可诱导共刺激分子配体在系统性红斑狼疮血清中水平及临床意义

目的 探讨可诱导共刺激分子配体（inducible costimulator molecule ligand，ICOSL）在系统性红斑狼疮（systemic lupus erythematosus，SLE）患者血清表达水平变化，并分析其临床意义。方法 纳入2015年3月1日~2015年8月31日安徽医科大学第一附属医院、第二附属医院的风湿科和肾脏科住院治疗的34例活动性SLE、15例非活动性SLE患者和33例年龄、性别相匹配的健康志愿者，酶联免疫吸附试验（enzyme-linked immunosorbent assay，ELISA）法检测血清标本可溶性ICOSL（sICOSL）水平。结果 与健康对照组相比，SLE、狼疮肾炎（lupus nephritis，LN）、活动组血清sICOSL水平降低（P₁=0.004；P₂=0.008；P₃=0.003）；但血清sICOSL水平与SLE疾病活动度、anti-dsDNA滴度、补体C3、补体C4、血沉、24小时尿蛋白、血肌酐、尿素氮均无相关性（均有P>0.05），并且实验室指标阳性组与阴性组sICOSL的血清水平差异均无统计学意义（均有P>0.05）。此外，糖皮质激素或者免疫抑制剂的应用并未对血清sICOSL水平产生影响（t=-0.69，P=0.495）。结论 SLE患者血清ICOSL表达水平降低，提示其可能参与了SLE的发生、发展，但其具体机制尚未明确，需要进一步研究。

Serum levels and clinical significance of soluble ICOSL in patients with systemic lupus erythematosus

Objective To investigate the serum levels of soluble inducible costimulator molecules ligand (ICOSL) in patients with systemic lupus erythematosus (SLE).Methods Serum levels of soluble ICOSL (Sicosl) were measured by enzyme linked immunosorbent assay (ELISA) using plasma samples from 49 SLE patients with or without active lupus and 33 healthy subjects.Results The levels of sICOSL in patients with SLE,lupus nephritis (LN) or active SLE groups were lower than those in healthy controls (P1 =0.004;P2 =0.008;P3 =0.003).However,we did not find any correlations between the concentration of sICOSL and disease activity or clinical indicators (anti-dsDNA titer,C3,C4,ESR,Scr,mTP,BUN) (all P ＞ 0.05),and laboratory indexes in positive groups and negative groups did not show difference (all P ＞ 0.05).Moreover,the application of corticosteroids or immunosuppressants did not affect the concentration of the sICOSL in SLE patients (t =-0.69,P =0.495).Conclusions Understanding the role of ICOSL in the occurrence and development of SLE may allow us to develop a promising therapeutic strategy for SLE.