The Relationship Between the Expression Levels of TGF-β,IL-17,and IL-18 in Peripheral Blood and Bone and Joint Damage in Patients with Brucellosis

DING Feixue; CHEN Handong; ZHAO Lili; YUAN Shuting; XUE Yunjie; ZHAO Meijia; YIN Shaoxin

doi:10.3639/j.issn.2095-3097.2025.11.025

Abstract：Objective To explore the relationship between the expression levels of transforming growth factor-β(TGF-β),interleukin-17(IL-17),and interleukin-18(IL-18)in peripheral blood and bone and joint damage in patients with brucellosis.Methods A total of 173 patients with brucellosis diagnosed in Qinhuangdao Third Hospital from December 2023 to December 2024 were selected as the research subjects and divided into the acute group(n=95)and the chronic group(n=78)based on the disease course.Another 50 healthy individuals undergoing physical examination during the same period were selected as the control group.The 173 patients with brucellosis were further divided into the bone and joint damage group(n=80)and the non-bone and joint damage group(n=93)based on the presence or absence of bone and joint damage.The levels of TGF-β,IL-17,and IL-18 in peripheral blood were detected using enzyme-linked immunosorbent assay.The diagnostic value of TGF-β,IL-17,and IL-18 in peripheral blood for bone and joint damage in patients with brucellosis was analyzed using receiver operating characteristic(ROC)curve analysis.Multivariate logistic stepwise regression analysis was used to analyze the influencing factors of bone and joint damage in patients with brucellosis.Results The levels of TGF-β,IL-17,and IL-18 in the acute and chronic groups were significantly higher than those in the control group(P<0.05).The level of TGF-β in the chronic group was significantly higher than that in the acute group,while the levels of IL-17 and IL-18 were significantly lower than those in the acute group(P<0.05).The levels of TGF-β,IL-17,and IL-18 in the bone and joint damage group were significantly higher than those in the non-bone and joint damage group(P<0.05).ROC curve analysis showed that the area under the curve of combined detection of TGF-β,IL-17,and IL-18 in peripheral blood for diagnosing bone and joint damage in patients with brucellosis was 0.903,which was significantly higher than that of TGF-β,IL-17,and IL-18 alone(0.819,0.742,and 0.786,respectively;Z=11.563,10.705,8.981,all P<0.001).The white blood cell count,C-reactive protein(CRP),procalcitonin,and erythrocyte sedimentation rate(ESR)in the bone and joint damage group were higher than those in the non-bone and joint damage group(all P<0.05).Multivariate analysis showed that CRP,ESR,TGF-β,IL-17,and IL-18 were independent risk factors for bone and joint damage in patients with brucellosis(P<0.05).Conclusion Elevated levels of TGF-β,IL-17,and IL-18 in peripheral blood are associated with bone and joint damage in patients with brucellosis and can serve as auxiliary diagnostic indicators for bone and joint damage in these patients.Moreover,the combined detection of the three markers demonstrates higher diagnostic efficiency.