系统性红斑狼疮患者外周血Th1细胞自噬相关标记物的表达

目的:探讨系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者外周血Th1细胞自噬相关标记物的表达情况及意义.方法:应用流式细胞术检测68例SLE患者及23例正常人外周血Th1细胞自噬相关标记物的表达水平,并分析其与补体C3 、SLEDAI评分和血清Anti-dsDNA水平的相关性.结果:SLE患者Th1细胞自噬标记物Beclin-1和Phospho-mTOR的水平均低于正常人,而LC3的水平高于正常人(均P＜0.05);活动期SLE患者Phospho-mTOR水平低于非活动期患者(P＜0.05).SLE患者Th1细胞Phospho-mTOR水平与SLEDAI评分呈负相关,与血清C3水平呈正相关,与血清Anti-dsDNA水平呈负相关(均P＜0.05).外周血Th1细胞Phospho-mTOR和补体C3水平变化在判断SLE患者疾病活动情况时敏感性高于血清Anti-dsDNA,但特异性不如血清Anti-dsDNA.结论:SLE患者外周血Th1细胞存在自噬异常现象,且自噬相关标记物Phos-pho-mTOR的表达与病情活动度相关,有望成为评价SLE活动度的指标之一.     

系统性红斑狼疮患者外周血单个核细胞转录因子NF—AT和AP—1活性的初步观察

目的观察系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)NF-AT和AP-1活性,并进一步探讨其临床意义.方法NF-AT和AP-1活性检测采用电泳迁移率改变法(EMSA).结果①活动期(19例)和缓解期(13例)SLE患者PBMC NF-AT活性均显著高于正常对照组(P＜0.05);活动期SLE显著高于缓解期(P＜0.05).②活动期SLE组PBMC AP-1活性均显著低于正常对照组(P＜0.01);缓解期SLE与正常对照组无明显差别(P＞0.05).③血清抗dsDNA抗体阳性SLE患者(21例)NF-AT明显高于抗dsDNA抗体阴性组(11例)(P＜0.05),而两组患者AP-1活性无显著差异(P＞0.05).④SLE患者PBMC NF-AT活性与CRP和SLEDAI呈正相关关系,与ESR、ANA、C3无相关关系;AP-1与上述各临床指标无相关关系.结论SLE外周血单个细胞中存在介导细胞内信号转导的转录因子NF-AT和AP-1表达异常,这可能与SLE的发病机制有关;NF-AT可能与SLE的疾病活性有关.     

Th1, Th2, and Th17 cytokines in systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the breakdown of immune tolerance leading to excessive inflammation and tissue damage. Imbalance in the levels of cytokines represents one of the multifactorial causes of SLE pathogenesis and it contributes to disease severity. Deregulated levels of T helper type 1 (Th1), type 2 (Th2), and type 17 (Th17) cytokines have been associated with autoimmune inflammation. Growing evidence has shown deregulated levels of Th1, Th2, and Th17 cytokines in SLE patients compared to healthy controls associated with disease activity and severity. In this review, we describe and discuss the levels of Th1, Th2, and Th17 cytokines in SLE patients, and clinical trials involving Th1, Th2, and Th17 cytokines in SLE patients. In particular, with the exception of IL-2, IL-4, and TGF-β1, the levels of Th1, Th2, and Th17 cytokines are increased in SLE patients associated with disease severity. Current phase II or III studies involve therapeutic antibodies targeting IFN-α and type I IFN receptor, while low-dose IL-2 therapy is assessed in phase II clinical trials.     

系统性红斑狼疮患者外周血单个核细胞中急性期蛋白反应因子的表达

目的　探讨系统性红斑狼疮 (SLE)患者外周血单个核细胞 (PBMC)中急性期蛋白反应因子 (APRF)的活性水平 ,以及IL 6和IL 10对APRF表达的影响。方法　采用凝胶阻滞电泳 (EMSA)的方法检测 4 0例SLE患者及 2 0例正常对照组PBMC中DNA结合蛋白APRF的表达水平。结果　所有活动期SLE患者均出现APRF电泳条带 ,17例非活动期SLE患者中有 10例出现APRF条带 ,而正常人对照组无 1例出现。 7例未出现APRF电泳条带的非活动期SLE患者PBMC加IL 10处理后均出现不同程度的APRF表达 ,而加IL 6处理时仍未出现APRF电泳条带。结论　SLE患者存在APRF的异常表达。在SLE中 ,IL 10信号转导途径中的某些调控机制 (如蛋白激酶 )可能发生改变 ,从而使得核内的APRF激活转录 ,提示IL 10很可能是通过APRF在SLE的发病机制中起作用 ,相反IL 6在SLE发病的作用机制很可能与APRF无关。     

系统性红斑狼疮患者外周血单个核细胞中白细胞介素-10mRNA表达的研究

目的 探讨白细胞介素(IL-10)在系统性红斑狼疮(SLE)中的作用。方法 采用逆转录多聚酶链反应(RT-PCR)及酶联免疫吸附法(ELISA)测定40例SLE患者和20例正常对照组外周血单核细胞(PBMC)IL-10mRNA表达及IL-10自发分泌水平。结果 SLE患者PBMC自发分泌IL-10水平及其IL-10mRNA表达水平均显著高于正常对照组(P<0.01),其中SLE活动期明显高于非活动期(P<0.01),而非活动期又明显高于正常对照组(P<0.01)。结论 IL-10在SLE发病中起重要作用,PBMC分泌IL-10水平对SLE诊断和病情活动性监测有重要临床意义,拮抗SLE患者体内IL-10水平,将为SLE治疗开辟一条新途径。     

Matrix metalloproteinase-9 and its natural inhibitor TIMP-1 expressed or secreted by peripheral blood mononuclear cells from patients with systemic lupus erythematosus

Matrix metalloproteinase-9 (MMP-9) was involved in inflammation and immune system dysfunctions. Besides immunologic abnormalities, systemic lupus erythematosus (SLE) also presents chronic inflammatory components. Therefore, a role of MMP-9 in SLE pathology might be supposed. To verify this hypothesis, SLE patients and healthy donors were compared for the MMP-9 and MMP-9 mRNA levels in peripheral blood mononuclear cells (PBMCs), the spontaneous secretion of MMP-9 and TIMP-1 and the MMP-9 activity. Thus, we found that fresh PBMCs from SLE patients expressed a significantly higher activity of MMP-9 and spontaneously released higher levels of MMP-9, as compared to healthy donors, while the secreted TIMP-1 level was the same for both groups. When the patients were sub-grouped based on disease status, the most increased pro-MMP-9 activity inside the PBMCs was identified for relapse SLE sub-group. A similar observation for SLE patients with positive serum fibrinogen was found. Following culture, the PBMCs from remission SLE patients secreted significantly higher MMP-9 level, than the PBMCs from relapse SLE patients. PBMCs from relapse SLE patients secreted the highest levels of TIMP-1, although this difference was not statistically significant. Taken together, these observations suggested the multiple roles of MMP-9 and TIMP-1 in progress of inflammation and tissue damage and/or in repair, depending on clinical stages of SLE.     

外周血CD19+B细胞PD-L1的表达与系统性红斑狼疮发病的相关性分析

目的:探讨程序性死亡配体1(Programmed death ligand-1,PD-L1)在系统性红斑狼疮(Systemic lupus erythema-tosus,SLE)患者外周血B细胞上的表达及临床意义。方法:应用流式细胞仪检测51例SLE患者和38例健康对照者外周血CD19+B细胞表面PD-L1的表达水平,比较SLE稳定组、活动组和健康对照组以及狼疮肾炎组和无狼疮肾炎组之间CD19+B细胞表面PD-L1表达阳性细胞的百分比,并分析其与临床表现及实验室检查数据的相关性。结果:SLE活动组和稳定组CD19+PD-L1+B细胞百分率均低于健康对照组,活动组又低于稳定组,差异均有统计学意义(均P<0.05)。狼疮肾炎患者CD19+PD-L1+B细胞百分率低于无狼疮肾炎患者(P<0.05)。SLE患者CD19+PD-L1+B细胞百分率与SLEDAI评分、尿蛋白定量、呈负相关,与C3呈正相关。SLE患者中抗dsDNA抗体、抗Sm抗体、抗U1snRNP抗体、抗核小体抗体阳性组外周血B细胞PD-L1表达水平均低于对应阴性组,且均有统计学意义(均P<0.05)。结论:SLE患者外周血CD19+B细胞表达PD-L1下降,与病情活动性和抗体产生有很好的相关性。     

系统性红斑狼疮病人血T,B淋巴细胞Bcl—2的表达

目的：探讨Ｂｃｌ－２在系统性红斑狼疮（ＳＬＥ）发病机制中作用。方法：采用流式细胞仪双标记法检测３１例ＳＬＥ病人外周血Ｔ、Ｂ细胞Ｂｃｌ－２蛋白表达。结果：发现活动期ＳＬＥ病人活动期ＳＬＤ病人ＣＤ３＾＋、ＣＤ４＾＋和ＣＤ８＾＋Ｔ细胞Ｂｃｌ－２蛋白表达明显高于非活动期ＳＬＥ病人、其他疾病组和正常对照组。ＣＤ１９＾＋Ｂ细胞Ｂｃｌ－２蛋白表达在各组之间并无统计学差异。ＣＤ３＾＋Ｔ细胞Ｂｃｌ－２蛋白表达的平均     

Detecting Epstein-Barr virus DNA from peripheral blood mononuclear cells in adult patients with systemic lupus erythematosus in Taiwan

Epstein-Barr virus (EBV) has been found by many serology studies to be associated with systemic lupus erythematosus (SLE). However, the results of DNA studies have been conflicting. Therefore, instead of antibody to EBV, we studied the association between EBV DNA and SLE. In this case-control study in Taiwan, we enrolled 87 SLE patients and 174 age- and sex-matched controls. Peripheral blood mononuclear cells of SLE patients and matched controls were tested for EBV DNA by polymerase chain reaction (PCR) and Southern blot. Of the 87 SLE patients, 71 (81.6%) were found to be positive for EBV DNA, while 85 (48.9%) of the 174 controls (odds ratio 4.64, 95% confidence interval 2.50–8.62, P<0.0001) were positive. While the EBV DNA-positive rate did not decline with age in SLE patients (P>0.05), it did decline with age in controls (P<0.05). Furthermore, based on a real-time quantitative PCR study, we have found a significant difference between EBV viral load in SLE and controls (P=0.008). Therefore, in our molecular study of DNA level, we found evidence for the association of EBV infection and SLE, suggesting that EBV contributes, if not to the development of SLE, then to disease perpetuation.     

系统性红斑狼疮患者外周血白细胞介素15的研究

目的：检测系统性红斑狼疮（SLE）患者血清白细胞介素15（IL-15）水平及外周血单个核细胞（PBMC）IL-15mRNA表达，并进一步分析其临床意义。方法：IL-15检测采用ELISA方法；PBMCIL-15mRNA表达采用原位杂交法检测。结果：①SLE组患者血清IL-15水平显著高于正常对照组（P〈0．01），活动期SLE患者血清IL-15水平显著高于缓解期患者（P〈0．05）。②发生临床肾损害者IL-15水平明显高于无肾损害者（P〈0．05），出现血清抗dsDNA抗体阳性、低补体C3血症、高IgG血症者血清IL-15水平均分别显著高于无上述表现者。③SLE患者PBMCIL-15mRNA表达量明显高于正常对照组（P〈0．05），活动期SLE显著高于缓解期（P〈0．05）。④SLE患者PBMC培养上清IgG、IgM和抗dsDNA抗体浓度均显著高于正常对照组；SLE患者PBMCIL-15mRNA表达量与细胞培养上清的IgG及抗dsDNA抗体滴度均呈正相关关系（分别为r=0．645和r=0．715，P〈0．05），而与IgM．无相关关系（r=0．451，P〉0．05）。⑤SEE患者PBMCIL-15mRNA表达量与血清IL-15水平呈正相关关系（r=0．726，P〈0．05）。结论：SLE患者存在外周血IL-15蛋白和基因表达异常，且与其分泌免疫球蛋白和自身抗体有关，提示IL-15可能参与SLE的病理生理过程。     

茯苓多糖对系统性红斑狼疮患者Th17/Treg平衡的影响

目的:研究茯苓多糖对系统性红斑狼疮(SLE)患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡的免疫调节作用。方法:选取45例SLE患者和35例健康对照者,应用磁珠分选法分离外周血CD4~+ T细胞,流式细胞术检测CD4~+ T细胞中Th17和Treg细胞的比例。用茯苓多糖分别处理健康对照者及患者的CD4~+ T细胞,MTT法检测细胞活力以测定茯苓多糖毒性,ELISA检测细胞中白细胞介素17(IL-17)、IL-6、IL-10及转化生长因子β(TGF-β)的含量,RT-q PCR和Western blot法分别测定维甲酸相关孤儿受体γt(RORγt)与叉头框蛋白P3(Foxp3)的mRNA和蛋白表达水平。结果:与健康对照组相比,SLE患者的Th17细胞比例显著升高,Treg细胞比例明显降低(P0.05)。用100μg/L的茯苓多糖处理SLE患者CD4~+ T细胞,与空白对照组相比,IL-17和IL-6的含量显著降低,IL-10和TGF-β的含量明显上升(P0.05);RORγt的mRNA和蛋白表达显著下降,同时Foxp3的表达在mRNA和蛋白水平上明显增加(P0.05);并且Th17/Treg的比值降低(P0.05)。结论:茯苓多糖可以通过升高Treg并降低Th17细胞的比例,对SLE起到一定的治疗作用。     

Th17细胞在系统性红斑狼疮免疫炎症反应中的作用机制研究

目的从Th17/Treg、IL-17及RORγt mRNA表达3方面进行研究,探讨Th17细胞在SLE免疫炎症反应中的作用机制。方法研究对象为26例活动期SLE患者、16例非活动期SLE患者和20例正常对照,采用细胞内染色流式细胞术检测Th17/Treg,ELISA法检测IL-17及RT-PCR法检测RORγt mRNA表达,并探讨它们与SLE疾病活动性的关系。结果活动期SLE患者组Th17/Treg、IL-17及RORγt mRNA表达水平显著高于非活动期及正常对照组;非活动期SLE患者组RORγt mRNA表达显著高于正常对照组,但两组间Th17/Treg、IL-17水平无显著差异。SLE患者Th17/Treg、IL-17及RORγt mRNA表达水平均与和SLEDAI呈正相关。结论 SLE患者存在着Th17细胞高表达现象,阻断Th17细胞分化的上游或下游均可能减轻SLE的免疫炎症反应而达到治疗SLE的目的。     

催乳素与系统性红斑狼疮Th1/Th2型细胞因子分泌异常

系统性红斑狼疮(SLE)是多种因素相互作用引起的自身免疫性疾病,其发病机制复杂。近年来,随着对神经内分泌免疫网络的研究和认识日渐增多加深,发现催乳素(PRL)与多种自身免疫性疾病相关,如SLE、类风湿性关节炎、干燥综合征等,其中与SLE的关系最引人注目,但具体作用机制还未明确。PRL作为一个自分泌/旁分泌的细胞因子,在细胞因子网络中起着重要的作用,影响其他细胞因子的产生。分别从SLE与Th1/Th2型细胞因子分泌异常、PRL与Th1/Th2细胞因子分泌异常、SLE与PRL的关系等作简要的分析非常重要。     

喘可治注射液对人外周血单个核细胞Th1/Th2细胞因子谱的影响

目的：通过研究喘可治注射液对人外周血单个核细胞（PBMCs）Th1／Th2细胞因子谱的影响，探讨喘可治注射液的免疫调节作用机制。方法：以流式微球分析（CBA）法检测不同处理情况下，人外周血单个核细胞分泌Th1（IFN-γTNF-α、IL-2）和Th2（IL4、IL-6、IL-10）细胞因子水平。结果：健康人PBMCs体外培养12小时后，上清中细胞因子主要为TNF-α和IL-6，喘可治使Th1和Th2细胞因子全面升高；喘可治对PDB加离子霉素诱导的PBMCs分泌Th1和Th2细胞因子具有抑制作用，并能抑制流感病人异常升高的INF-γ、TNF-α、IL-6和IL-10分泌。结论：喘可治注射液上调健康人PBMCs分泌TH1和Th2细胞因子，对异常活化的PBMCs分泌的Th1和Th2细胞因子则具有下调作用。     

系统性红斑狼疮患者外周血单个核细胞miR-125b及miR-145的表达及临床意义

目的探讨miR-125b及miR-145在系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中的表达水平及其临床意义。方法选取海南省人民医院收治的136例SLE患者,采用SLE病情活动指数(SLEDAI)评分将其分为低活动组(n=75)和高活动组(n=61),另选取60例健康体检者作为对照组。采用实时定量PCR(RT-PCR)法检测各组PBMC中miR-125b及miR-145水平,分析其对SLE患者的诊断价值。Pearson相关分析SLE患者miR-125b及miR-145水平与抗双链DNA(dsDNA)抗体、C3、C4、IgG、血沉(ESR)、C反应蛋白(CRP)及SLEDAI评分的相关性。结果 SLE组、高活动组和低活动组抗dsDNA抗体、ESR、IgG及CRP水平均明显高于对照组(P<0.05),而C3及C4水平均明显低于对照组(P<0.05)。SLE组、高活动组和低活动组PBMC中miR-125b(0.84±0.23、0.42±0.09和1.53±0.28 vs 6.12±1.83)及miR-145(0.68±0.17、0.35±0.06和1.12±0.20 vs 2.15±0.64)表达水平均明显低于对照组(P<0.01),且高活动组PBMC中miR-125b(0.42±0.09 vs 1.53±0.28)及miR-145(0.35±0.06 vs1.12±0.20)表达水平明显低于低活动组(P<0.01)。SLE患者治疗后miR-125b(2.60±0.71 vs 0.84±0.23)及miR-145(1.96±0.58 vs 0.68±0.17)表达水平明显高于治疗前(P<0.01),SLE患者治疗后抗dsDNA抗体(96.24±17.20 vs 272.36±64.35)水平明显低于治疗前(P<0.01)。ROC曲线分析显示,miR-125b、miR-145及抗dsDNA抗体三项联合诊断SLE的AUC(95%CI)为0.928(0.871～0.986),其敏感度(90.4%)和特异度(85.0%)较好。相关分析显示,SLE患者miR-125b、miR-145与抗dsDNA抗体、IgG、SLEDAI评分均呈负相关(P<0.05),miR-125b与miR-145呈明显正相关(r=0.805,P<0.05)。结论 miR-125b及miR-145水平在SLE患者PBMC中明显降低,且与SLE病情活动相关,联合抗dsDNA抗体检测对SLE诊断具有一定价值。     

Expression of BAFF and BR3 in patients with systemic lupus erythematosus

The objective of this study was to examine the relationship between the expression ofB cell activating factor (BAFF) and BAFF receptor in patients with disease activityof systemic lupus erythematosus (SLE). Real-time RT-PCR was used to examine BAFF mRNAexpression in peripheral blood monocytes of active and stable SLE patients andhealthy controls. The percentage of BAFF receptor 3 (BR3) on B lymphocytes wasmeasured by flow cytometry. Soluble BAFF levels in serum were assayed by ELISA.Microalbumin levels were assayed by an automatic immune analysis machine. BAFF mRNAand soluble BAFF levels were highest in the active SLE group, followed by the stableSLE group, and controls (P<0.01). The percentage of BR3 on B lymphocytes wasdownregulated in the active SLE group compared with the stable SLE group and controls(P<0.01). BAFF mRNA levels and soluble BAFF levels were higher in patients whowere positive for proteinuria than in those who were negative (P<0.01). Thepercentage of BR3 on B lymphocytes was lower in patients who were positive forproteinuria than in those who were negative (P<0.01). The BAFF/BR3 axis may beover-activated in SLE patients. BAFF and BR3 levels may be useful parameters forevaluating treatment.     

Nifedipine suppresses Th1/Th2 cytokine production and increased apoptosis of anti-CD3 + anti-CD28-activated mononuclear cells from patients with systemic lupus erythematosus via calcineurin pathway

Increased Ca²⁺ influx is found in mononuclear cells (MNC) of patients with systemic lupus erythematosus (SLE). The role of calcineurin and potential implication of calcium channel blocker to suppress the abnormal Ca²⁺ influx in SLE remain to be determined. In the present study, we found that the expression and phosphatase activity of calcineurin, but not calcineurin inhibitor in SLE-MNC were greater than normal MNC. Functionally, 1 μM nifedipine could suppress SLE-MNC IFN-γ secretion but 10 μM nifedipine was required for suppressing that of normal MNC. IL-10 secretion by both SLE-MNC and normal MNC was suppressed by 1 μM nifedipine. However, high dose of nifedipine (50 μM) suppressed NFATc1 activation in SLE-MNC and enhanced apoptosis of anti-CD3 + anti-CD28-activated SLE-MNC irrelevant to expression of Fas ligand. These data suggest that SLE-MNC overexpressed calcineurin and hyper-responded to L-type Ca²⁺ channel blocker-mediated apoptosis and cytokine suppression. We proposed that L-type Ca²⁺ channel blocker maybe a potential medication for controlling SLE.