Abstract: Objective To explore the role of inflammatory factors[interleukin-1β(IL-1β),interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α)] in the formation of haemophilic arthropathy in children with severe hemophilia A, and to provide theoretical basis for further prevention and treatment target of hemophilia joint disease.Methods The eligibility hemophilia A children were enrolled from the Hemophilia Outpatient Clinic of Beijing Children Hospital during 2015-2016. Patients were divided into non-joint bleeding(NJB) group, joint bleeding(JB) group[acute joint bleeding(AJB) group, chronic joint bleeding(CJB) group]. Peripheral venous blood was collected, the expression of IL-1β, IL-6 and TNF-α in blood serum were detected by enzyme-linked immunosorbent assay (enzyme-linked immunosorbent assay, ELISA). The expression of mRNA of IL-1β, IL-6 and TNF-α was detected by reverse transcription-polymerase chain reaction (RT-PCR).Statistical analysis the levels of IL-1β, IL-6 and TNF-α in blood serum and their mRNA expression.Results A total of 47 cases were collected in the patients group, including 17cases of NJB group, 17 cases of AJB group (8 cases with target joint, 9 cases without target joint) and 13 cases of CJB group. Median age was 5.5 years (2 years to18 years). There was significant difference in the expression of mRNA of TNF-α between NJB group, JB group and AJB group(P<0.05). There was significant difference in the expression of mRNA of TNF-α between AJB group with arthropathy (n=8, 5.584±3.634) and AJB group without arthropathy (n=9, 1.680±1.590) (P=0.02).Conclusion The expression of IL-1β, IL-6 and TNF-α in children with hemophilia increased in acute joint bleeding, and the expression of TNF-α increased mainly in acute, chronic and with haemophilic arthropathy, so TNF-α is the key of cytokines in the formation of haemophilic arthropathy in children with severe hemophilia A.

Key words: children with severe hemophilia A, haemophilic arthropathy, inflammatory factors