系统性红斑狼疮患者CXCL16水平检测及其临床意义

目的探讨SLE患者血清CXC趋化因子配体(CXCL16)水平变化及其与SLE患者疾病活动程度之间的关系和临床意义。方法收集SLE患者20例,并随机抽取同期体检人群中性别和年龄相匹配的20名健康人为健康对照组。对2组C-肽、TG、CRP、CXCL16、补体C3水平进行比较,并与SLE活动程度进行回归分析。结果 SLE组的血清CXCL16水平明显高于健康对照组(P<0.05)。多元逐步回归分析发现C-肽、血肌酐、CRP、CXCL16、补体C3是SLE患者血清预后的独立危险因素。结论 SLE组患者血清CXCL16水平变化与狼疮活动程度密切相关,但其具体发病机制还有待进一步研究。     

系统性红斑狼疮患者血清干扰素诱导蛋白10的表达水平及临床意义

目的 探讨趋化因子干扰素诱导蛋白10(IP-10)在系统性红斑狼疮(SLE)患者血清中的表达水平及其对SLE的临床诊断价值.方法 采用ELISA法检测96例SLE患者以及30例正常对照组血清中IP-10表达水平,比较分析其与SLE病情活动指数(SLEDAI评分)、疾病活动性指标抗双链DNA(dS-DNA)抗体、抗C1q...     

系统性红斑狼疮患者外周血B淋巴细胞中TLR9的表达及其临床意义

目的:研究Toll样受体9(TLR9)在系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者外周血B淋巴细胞中的表达,分析TLR9与疾病活动和药物治疗的关系。方法:使用流式细胞仪检测63例确诊的SLE患者和25例健康人外周血CD19+B淋巴细胞上TLR9的表达情况,比较活动期治疗前后、非活动期和健康对照组B细胞上TLR9的表达差异。结果:活动期SLE患者治疗前外周血CD19+B细胞TLR9的表达率高于治疗后、非活动期SLE患者及正常对照组(P<0.01);活动期SLE患者经治疗B细胞TLR9表达率明显降低,但仍高于非活动期和正常对照组(P>0.05);SLE患者外周血B细胞TLR表达与系统性红斑狼疮疾病活动度评分(SLEDAI)正相关(P<0.05)。结论:TLR9在外周血B细胞可作为判断SLE患者疾病活动度和药物治疗效果的参考指标。     

系统性红斑狼疮患者外周血单一核细胞CX3CR1趋化因子受体mRNA的表达

目的:探讨趋化因子受体CX3CR1在系统性红斑狼疮(SLE)患者外周血单一核细胞(PBMC)中的表达,及 其与疾病活动的相关性.方法:收集93例确诊的SLE患者和30例正常人的PBMC,提取RNA.应用RT-PCR方法检 测CX3CRl mRNA表达水平,并与疾病活动度评分(SLEDAI)作直线相关性分析.结果:①CX3CR1 mRNA在PBMC中 的表达水平,活动期(3.735±0.557)与非活动期(0.530 ±0.045),两者差异有统计学意义(t=2.606,P=0.01);非活动期与对照组(0.146±0.02)间的差异有统计学意义(t=5.831,P=0.000);患者组(2.819±1.347)与对照组间的差异有统计学意义(t=3.921,P=0.000).②SLE患者组CX3CR1 mRNA水平与疾病活动度评分(SLEDAI)呈正相关(r=0.445,t=4.523,P<0.001).③不具有血管炎、肌炎、肾损及血小板减少的患者与具有上述相应临床特征的患者比较,CX3CR mRNA表达水平更高,差异具有统计学意义.结论:CX3CR1mRNA表达水平在活动期SLE比非活动期增高,与疾病的活动性(SLEDAI)呈正相关.CX3CR1可能反映疾病的活动性、参与特异器官受累的发生.     

联合检测系统性红斑狼疮患者血尿趋化因子的临床意义

目的了解系统性红斑狼疮(SLE)患者血、尿巨噬细胞炎症蛋白-1α(MIP-1α)、巨噬细胞炎症蛋白-1β(MIP-1β)、激活正常T细胞表达和分泌因子(RANTES)浓度变化并探讨其临床意义。方法用双抗体夹心ELISA方法检测37例SLE患者和20例健康志愿者的血清及尿液的MIP-1α、MIP-1β、RANTES浓度,分析其变化与SLE发病及疾病活动的关系。结果血、尿MIP-1α、MIP-1β浓度在SLE患者显著升高(P<0.001,P=0.003),其中血MIP-1α在狼疮肾炎和非狼疮肾炎患者均显著升高(P<0.01,P=0.004),血MIP-1β主要在非狼疮肾炎患者显著升高(P=0.012);血MIP-1α、MIP-1β浓度在激素治疗后显著降低(P=0.001,P=0.008);血、尿间趋化因子浓度无显著相关,尿RANTES浓度与SLEDAI显著正相关(r=0.515,P=0.014)。结论趋化因子参与了SLE的发病,在不同脏器损害的SLE患者中趋化因子所起的作用不同,血、尿趋化因子浓度间无显著相关,联合检测血、尿趋化因子浓度,有利于评估SLE的脏器损害和疾病活动。     

miR-203在系统性红斑狼疮患者外周血单个核细胞中的表达及临床意义

目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血单个核细胞中miR-203的表达水平与疾病活动度?肾脏受累情况等临床表现之间的关系,初步探讨miR-203在SLE中的临床意义?方法:收集31例SLE患者?16例健康志愿者外周血标本,根据肾脏受累分为狼疮肾炎21例和SLE无肾脏受累10例?采用实时荧光定量聚合酶链反应(real-time fluorescence quota polymerase chain reaction,qRT-PCR)检测外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)中miR-203表达,比较各组间miR-203表达水平的差异,并分析其与SLE临床指标之间的关系?结果:SLE患者miR-203表达明显低于正常对照组,差异具有统计学意义(P < 0.05);狼疮肾炎组患者miR-203表达低于SLE无肾脏受累组和正常对照组,差异具有统计学意义(P < 0.01);SLE患者miR-203表达水平与24 h尿蛋白?肾脏急性指数呈明显负相关(P < 0.01)?结论:SLE患者PBMCs中miR-203的表达水平降低,表明miR-203在SLE发病机制中可能发挥一定作用;狼疮肾炎患者miR-203的表达降低,提示miR-203可能参与了狼疮肾炎的发病?     

系统性红斑狼疮患者外周血T细胞CTLA-4表达及其临床意义

目的：研究系统性红斑狼疮（systemic lupus erythematosus, SLE）T细胞中CTLA-4的表达及临床意义。方法：分离正常人和SLE患者的外周血单个核细胞（peripheral blood mononuclear cells,PBMCs）,以抗-CD3、抗-CD28刺激培养48 h,刺激培养前后收取细胞,以流式细胞术（FCM）检测CD4+和CD8+T细胞中CTLA-4+细胞比例,并分析其与SLE疾病活动性指数（SLEDAI）和肾损害的关系。再以ELISA法检测培养上清中游离的CTLA-4水平。结果：SLE患者刺激前的CD4+和CD8+T细胞且主要是CD25+T细胞中CTLA-4+细胞的比例较正常人显著增高,与SLEDAI呈正相关;而其CD8+CD28- T细胞中CTLA-4+细胞比例也显著高于正常人,但与SLEDAI之间无显著相关性;经抗-CD3、抗-CD28抗体刺激后,其CD4+CD25+T细胞、CD8+CD25+T细胞或CD8+CD28-T细胞中CTLA-4+细胞的比例却显著低于正常人,但与SLEDAI之间无显著相关性,仅在活动性SLE患者中有肾损组的CD8+CD28-T细胞中CTLA-4+细胞的比例显著低于非肾损组;而且经刺激培养后SLE患者PBMC上清中游离的CTLA-4水平也显著低于正常人。结论：SLE患者新鲜分离的T细胞（CD4+及CD8+）中CTLA-4表达异常增高,反映T细胞异常活化和疾病活动;另一方面,SLE患者T细胞又存在CTLA-4诱导性表达障碍,可能与SLE T细胞体外再活化能力减弱有关。     

系统性红斑狼疮患者外周血淋巴细胞凋亡的初步研究

为探讨细胞凋亡及其相关基因与系统性红斑狼疮（ＳＬＥ）患者病情关系,作者采用末端脱氧核苷酸转移酶介导的缺口末端标记法及 式细胞仪,观察了２９例ＳＬＥ患者外周血淋巴细胞（ＰＢＬ）凋亡现象,并应用免疫组化ＡＢ ｂｃｌ－２蛋白和Ｆａｓ蛋白的表达;结果显示：（１）ＳＬＥ患者ＰＢＬ凋亡率明显高于正常组及类风湿关节炎组（Ｐ〈０．００１）,经４８小时培养后ＰＢＬ凋亡率更高,可达３３．４４％;（２）ＰＢＬ凋亡率与疾     

系统性红斑狼疮患者外周血白细胞增多的临床意义

目的探讨系统性红斑狼疮（Systemic Lupus Erythematosus,SLE）患者外周血白细胞增多主要原因及其临床意义。方法采用病例对照研究的方法对270例系统性红斑狼疮（SLE）患者的临床资料进行回顾性研究。结果270例SLE患者中有38例白细胞增多,发生率为14．1％。该38例中有27例（71．1％）与感染有关,11例与原发病活动有关。结论SLE患者白细胞增多不要盲目加大糖皮质激素和细胞毒药物剂量,注意并发感染的诊断与治疗。     

The Gene Expression Patterns of Peripheral Blood Mononuclear Cells in Patients with Systemic Lupus Erythematosus

This study examined the gene expression patterns of peripheral blood mononuclear cells(PBMCs) in patients with systemic lupus erythematosus(SLE) by using serial analysis of gene ex-pression(SAGE) technology.Following the construction of serial analysis of gene expression(SAGE) library of PBMCs collected from 3 cases of familial SLE patients,a large scale of tag sequencing was performed.The data extracted from sequencing files was analyzed with SAGE 2000 V 4.5 software.The top 30 expressed genes of SLE patients were uploaded to http://david.niaid.nih.gov/david/ease.htm and the functional classification of genes was obtained.The differences among those expressed gene were analyzed by Chi-square tests.The results showed that a total of 1286 unique SAGE tags were identified from 1814 individual SAGE tags.Among the 1286 unique tags,86.8% had single copy,and only 0.2% tags had more than 20 copies.And 68.4% of the tags matched known expressed sequences,41.1% of which matched more than one known expressed sequence.About 31.6% of the tags had no match and could represent potentially novel genes.Ap-proximately one third of the top 30 genes were ribosomal protein,and the rest were genes related to metabolism or with unknown functions.Eight tags were found to express differentially in SAGE li-brary of SLE patients.This study draws a profile of gene expression patterns of PBMCs in patients with SLE.Comparison of SAGE database from PBMCs between normal individuals and SLE pa-tients will help us to better understand the pathogenesis of SLE.     

系统性红斑狼疮患者外周血单个核细胞单链DNA表达研究

目的研究系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）中单链DNA（ssDNA）表达情况。方法流式细胞术检测26例SLE患者（SLE组）外周血ssDNA表达阳性的PBMC细胞百分比（ssDNA阳性率）,设立正常对照组（n=17）和其他结缔组织病（CTD）对照组（n=7）。结果 SLE组、正常对照组和CTD对照组外周血B淋巴细胞中ssDNA阳性率分别为（0.906±0.838）%、（0.216±0.371）%和（0.270±0.311）%。统计学分析表明,SLE组患者外周血B淋巴细胞中ssDNA阳性率显著高于两对照组（P〈0.01,P〈0.05）;SLE组内有与无狼疮肾炎患者的外周血B淋巴细胞中ssDNA阳性率分别为（1.228±0.259）%和（0.510±0.436）%,两者比较差异有统计学意义（P〈0.05）。结论 SLE和狼疮肾炎的发生和发展可能与患者外周血表达ssDNA的B淋巴细胞异常增多有关。     

系统性红斑狼疮患者外周血单个核细胞单链DNA表达研究

目的 研究系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中单链DNA(ssDNA)表达情况.方法 流式细胞术检测26例SLE患者(SLE组)外周血ssDNA表达阳性的PBMC细胞百分比(ssDNA阳性率),设立正常对照组(n=17)和其他结缔组织病(CTD)对照组(n=7).结果 SLE组、正常对照组和CTD对照组外周血B淋巴细胞中ssDNA阳性率分别为(0.906±0.838)%、(0.216±0.371)%和(0.270±0.311)%.统计学分析表明,SLE组患者外周血B淋巴细胞中ssDNA阳性率显著高于两对照组(P<0.01, P<0.05);SLE组内有与无狼疮肾炎患者的外周血B淋巴细胞中ssDNA阳性率分别为(1.228±0.259)%和(0.510±0.436)%,两者比较差异有统计学意义(P<0.05).结论 SLE和狼疮肾炎的发生和发展可能与患者外周血表达ssDNA的B淋巴细胞异常增多有关.     

Abnormal expression of CD43 in patients with systemic lupus erythematosus and its clinical significance

Background  Previous studies indicate that CD43 plays a role in regulating the adhesion of lymphocytes, cell mutation and activation, however, little is known about its effect on systemic lupus erythematousus (SLE). This study was designed to explore the clinical significance of CD43 in SLE patients.

Methods  We used microarray and real-time PCR to detect the mRNA and protein expression of magnetic bead sorted T cells and B cells from peripheral blood mononuclear cells (PBMCs) of SLE patients, and analyzed the relationship between CD43 and the clinical indexes.

Results  Both microarray and real-time PCR results showed that CD43 mRNA was significantly decreased in PBMCs of SLE patients compared with healthy controls (P <0.001). There were no significant differences between lupus nephritis and non-lupus nephritis patients, and neuropsychiatric and non-neuropsychiatric patients. CD43 mRNA expression was significantly reduced in T cells but not in B-cells in SLE patients compared to healthy controls (P <0.01). Compared with healthy controls, the percentage of CD43⁺ cells in the PBMCs of SLE was significantly decreased (P=0.004), and the CD43 fluorescence intensity in CD3⁺/CD43⁺ cells and CD19⁺/CD43⁺ cells was also significantly weaker than in healthy controls (P=0.039 and 0.003). There was no significant difference in the percentage of CD3⁺/CD43⁺ cells, CD19⁺/CD43⁺ cells between the two groups. The CD43 fluorescence intensity in CD3⁺/CD43⁺ cells was inversely correlated with the levels of IgG and IgM (r= –0.8 and –0.6).

Conclusions  Compared to healthy controls, both CD43 mRNA and protein expressions were reduced in T cells from patients with SLE, and were inversely correlated with IgG.

     

Effects of sex hormones on apoptosis in peripheral blood mononuclear cells from patients with systemic lupus erythematosus

Objective To study the effects of dehydroepiandrosterone (DHEA) and/or estradiol (E(2) ) on apoptosis in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE).Methods The percentage of apoptosis of PBMCs from SLE patients and healthy blood donors were examined by means of AO staining 48 h after culture with DHEA and/or E(2) at physiologic or pathologic concentrations.Results The percentage apoptosis of PBMCs from SLE patients is higher than that of healthy blood donors (P&lt;0.01). E(2) , whether at physiological or at p a thological concentrations, had no effects on apoptosis of PBMCs from both S LE patients and healthy donors (P&gt;0.05). Both DHEA and DHEA plus E(2) at physiologic concentrations, had no effect on apoptosis of PBMCs from healthy d onors (P&gt;0.05), but significantly inhibited that of SLE patients ( P&lt;0.05); at pathologic concentrations,they promoted apoptosis of PBMCs fr om SLE patients as well as healthy blood donors (P&lt;0.05). There were no significant differences between the effects of DHEA and that of DHEA plus E(2) (P&gt;0.05). Conclusion DHEA plays an important role in the apoptosis of PBMCs from SLE patients; low serum levels of DHEA may cause accelerated apoptosis.     

系统性红斑狼疮患者外周血单个核细胞TNIP1基因表达

目的 探讨TNIP1 基因在系统性红斑狼疮(SLE)患者外周血单个核细胞中的表达情况,以及与SLE疾病活动指数(SLEDAI)、单核苷酸多态性(SNP)位点rs10036748的相关性.方法 收集61例SLE患者和66例正常对照的临床资料及血样,采用实时荧光定量PCR法检测外周血单个核细胞中TNIP1 mRNA表达量;应用Sequenom MassArray技术对所有病例对照SNP rs10036748位点进行基因分型.结果 SLE患者TNIP1基因 mRNA表达低于正常对照组(P=0.000 4);TNIP1基因 mRNA表达水平与SLEDAI和SNP rs10036748基因型之间无相关性.结论 TNIP1基因在SLE发生中可能起着某种作用.     

神经精神性狼疮患者的临床特点

目的了解神经精神性狼疮(neuropsychiatric systemic lupus erythematosus,NPSLE)患者的临床特点,加强对该病的认识,以指导临床进行早期诊断和治疗,改善疾病预后。方法选取2011年6月—2016年6月在海南省人民医院住院的82例NPSLE患者作为病例组,同期收集本院确诊为系统性红斑狼疮(systemic lupus erythematosus,SLE)但无神经精神症状的82名住院患者作为对照组,了解NPSLE患者神经精神症状,并比较两组患者的一般情况、临床表现、实验室和免疫学检查。结果 82例NPSLE患者,男性9例,女性73例,年龄(33.2±16.7)岁,病程1年者占69.5%,病例组患者病程要短于对照组(P0.05);62.2%的NPSLE患者在SLE发病3年内出现神经精神症状,常见的症状为狼疮性头痛(20.0%)、癫痫(12.0%)、性格改变(10.5%)和焦虑(10.5%),85.4%的患者合并有其他临床表现,主要为面部红斑(68.3%)、肾脏受累(59.8%)、关节疼痛(42.7%)等,与对照组相比,NPSLE患者更易合并光感性皮疹(P0.05);两组患者血小板、血肌酐、补体C4、免疫球蛋白Ig M、抗ds-DNA抗体、抗r-RNP抗体差异有统计学意义(P0.05)。结论 NPSLE患者偏向于青年女性,常发生于SLE病程的早期阶段,大部分患者在SLE发病3年内会出现神经精神症状,且更易合并光感性皮疹,血小板、肌酐、补体C4的降低和Ig M、抗ds-DNA抗体、抗r-RNP抗体水平的升高可辅助NPSLE进行早期诊断和预测。