胰岛素样生长因子与系统性硬皮病的相关性

  目的  探讨胰岛素样生长因子(insulin-like growth factor, IGF)与系统性硬皮病(systemic sclerosis, SSc)的关系。  方法  采集2010年至2011年北京协和医院皮肤科就诊的24例SSc患者血清, 其中弥漫型SSc 12例, 局限型SSc 12例; 另外采集12名健康对照者及6例系统性红斑狼疮患者血清, 通过ELISA法检测血清IGF系统各因子的表达, 并结合患者临床资料进行分析。  结果  SSc患者血清IGF-Ⅰ和胰岛素样生长因子结合蛋白(insulin-like growth factor binding protein, IGFBP)-3水平高于健康对照组[分别为(49.21±37.94) ng/ml vs.(15.54±9.07) ng/ml和(3.38±2.09) ng/ml vs.(1.00±0.83) ng/ml, P < 0.001], 且SSc患者血清IGF-Ⅰ与IGFBP-3水平呈正相关(r=0.883, P < 0.001)。血清IGF-Ⅰ和IGFBP-3水平与患者年龄、病程、Rodnan皮肤评分不存在相关性。血清IGF-Ⅰ和IGFBP-3水平在Scl-70抗体阳性与阴性SSc患者间及在肺间质纤维化与无肺间质纤维化SSc患者间差异均无统计学意义。SSc患者血清IGF-Ⅱ、IGFBP-5和IGFBP相关蛋白1(IGFBP-related protein 1, IGFBP-rP1)水平与健康对照组比较差异无统计学意义。  结论  SSc患者血清IGF-Ⅰ和IGFBP-3水平升高, IGF系统可能参与了SSc的发病机制。

Relationship between Insulin-like Growth Factor and Patients with Systemic Sclerosis

Objective To analyze the role of insulin-like growth factor （IGF） in patients with systemic sclerosis （SSc） and explore the relationship between these cytokines and the clinical characteristics of SSc. Methods Serum samples were obtained from 24 SSc patients [ 12 patients with diffuse cutaneous SSc （dcSSc） and 12 patients with limited cutaneous SSc （lcSSc） ], 12 healthy controls and 6 patients with systemic lupus erythematosus （SLE）. The levels of circulating IGF- I , IGF-II , insulin-like growth factor binding protein （IGFBP） -3, IGFBP-5, IGFBP-related protein 1 （ IGFBP-rP1 ）, and transforming growth factor-β （ TGF-β1 ） were measured with ELISA kits. Results The mean serum IGF- I and IGFBP-3 levels were significantly higher in SSc patients than in healthy controls [ （49.21 ± 37.94 ） ng/ml vs. （15.54 ± 9.07 ） ng/ml; （3.38 ± 2.09 ） ng/ml vs. （ 1.00 ± 0.83 ） ng/ml, both P 〈 0. 001 ]. A positive correlation between serum IGF- I and IGFBP-3 levels was found （r = 0. 883, P 〈 0. 001 ）. Serum IGF- I and IGFBP-3 levels were not associated with age, disease course, and the modified Rodnan total skin thickness score. There were no significant differences in serum IGF- I and IGFBP-3 levels between patients with Scl-70 antibody and patients without Scl-70 antibody. Also, the serum IGF- I and IGFBP-3 levels showed no significant difference between patients with pulmonary interstitial fibrosis and patients without pulmonary interstitial fibrosis. There were no significant differences in serum IGF-11 , IGFBP-5, and IGFBP-rP1 levels between patients with SSc and healthy controls. Conclusion Serum IGF- I and IGFBP-3 levels increase in SSc patients. IGF may play a role in pathogenesis of SSc.