Abstract：Objective To explore the expression and clinical significance of phosphorylated protein kinase B (p-AKT), B-lymphoma-2 (Bcl-2) and matrix metalloproteinase-9 (MMP-9) in synovial tissues of patients with rheumatoid arthritis (RA). Methods Fifteen patients with RA who were hospitalized in orthopedics department of General Hospital of Eastern Theater Command from March 2013 to March 2022 were included in the RA group, while 10 patients with joint injuries who underwent knee surgeries during the same period were included in the control group. Synovial histopathological specimens and clinical data of RA patients were collected. Synovial tissue characteristics were assessed from a pathological perspective. Immunohistochemical staining was used to detect the expression of p-AKT, Bcl-2 and MMP-9 proteins in the synovial tissues of RA patients. Results There was no significant difference in age or gender between two groups (P>0.05). White blood cells (WBC), monocytes (MONO), neutrophils (NEUT), c-reactive protein (CPR), rheumatoid factors (RF) and anti-cyclic citrullinated peptide antibody (Anti-CCP) in RA group were significantly higher than those in the control group (P<0.05 or P<0.01). The Krenn’s pathological score of synovial tissues in the RA group was significantly higher than that in the control group (P<0.05 or P<0.01). Compared with the control group, the expressions of p-AKT, Bcl-2 and MMP-9 in the synovial tissue of the RA group were significantly higher than those of the control group (P<0.05 or P<0.01). The expression of p-AKT was positively correlated with ESR (r=0.680, P=0.005) and DAS28-3 (r=0.634, P=0.011). The expression of Bcl-2 was positively correlated with erythrocyte sedimentation rate (ESR) (r=0.640, P=0.010) and CRP (r=0.584, P=0.022). The expression of MMP-9 was positively correlated with ESR (r=0.809, P=0.000) and Disease Activity Score 28-3 (DAS28-3) (r=0.590, P=0.021). The expression of Bcl-2 and MMP-9 was positively correlated (r=0.630, P=0.012). Conclusions The expressions of p-AKT, Bcl-2 and MMP-9 increase in the synovial tissues of RA patients, which is positively correlated with indicators related with RA disease activity. The Overproliferation of synovium in RA patients may be related with the activation of AKT-related signaling pathways and the overexpression of apoptosis inhibitory protein Bcl-2.
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