RhoA参与系统性红斑狼疮发病的相关性研究

本研究旨在探索RhoA在SLE患者中的表达及临床意义。通过RT-PCR方法,检测诊断明确的SLE患者(n=40)与健康对照者(n=58)外周血细胞中RhoA的表达水平,分析其与SLE临床特征及IFN积分的相关性。同健康对照组相比,RhoA在SLE患者的外周血细胞中的表达水平显著升高(P0.000 1),结合临床资料分析提示RhoA的表达水平与SLE疾病活动指数(SLEDAI)及肾脏损害活动指数(Renal-SLEDAI)呈正相关,通过干扰素积分相关性研究,发现RhoA的基因表达与干扰素积分显著正相关。课题组的研究结果表明RhoA与SLE疾病活动性相关,RhoA可能参与了SLE的发病。     

系统性红斑狼疮患者外周血NK细胞TIGIT的表达和意义

目的探讨TIGIT在系统性红斑狼疮(SLE)患者外周血NK细胞上的表达及临床意义,以阐明其在SLE发生和发展中的作用。方法应用流式细胞仪检测44例SLE患者和27例健康对照外周血NK细胞表面TIGIT表达水平,比较SLE组和健康对照组以及SLE稳定组与SLE活动组之间NKT细胞表面TIGIT表达水平,并分析其与实验室检查数据及治疗的相关性。2组间比较采用t检验或者非参数检验,2变量之间相关性采用Pearson相关分析。结果 SLE组NK细胞TIGIT表达百分率显著低于健康对照组(P0.01),SLE组NK细胞TIGIT表达平均荧光强度(MFI)显著低于健康对照组(P0.05),SLE活动组NK细胞TIGIT表达百分率显著低于SLE稳定组(P0.05),而SLE活动组NK细胞TIGIT表达MFI与SLE稳定组之间无差异(P0.05)。SLE患者中抗r RNP抗体阳性组外周血NK细胞TIGIT表达百分率显著低于对应阴性组(P0.05)。SLE患者NK细胞TIGIT表达百分率与C3呈正相关(P0.05),与SLE疾病活动度指数(SLEDAI)呈负相关(P0.05)。经过治疗后SLE患者NK细胞TIGIT表达百分率可明显升高(P0.05)。结论 SLE患者外周血NK细胞TIGIT表达异常,与SLEDAI、自身抗体产生、炎症有明确的相关性。     

四种常见风湿性疾病患者血清中IL-17水平变化的研究

目的:通过对4种常见风湿性疾病患者血清IL-17水平的检测,探讨IL-17在风湿性疾病发病过程中可能存在的意义。方法:采用酶联免疫吸附试验(ELISA)测定了常见四种风湿性疾病及20例正常人血清IL-17水平,同时对其与有关免疫指标进行相关性检验。结果:(1)类风湿关节炎(RA)、系统性红斑狼疮(SLE)、干燥综合征(SS)及强直性脊柱炎(AS)患者血清IL-17水平明显高于正常对照组。(2)RA患者血清IL-17水平与类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平呈显著正相关,与ACR分值呈正相关;AS患者血清IL-17水平与ESR、CRP水平呈显著正相关;SS及SLE患者血清IL-17水平与IgG水平呈正相关,与C3水平呈负相关;SLE患者血清IL-17水平与SLEDAI评分呈正相关。(3)糖皮质激素治疗前后SLE患者血清IL-17水平差异显著,4种常见风湿性疾病患者组间IL-17水平无差异。结论:RA、SLE、AS及SS患者血清IL-17水平明显升高,在疾病活动期尤为明显,提示IL-17可能在风湿性疾病的发生发展中具有重要作用。     

系统性红斑狼疮外周血单个核细胞cFLIP-L mRNA和cFLIP-S mRNA表达的研究

目的 探讨系统性红斑狼疮(system lupus erythematosus,SLE)患者外周血单个核细胞(peripheral blood monouuclear cells,PBMC)中细胞型Fas相关死亡域样白介素-1β转换酶抑制蛋白(cFLIP)表达的意义.方法 应用半定量RT-PCR方法检测38例SLE患者和21名正常人PBMC中cFLIP-L mRNA和cFLIP-S mRNA的表达水平,并与SLE疾病活动指数(SLEDAI)评分进行相关性分析.结果 ① SLE患者PBMC中cFLIP-L mRNA和cFLIP-S mRNA表达水平均明显高于正常对照组(P＜0.01);SLE患者活动组cFLIP-L mRNA表达水平显著高于非活动组(P＜0.05),cFLIP-S mRNA表达水平在SLE患者活动组与非活动组之间没有显著性差异(P＞0.05). ② SLE患者cFLIP-L mRNA表达水平与SLEDAI评分呈正相关(r=0.423,P＜0.01);而cFLIP-S mRNA表达水平与SLEDAI评分无明显相关性(r=0.270,P＞0.05).结论 cFLIP-L mRNA和cFLIP-S mRNA可能在SLE发病机制中起重要作用.     

系统性红斑狼疮患者血中sCD30L的变化及其临床意义

目的:通过检测系统性红斑狼疮(SLE)患者血清中可溶性CD30配体(sCD30L)的表达水平, 探讨其水平变化及在疾病发病中的作用.方法:选取符合1982年美国风湿病学会制定的SLE诊断标准的45例SLE患者, 另选20例健康人作对照, 采取双抗体夹心ELISA方法检测SLE组及对照组血清中的sCD30L的水平, 同时检测临床相关指标, 分析sCD30L在各组患者血中的变化及其与临床各指标的相关性.结果:SLE 血清sCD30L水平为(21.20±10.90)μg/L, 显著高于正常对照组水平;(6.45±1.17)μg/L, P<0.01].SLE血清sCD30L水平与ds-DNA, 尿α1, SLEDAI评分呈正相关(r=0.324, P<0.05;r=0.658, P<0.05;r=0.486, P<0.05), 特别是在SLEDAI评分大于10分和早期狼疮性肾炎的患者中相关性更强(r=0.508, P<0.01;r=0.715, P<0.01).SLE患者血清sCD30L水平明显升高, 其升高水平与ds-DNA, 尿α1, SLEDAI评分呈正相关.结论:sCD30L的表达异常可能是SLE 发病的重要环节, 在一定程度上反映疾病活动, 特别在早期狼疮性肾炎的发病及诊断中起重要作用.     

系统性红斑狼疮患者外周血CD4+和CD8+T细胞PD-1的表达和意义

目的 探讨程序性死亡分子1 (PD-1)在系统性红斑狼疮(SLE)患者外周血CD4+和CD8+T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T细胞亚群表面PD-1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CD4+和CD8+T细胞表面PD-1表达的百分比,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CD4+T细胞PD-1表达水平高于健康对照组和不活动组,差异均有统计学意义(P＜0.05).SLE活动组、稳定组CD8+T细胞PD-1表达水平均高于健康对照组,差异有统计学意义(P＜0.05).狼疮肾炎患者CD4+PD-1+和CD8+PD-1+T细胞分别高于无狼疮肾炎患者(P＜0.01).SLE患者中抗dsDNA抗体、抗Sm抗体、抗核小体抗体阳性组外周血CD4+和CD8+T细胞PD-1表达水平均高于对应阴性组.SLE患者CD4+和CD8+T细胞PD-1表达百分率与SLE疾病活动度指数(SLEDAI)、尿蛋白定量呈正相关,与补体C3呈负相关.结论 SLE患者外周血CD4+和CD8+T细胞PD-1表达异常,与SLEDA1和自身抗体产生有明确的相关性.     

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PBMCs c-myc mRNA的表达及其与疾病活动性相关性研究

目的:探讨系统性红斑狼疮(SLE)外周血单个核细胞(PBMCs)的c-myc mRNA表达在SLE发病中的作用.方法:从33例SLE患者及20例健康对照组外周静脉血中分离PBMCs,提取总RNA作模板,按文献设计合成c-myc引物,以β-actin作内参,应用半定量逆转录-聚合酶链反应(RT-PCR)检测SLE患者及健康对照的PBMCs c-myc mRNA表达水平并进行组间比较,用系统性红斑狼疮疾病活动性指数(SLEDAI)评定每例患者疾病活动性,并对SLE患者PBMCs的c-myc mRNA表达水平与SLEDAI进行相关分析.结果:c-myc及β-actin的RT-PCR扩增产物电泳显示分别为268和163 bp条带.SLE患者PBMCs的c-myc mRNA相对表达量为0.58±0.26,而正常对照的相对表达量为0.07 ±0.04,两组差别有显著性(t'=11.024,P=0.000).25例活动期SLE患者的c-myc mRNA相对表达量为0.62±0.25,而8例缓解稳定期SLE患者的c-myc mRNA相对表达量为0.25 ±0.01,组间差别也有显著性(t'=7.86,P=0.000).SLE患者PBMCs的c-myc mRNA相对表达量与SLEDAI呈正相关(r =0.865 1,P＜0.05).结论:SLE患者PBMCs的c-myc mRNA表达异常,c-myc mRNA表达水平与SLE疾病活动评分指数呈直线正相关关系.c-myc mRNA表达水平可作为判断SLE疾病活动性的一个指标.     

嘌呤核苷磷酸化酶与系统性红斑狼疮发病的相关性研究

嘌呤核苷磷酸化酶(PNP)介导嘌呤降解,异常时会影响DNA合成。本研究探讨PNP与SLE发病的相关性。检测了诊断明确的42例系统性红斑狼疮患者和48例正常对照者PBMC、12例狼疮肾炎患者肾穿样本和10例肾癌患者癌旁正常肾脏样本中PNP的表达格局,继而分析了PNP与SLE患者的临床表现。由于I型干扰素通路的异常活化在SLE发病中起重要作用,因此本研究还分析了PNP表达与干扰素积分的相关性。结果表明:与正常人相比,狼疮病人PBMC和肾脏组织中PNP表达水平均显著性降低。进一步通过干扰素积分相关性分析发现,狼疮肾炎患者肾脏组织PNP的表达水平与干扰素积分呈负相关,提示PNP可能参与I型干扰素通路的调节。本研究表明狼疮患者PNP表达异常,可能参与SLE的发病。     

系统性红斑狼疮患者外周血淋巴细胞CD1c的表达

目的 :研究系统性红斑狼疮 (SLE)患者外周血淋血细胞CD1c的表达情况及与疾病活动性之间的关系。方法 :用流式细胞仪检测了 4 7例SLE患者外周血淋巴细胞CD1c的表达及淋巴细胞表型分析 ,并评价与疾病活动性的关系。结果 :SLE活动组病人CD1c 细胞百分率显著增高 (P <0 0 5 ) ,CD4 细胞百分率显著降低 (P <0 0 1) ,CD3 、CD8 细胞百分率正常 ,CD2 0 细胞数增高 (P <0 0 1)。稳定期病人CD1c 细胞百分率正常 ,CD4 、CD8 、CD2 0 细胞百分率均正常。SLE患者CD1c细胞阳性率与患者SLEDAI的评分有显著的相关性 (r=0 6 8,P <0 0 1) ,与抗dsDNA抗体的表达有显著相关性 (r =0 36 ,P <0 0 5 ) ,与抗心磷脂抗体的表达有显著的相关性 (r=0 6 4 ,P <0 0 1) ,与血清C3水平有显著相关性 (r =- 0 35 ,P <0 0 5 )。活动期病人经治疗后CD1c的表达明显下降。结论 :系统性红斑狼疮患者外周血CD1c表达与疾病的活动性明显相关 ,CD1c可能在SLE脂类抗原及核酸类抗原的递呈及抗双链DNA抗体、抗磷脂抗体的产生中起重要作用。     

Peripheral circulating activated b-cell populations are associated with nephritis and disease activity in patients with systemic lupus erythematosus

B-cell-dependent autoantibody production is a hallmark of systemic lupus erythematosus (SLE) which requires costimulatory molecules. The aim of the study was to analyse the expression of costimulatory molecules on B cells in patients with SLE. Twenty-six patients with SLE (four male, 22 female, mean age 46 +/- 15 years) as defined by the American College of Rheumatology criteria and 13 healthy controls (three male, 10 female, mean age 43 +/- 15 years) were included in the study. In a subgroup analysis, SLE patients were divided according to renal involvement due to SLE (10 with and 16 patients without renal involvement). Clinical disease activity was assessed according to the systemic lupus erythematosus disease activity index (SLEDAI). Blood B-cell populations were analysed by FACS for the cell surface marker expression of CD27, CD38, CD71, CD80, CD86 and CD137 ligand. The expression levels of CD71, CD80 and CD86 on B cells were significantly enhanced in SLE patients when compared with healthy controls (27 +/- 3% versus 11 +/- 2%, P = 0.0003, 55 +/- 2% versus 28 +/- 4%, P < 0.0001, 34 +/- 3% versus 12 +/- 2%, P < 0.0001). CD86 expression was significantly elevated in patients with renal involvement when compared with patients without renal disease (43 +/- 6% versus 28 +/- 3%, P < 0.05). There was a significant correlation between the expression levels of CD80 and CD86 on CD19(+) B cells and disease activity. Moreover, prednisone dose significantly correlated with SLEDAI (r = 0.5, P = 0.02) and with the expression levels of CD86 (r = 0.47, P = 0.02). A pathological B-cell population is associated with disease activity and renal involvement in SLE which are obviously resistant to therapy with medium doses of prednisone.     

Increased CCR4 expression on circulating CD4(+) T cells in ankylosing spondylitis, rheumatoid arthritis and systemic lupus erythematosus

Previous studies have suggested that CCR4 is particularly important in the selective recruitment of various subsets of leucocytes in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). In this study, we examined the percentage of CD4(+)/CCR4(+) T cells within circulating lymphocytes in active ankylosing spondylitis (AS), RA and SLE patients. The clinical significance of CCR4 expression as well as possible associations between the expression and serum levels of tumour necrosis factor (TNF)-alpha, interferon (IFN)-gamma and interleukin (IL)-10 were also examined. Our results showed that the percentage of CD4(+)/CCR4(+) T cells was significantly elevated in AS and RA patients as compared with normal controls. The percentage was also significantly higher in SLE patients who had received no treatment with glucocorticoids or cytotoxic drugs (untreated SLE) than that in controls. In addition, the percentage of CD4(+)/CCR4(+) T cells showed significant positive correlations with the Bath ankylosing spondylitis disease activity index (BASDAI) in AS and with the SLE disease activity index (SLEDAI) in untreated SLE. Of all the cytokines examined, the elevated serum IL-10 level was closely correlated with the percentage of CD4(+)/CCR4(+) T cells in AS, RA and untreated SLE. These results suggest that CCR4 may be crucial in the pathogenesis of AS, RA and SLE. The percentage of CD4(+)/CCR4(+) T cells can serve as a useful marker for the activity of AS and untreated SLE.     

Increased prevalence of transfusion-transmitted virus and cross-reactivity with immunodominant epitopes of the HRES-1/p28 endogenous retroviral autoantigen in patients with systemic lupus erythematosus

OBJECTIVE: Systemic lupus erythematosus (SLE) patients produce autoantibodies to HRES-1/p28, a human endogenous retrovirus-encoded nuclear protein. To identify cross-reactive viral antigens capable of triggering autoreactivity, HRES-1/p28 epitopes were mapped by SLE antibodies. METHODS: Forty-four peptides overlapping HRES-1/p28 and 13 viral peptides were synthesized on cellulose membrane and tested for recognition by antibodies from 16 HRES-1 Western blot seropositive SLE patients. Transfusion-transmitted virus (TTV) was detected by gene amplification in sera of 211 SLE patients, 78 healthy SLE family members, 199 unrelated healthy donors, and 91 rheumatoid arthritis (RA) patients. RESULTS: HRES-1/p28 residues 41-55, 121-135, and 156-170 were recognized by 12/16 (75.0%), 11/16 (68.8%), and 9/16 lupus sera (56.25%) and considered immunodominant. HRES-1/p28 residues 121-135 harbor cross-reactive epitope with retroviral peptides and the 70 K U1snRNP lupus autoantigen. HRES-1/p28 residues 41-55 and 156-170 exhibited the highest prevalence of cross-reactivity with TTV peptide ORF2a (14/16, 87%). Prevalence of TTV DNA was increased in lupus patients (120/211) with respect to healthy (66/199; P < 0.0001) or RA controls (23/91; P < 0.0001). TTV prevalence in healthy lupus relatives (40/78) was decreased with respect to lupus patients (80/121; P = 0.0184) and increased with respect to unrelated healthy donors (66/199; P = 0.0026). HRES-1/p28 Western blot reactivity was observed in 12/23 TTV PCR-negative donors and 43/58 TTV PCR-positive donors (P < 0.0281). CONCLUSIONS: Increased prevalence of TTV and molecular mimicry with HRES-1/p28 may contribute to generation of antinuclear antibodies and pathogenesis of SLE.     

DNA levels in circulating immune complexes decrease at severe SLE flares-correlation with complement component C1q.

The objective of this study was to investigate the relationship of DNA content in circulating immune complexes with disease course and activity in SLE. The DNA content in circulating immune complexes containing anti-DNA antibodies of IgG class was determined in serial samples from 28 patients with SLE by a quantitative immunochemical assay. The patients presented various active disease manifestations over 5-55 months. Disease activity (SLEDAI-score), drug treatment and ACR-criteria were recorded. Levels of anti-dsDNA, CRP, leukocytes, complement components C3, C4 and C1q were measured. Patients with severe flares and high SLEDAI scores had low Clq levels at onset of active disease manifestations. The patients with low C1q serum levels during flare (n=13) had significantly lower amounts of DNA in immune complexes than patients with normal Clq (P=0.001). Levels of DNA in immune complexes correlated with Clq at flares (r=0.62, P<0.0001) and correlated inversely with SLEDAI scores (r=-0.47, P=0.012). In conclusion, the low levels of DNA in circulating immune complexes found in severely ill SLE patients with concomitantly low serum concentrations of Clq prior to flares might be related to tissue deposition of immune complexes.     

CD134 expression on CD4+ T cells is associated with nephritis and disease activity in patients with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is characterized by a deviation of the immune system that involves T cell-dependent autoantibody production. The aim of this study was to investigate the role of co-stimulatory markers on T cells in this disease. Twenty-eight patients with SLE as defined by the American College of Rheumatology (ACR) criteria and 11 healthy controls were included into the study. Eleven patients had biopsy-proven lupus nephritis while 17 patients had no clinical evidence of lupus nephritis. Clinical disease activity was assessed according to the systemic lupus erythematosus disease index (SLEDAI). CD4+ T cell populations in the peripheral blood were analysed for the expression of co-stimulatory markers CD45RO, CD70, CD80, CD86, CD137, CD137L, CD134, CD152, CD154 and ICOS. SLE patients showed an increased frequency of peripheral CD4+ T cells expressing high levels of CD80, CD86 and CD134 compared to healthy controls (7.1 +/- 1.5% versus 1.7 +/- 0.9%; P < 0.005; 2.3 +/- 0.4% versus 1.0 +/- 0.2%; P = 0.008, 20.2 +/- 2.0% versus 10.6 +/- 1.9%; P < 0.005, respectively). Significantly higher levels of CD80 on CD4+ T cells were detected in SLE patients with lupus nephritis compared to patients without nephritis (11.9 +/- 3.3% versus 4.0 +/- 0.7%; P < 0.005). There was an increased presence of CD134+ CD4+ cells in SLE patients with lupus nephritis (27.5 +/- 4.0% versus 15.5 +/- 1.3%; P < 0.005). CD80 and CD134 expression was significantly correlated with SLEDAI (r = 0.42, P = 0.03; r = 0.56, P < 0.005). Co-stimulatory molecules on CD4+ T cells are associated with renal disease and disease activity in patients with systemic lupus erythematosus.     

类风湿关节炎外周血单核细胞亚群CD64表达及意义

目的：探讨CD64在类风湿关节炎（RA）患者外周血单核细胞亚群上的表达及临床意义,以阐明其在RA发生和发展中的作用。方法：应用流式细胞仪检测44例RA患者和22例正常对照者外周血单核细胞亚群的比例及其CD64的表达,比较RA组和正常对照组之间各单核细胞亚群的比例及其表面CD64表达水平,并分析各单核细胞亚群表面CD64表达与实验室检查数据的相关性。两组间比较采用t检验或者非参数检验,两变量之间相关性采用Pearson或Spearman相关分析。结果：(1)RA组中间型单核细胞比例高于对照组,差异有统计学意义(P<0.01);RA组经典型单核细胞比例和非经典型单核细胞比例低于对照组(P<0.05),差异有统计学意义。(2)RA组各单核细胞亚群CD64表达(MFI)显著高于对照组,差异有统计学意义(P<0.05)。(3)RA患者外周血经典型单核细胞和中间型单核细胞CD64表达(MFI)与DAS28呈正相关(r_s=0.308,P=0.044;r_s=0.302,P=0.049)。(4)RA患者各单核细胞亚群CD64表达(MFI)与ESR,CRP呈正相关(r_s=0.410,P=0.008;r_s=0.475,P=0.003;r_s=0.448,P=0.003;r_s=0.473,P=0.004;r_s=0.348,P=0.026;r_s=0.340,P=0.042)。(5)RA患者RF阳性组、ACPA阳性组外周血经典型单核细胞、中间型单核细胞上CD64表达(MFI)明显高于对应的阴性组,差异有统计学意义(P<0.05)。(6)中间型单核细胞CD64高表达组血清细胞因子IL-6水平明显升高,差异有统计学意义(P<0.05)。结论：RA患者外周血单核细胞亚群CD64表达异常,经典型单核细胞和中间型单核细胞CD64表达与炎症水平、自身抗体产生和疾病活动性有明确的相关性。以外,中间型单核细胞CD64的表达与细胞因子相关。     

Induction of apoptosis in monocytes and lymphocytes by serum from patients with systemic lupus erythematosus − an additional mechanism to increased autoantigen load?

The most likely source of autoantigens in systemic lupus erythematosus (SLE) is apoptotic material. Because increased levels of circulating apoptotic cells are found in SLE we wanted to investigate the capacity of serum from patients with SLE or other autoimmune or infectious diseases and normal healthy donors (NHD) to induce apoptosis in normal monocytes, lymphocytes and corresponding cell lines, in relation to clinical and immunological data. Monocytes and lymphocytes from healthy donors were incubated with sera from 37 SLE patients, 37 sex- and age-matched NHD and sera from patients with rheumatoid arthritis, vasculitis, sepsis and mononucleosis. Sera from SLE patients were sampled at both active and inactive disease. The apoptosis-inducing effect (AIE) of these sera was monitored with flow cytometry using annexin V and propidium iodide (PI) binding. The AIE in monocytes and lymphocytes was significantly higher in sera from SLE patients than in other patient groups and NHD (P < 0.001) and was also higher when cell lines were used. Level of C5a in cell culture supernatant correlated with AIE in monocytes (r = 0.451, P = 0.005), suggesting involvement of complement. Heat-inactivation of sera did not affect the AIE, nor did depletion of IgG by protein G absorption of serum. Kinetic analyses showed a peak in apoptosis induction at 12-16 h, with a delayed PI positivity. AIE was equally high using sera from active and inactive SLE cases, and did not correlate with the SLE Disease Activity Index (SLEDAI). Thus, SLE serum has a strong and apparently disease-specific apoptosis-inducing capacity, which could contribute to a high load of potential autoantigen.     

系统性红斑狼疮患者血清IL-10的水平及临床意义

目的 观察系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清IL-10的表达与疾病活动的关系.方法 选取22例SLE患者及24名健康人作为对照,根据狼疮疾病活动指数(SLE disease activity index,SLEDAI)将SLE患者分为活动期组和非活动期组,检测血清抗dsDNA抗体,血清总补体溶血活性(CH50)及C反应蛋白(C reactive protein,CRP),酶联免疫吸附法(ELISA)检测血清IL-10表达.结果 与对照组[(18.11±6.97)ng/L]相比,IL-10在SLE活动期组[(78.54±5.62)ng/L,P＜0.01]及非活动期组[(30.36±10.98)ng/L,P＜0.05]均有所增高,活动期组增高更为明显(与非活动期组相比,P＜0.05).IL-10水平与SLEDAI呈正相关(SLE活动期,r=0.77,P＜0.01;SLE非活动期,r=0.84,P＜0.01),IL-10的水平与抗dsDNA抗体(r=0.71,P＜0.01)、CRP(r=0.63,P＜0.01)和CH50(r=-0.56,P＜0.05)均相关.结论 IL-10在SLE患者血清中表达升高,在疾病活动时更为明显,IL-10能反应疾病活动的程度,可以做为临床观察SLE疾病活动的指标之一.     

Elevated production of interleukin-18 is associated with renal disease in patients with systemic lupus erythematosus

To investigate the production mechanism and proinflammatory role of the cytokine interleukin (IL-18) in lupus nephritis, we investigated the plasma concentrations of IL-18 and nitric oxide (NO) and the release of IL-18 and NO from mitogen-activated peripheral blood monomuclear cells (PBMC), in 35 SLE patients with renal disease (RSLE), 37 patients without renal disease (SLE) and 28 sex- and age-matched healthy control subjects (NC). IL-18 and NO concentrations were measured by ELISA and colourimetric non-enzymatic assay, respectively. Gene expressions of IL-18 and IL-18 receptor were analysed by RT-PCR. Plasma IL-18 and NO concentrations were significantly higher in RSLE than NC (both P < 0.01). Elevation of plasma IL-18 in RSLE correlated positively and significantly with SLE -disease activity index and plasma NO concentration (r = 0.623, P < 0.0001 and r = 0.455, P = 0.017, respectively), and the latter also showed a positive and significant correlation with plasma creatinine (r = 0.410, P = 0.034) and urea (r = 0.685, P < 0.0001). There was no significant difference in gene expressions of IL-18 and IL-18 receptor in PBMC among RSLE, SLE and NC. Percentage increase in culture supernatant IL-18 concentration was significantly higher in RSLE than SLE and NC (both P < 0.05). The basal NO release was significantly higher in RSLE than that in SLE and NC (both P < 0.005). IL-18 is therefore suggested to play a crucial role in the inflammatory processes of renal disease in SLE.