c-FLIP在SLE患者外周血B细胞的表达及与临床特征的相关性研究

目的 探讨SLE患者外周血B细胞凋亡抑制蛋白c-FLIP的表达及其与临床特征的相关性。方法 53例SLE患者和30例正常人对照组，采用流式细胞术检测外周血B细胞c-FLIP表达阳性率，采用ELISA方法检测血清中IL-4和IL-10的水平。结果 活动期SLE患者（18例）外周血B细胞内c-FLIP表达（3.11% ± 0.70%）明显高于非活动期患者（35例）（0.78% ± 0.28%）和正常人对照组（0.68% ± 0.12%）（P均 < 0.05），而非活动期组和正常人对照组比较，差异无统计学意义（t = 1.56，P > 0.05）。SLE患者外周血B细胞c-FLIP的表达与SLEDAI、ESR、C反应蛋白、ANA 滴度均呈正相关（P均 < 0.05）；伴有WBC减少的36例SLE患者中c-FLIP的表达与WBC的数目呈负相关（P < 0.01）。伴有狼疮肾炎的23例SLE患者的外周血B细胞内c-FLIP的表达（3.04% ± 1.09%）明显高于30例不伴狼疮肾炎者（1.76% ± 1.09%）（t = 4.23，P < 0.05）。SLE患者c-FLIP的表达与血清中IL-4和IL-10的水平均呈正相关（P均 < 0.01）。结论 活动期SLE患者外周血B细胞c-FLIP高表达，且与SLE病情严重程度正相关。同时其表达水平与SLE患者血清中IL-4和IL-10水平呈正相关。

Expression of cellular FLICE inhibitory proteins in peripheral blood B lymphocytes in patients with systemic lupus erythematosus

Objective To study the expression of cellular FLICE inhibitory proteins(c-FLIP)in peripheral blood B lymphocytes in patients with systemic lupus erythematosus (SLE)and its correlation with clinical features.Methods Blood samples were obtained from 53 patients with SLE and 30 normal human controls.Flow cytometry and ELISA were performed to measure the expression of c-FLIP in pefipheral blood B lymphocytes and serum levels of IL-4 and IL-10,respectively.Relevant laboratory examinations were carried out for these patients.SLE disease activity index(SLEDAI)score was calculated for patients.Results The positivity rate of c-FLIP in B lymphocytes was 3.11%±0.70%in 18 patients with active SLE.significantly higher than that in 35 patients with inactive SLE (0.78%±0.28%)and normaI controls(0.68%±0.12%),while no statistical difierence was found between inactive patients and controls(t=1.56,P＞0.05).In SLE patients,the expression of c-FLIP showed a positive correlation with SLEDAl score(r=0.96.P＜0.05),erythrocyte sedimentation rate(r=0.96,P＜0.01),serum level of C reactive protein(r=0.92.P＜0.01)and the titer of antinuclear antibodies(r=0.86,P＜0.01),whereas in 36 patients with leucopenia.a negative correlation was noticed between white blood cell count and the expression level of c-FLIP(r=-0.94,P＜0.0 1).The 23 patients with lupus nephritis had a higher level of c-FLIP than those without lupus nephritis(3.04%±1.09%vs 1.76%±1.09%,t=4.23,P＜0.05).Additionally.the expression of c-FLIP positively correlated with the serum level of IL-4 and IL-10(r=0.80,0.89.respectively,both P＜0.01).Conclusions In patients with active SLE,the expression of c-FLIP is upregulated in peripheral blood B lymphocytes,and positively correlated with the severity of SLE as well as the serum level of IL-4 and IL-10.The upregulation of c-FLIP in B cells might play a certain role in deficient apoptosis or clearance of activated B cells in SLE.