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系统性红斑狼疮(systemic lupus erythematosus, SLE)是一种可累及多系统器官的自身免疫性疾病,病人体内产生的多种自身抗体是导致SLE病理性损害的关键原因,而B细胞活化产生自身抗体过程中需要活化T细胞的辅助。已有研究[1-2]表明,T淋巴细胞活化需要抗原信号(第一信号)和共刺激信号(第二信号)的共同作用,其中B7/CD28、CD137L/CD137是T细胞活化最重要的共刺激信号,其在SLE病人淋巴细胞上的表达可能影响着疾病的发生发展。同时,淋巴细胞共刺激分子在一定条件下可从细胞表面脱落至血清中成为可溶性分子,其在SLE病人血清中含量变化情况以及与病情活动性的关系尚不清楚。本研究检测了SLE病人血清中可溶性CD28(sCD28)、可溶性CD137(sCD137)的含量,并以正常对照组做比较,探讨其与SLE临床表现、相关实验室指标以及病情活动性的关系。
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SLE病人组血清sCD28和sCD137水平均显著高于健康对照组, 差异有统计学意义(P < 0.01)(见表 1)。
分组 n sCD28 sCD137 SLE病人组 54 5.85±2.59 1.89±1.10 健康对照组 26 2.36±0.65 0.31±0.08 t — 6.70 7.29 P — < 0.01 < 0.01 表 1 2组血清sCD28、sCD137的含量比较(x±s;ng/mL)
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SLE中度活动组血清sCD28和sCD137水平均高于轻度活动组,差异有统计学意义(P < 0.01);SLE重度活动组血清sCD28和sCD137水平均高于中度活动组,差异有统计学意义(P < 0.01)(见表 2)。
分组 n sCD28/(ng/mL) sCD137/(ng/mL) SLEDAI评分/分 SLE轻度活动组 24 3.38±0.97 0.87±0.32 3.42±0.96 SLE中度活动组 22 5.91±1.23** 1.96±0.55** 9.21±3.71 SLE重度活动组 8 8.64±1.32## 2.84±0.60## 14.77±2.56 F — 72.00 63.46 — P — < 0.01 < 0.01 — MS组内 — 2.382 0.076 — q检验:与轻度活动组比较**P < 0.01;与中度活动组比较##P < 0.01 表 2 不同活动度SLE病人血清sCD28、sCD137水平及SLEDAI评分(x±s)
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SLE病人sCD28、sCD137的水平与SLEDAI评分、抗核抗体(ANA)水平呈正相关,与C3水平呈负相关(P < 0.01)(见表 3)。
实验室参数 n sCD28 sCD137 SLEDAI 54 0.974 0.963 IgG/(g/L) 54 0.184 0.176 IgM/(g/L) 54 0.056 -0.082 IgA/(g/L) 54 0.003 -0.164 补体C3/(g/L) 54 -0.427 -0.396 补体C4/(g/L) 54 -0.097 -0.113 ANA 54 0.389 0.326 表 3 SLE病人血清sCD28、sCD137水平与SLEDAI评分和实验室指标相关性(r)
SLE病人外周血sCD28、sCD137水平及临床意义
Levels and clinical significance of sCD28 and sCD137 in peripheral blood of SLE patients
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摘要:
目的探讨SLE病人血清可溶性T细胞共刺激分子sCD28、sCD137的水平及其与SLE病情活动的相关性。 方法收集不同活动度的SLE病人及健康对照者外周血,分离血清,采用BA-ELISA法定量检测受试者外周血中sCD28、sCD137含量,分析比较其含量变化与SLE疾病活动度及相关实验室指标的相关性。 结果SLE病人组血清sCD28和sCD137水平均显著高于健康对照组(P < 0.01);中度活动组血清sCD28水平和sCD137水平显著高于轻度活动组;重度活动组血清sCD28水平和sCD137水平显著高于中度活动组(P < 0.01);SLE病人血清sCD28、sCD137水平与病人SLEDAI评分、抗核抗体水平呈正相关,与C3水平呈负相关(P < 0.01)。 结论SLE病人血清sCD28和sCD137水平显著升高且与其疾病活动度呈正相关,有望成为判断SLE病情活动度的参考指标之一。 Abstract:ObjectiveTo investigate the correlation of the serum levels of sCD28 and sCD137 in systemic lupus erythematosus(SLE) and its significance. MethodsThe serum sCD28 and sCD137 in 54 patients with SLE and in healthy control were detected by BA-ELISA.The correlation of the serum levels of sCD28 and sCD137 with the SLE patients'disease activity index(SLEDAI) score and laboratory findings were analyzed. ResultsThe levels of serum sCD28 and sCD137 in SLE were significantly higher than those in healthy control group(P < 0.01).The levels of serum sCD28 and sCD137 in active SLE were significantly higher than those in remission(P < 0.01).The levels of serum sCD28 and sCD137 in SLE were positively correlated with SLEDAI score and antinuclear antibaby, but were negatively correlated with complement C3(P < 0.01). ConclusionsThere was positive correlation between the levels of serum sCD28 and sCD137 in SLE and its diseases activity index, which is expected to be one of the reference indexes to judge SLE disease activity. -
Key words:
- systemic lupus erythematosus /
- costimulatory molecule /
- sCD28 /
- sCD137
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表 1 2组血清sCD28、sCD137的含量比较(x±s;ng/mL)
分组 n sCD28 sCD137 SLE病人组 54 5.85±2.59 1.89±1.10 健康对照组 26 2.36±0.65 0.31±0.08 t — 6.70 7.29 P — < 0.01 < 0.01 表 2 不同活动度SLE病人血清sCD28、sCD137水平及SLEDAI评分(x±s)
分组 n sCD28/(ng/mL) sCD137/(ng/mL) SLEDAI评分/分 SLE轻度活动组 24 3.38±0.97 0.87±0.32 3.42±0.96 SLE中度活动组 22 5.91±1.23** 1.96±0.55** 9.21±3.71 SLE重度活动组 8 8.64±1.32## 2.84±0.60## 14.77±2.56 F — 72.00 63.46 — P — < 0.01 < 0.01 — MS组内 — 2.382 0.076 — q检验:与轻度活动组比较**P < 0.01;与中度活动组比较##P < 0.01 表 3 SLE病人血清sCD28、sCD137水平与SLEDAI评分和实验室指标相关性(r)
实验室参数 n sCD28 sCD137 SLEDAI 54 0.974 0.963 IgG/(g/L) 54 0.184 0.176 IgM/(g/L) 54 0.056 -0.082 IgA/(g/L) 54 0.003 -0.164 补体C3/(g/L) 54 -0.427 -0.396 补体C4/(g/L) 54 -0.097 -0.113 ANA 54 0.389 0.326 -
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