北京大学学报(医学版) ›› 2017, Vol. 49 ›› Issue (5): 829-834. doi: 10.3969/j.issn.1671-167X.2017.05.015
刘洪江1, 石连杰2, 胡凡磊1, 姚海红1, 栗占国1, 贾园1
LIU Hong-jiang1, SHI Lian-jie2, HU Fan-lei1, YAO Hai-hong1, LI Zhan-guo1, JIAYuan1
摘要: 目的 检测趋化因子配体19(C-C chemokine ligand 19, CCL19)在系统性红斑狼疮(systemic lupus erythematosus, SLE)患者血清中的表达,并分析其与SLE患者临床和实验室指标的关系,探讨CCL19在SLE发病机制中的可能作用。方法 采用酶联免疫吸附试验(enzyme linked immunosorbent assay, ELISA)法检测90例SLE患者(未接受过糖皮质激素和免疫抑制剂治疗的初治患者15例,曾治疗过的患者75例)和30名健康对照血清中CCL19的表达水平,分析SLE患者血清CCL19水平与临床特征和实验室指标的相关性。利用流式细胞术检测SLE患者B细胞及其亚群的比例,并进行血清CCL19水平与B细胞及其亚群比例的相关性分析。数据分析采用独立样本t检验、配对t检验、Pearson和Spearman相关分析。结果 (1)SLE初治患者和经治患者血清CCL19表达水平[分别为(596.25±409.19) ng/L和(422.90±395.84) ng/L]显著高于健康对照组[(157.79±125.23) ng/L,P均<0.001],初治患者组血清CCL19表达水平又高于经治患者组(P<0.05);(2)SLE患者血清CCL19表达水平与抗双链脱氧核糖核酸(double-stranded deoxyribonucleic acid, dsDNA)抗体、抗核小体抗体(anti-nucleosome antibody, AnuA)水平呈正相关(分别为r=0.38, P=0.007; r=0.332, P=0.029),与免疫球蛋白IgA、IgG、IgM水平呈正相关(分别为r=0.30, P=0.005; r=0.31, P=0.003; r=0.469, P=0.0001);(3)SLE有光过敏、关节炎和继发干燥综合征患者血清CCL19表达水平[分别为(562.25±399.12) ng/L、(565.6±435.24) ng/L和(694.9±531.02) ng/L]分别较无光过敏、无关节炎和未继发干燥综合征SLE患者高[分别为(394.7±281.42) ng/L、(385.90±325.33) ng/L和(424.8±305.46) ng/L],P均<0.05;(4)血清CCL19水平与外周血CD27-B 细胞和CD27-IgD-双阴性记忆性 B 细胞的比例呈正相关(分别为r=0.519, P=0.007; r=0.461, P=0.018),与CD27+记忆性B细胞和CD27+IgD-转化后记忆性B细胞的比例呈负相关(分别为r=-0.433, P=0.027; r=-0.616, P=0.001)。结论 SLE患者血清中高表达CCL19,与自身抗体的产生显著相关,CCL19可能通过影响B细胞亚群分布的内稳态参与SLE发病。
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