index (SII), calcium binding proteinA8/A9 complex (S100A8/ A9) and monocyte chemoattractant protein-1 (MCP-1) in rheumatoid arthritis (RA). Methods: From January 2020 to December 2021, 154 patients diagnosed with RA in the outpatient and inpatient clinics of the Second Affiliated Hospital of Nanchang University and Yingtan People's Hospital were selected as the RA group, A total of 303 cases including 78 cases of Sjogren's syndrome (SS), 62 cases of systemic lupus erythematosus (SLE), 79 cases of ankylosing spondylitis (AS) and 84 cases of osteoarthritis (OA) were selected as as a non-RA group, and 43 healthy people who underwent physical examination at the same time in the hospital were selected as the healthy control group.The levels of HMGB1, S100A8/A9 and MCP-1 were detected by enzyme-linked immunosorbent assay (ELISA), platelets (PLT) and lymphocytes (L) were detected by sheath flow electrical impedance method, neutrophils (N) were detected by flow cytometry combined with fluorescence staining,(N), calculate SII and detect other laboratory indicators.The disease activity index 28 (DAS28) score was used to evaluate the disease activity of RA and the efficacy after treatment,the patients with RA were followed up at 1 month, 2 months and 3 months after treatment, and the correlation between the detection indicators in each period was analyzed. Results: ① the levels of HMGB1, SII, S100A8/A9 and MCP-1 in RA group were significantly higher than those in healthy control group (P < 0.01),and the AUC area of RA diagnosis was 0.86, 0.79, 0.84 and 0.80, respectively, the AUC area of HMGB1 was the largest. ② The positive rates of HMGB1, SII, S100A8 / A9 and MCP-1 in RF (-) and Anti-CCP (-) groups were 37.50%, 37.50%, 50.00% and 62.5%, respectively. The positive rate of MCP-1 was the highest. ③ The levels of HMGB1, S100A8 / A9 and MCP-1 in high disease activity group and middle disease activity group were higher than those in low disease activity group, remission group and healthy control group (P < 0.05).④ HMGB1, SII, S100A8 / A9 and MCP-1 were positively correlated with DSA28 score (r= 0.476, 0.286, 0.522 and 0.441, respectively, P < 0.01); Δ HMGB1, Δ SII, Δ S100A8 / A9 and Δ MCP-1 and Δ DAS28 before and after treatment in RA patients was positively correlated (r = 0.628, 0.524, 0.603 and 0.579, P < 0.01). Conclusion: HMGB1, SII, S100A8/A9 and MCP-1 show better diagnostic performance in RA, especially improving the detected rate of RF (-) and Anti-CCP (-) RA patients;Besides,HMGB1, SII, S100A8/A9 and MCP-1 can be used for disease activity monitoring and disease evaluation of RA patients.