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

• 论著 • 上一篇    下一篇

趋化因子配体19在系统性红斑狼疮中的表达及其与B细胞异常的相关性研究

刘洪江1, 石连杰2, 胡凡磊1, 姚海红1, 栗占国1, 贾园1   

  1. 1. 北京大学人民医院风湿免疫科,北京 100044;
    2. 北京大学国际医院风湿免疫科,北京 102206
  • 收稿日期:2015-10-15 出版日期:2017-10-18 发布日期:2017-10-18
  • 基金资助:
    国家自然科学基金(81501396、81302554、31470039、81202343、81401341)资助

Increased serum C-C chemokine ligand 19 levels correlated with B cell abnormalities in systemic lupus erythematosus

LIU Hong-jiang1, SHI Lian-jie2, HU Fan-lei1, YAO Hai-hong1, LI Zhan-guo1, JIAYuan1   

  1. 1.Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China;
    2. Department of Rheumatology and Immunology, Peking University International Hospital, Beijing 102206, China
  • Received:2015-10-15 Online:2017-10-18 Published:2017-10-18
  • Supported by:
    Supported by the National Natural Science Foundation of China (81501396, 81302554, 31470039, 81202343, 81401341)

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。

关键词: 红斑狼疮, 系统性, 趋化因子配体19, B细胞, 自身抗体

Abstract: Objective: To detect the levels of serum C-C chemokine ligand 19 (CCL19) in patients with systemic lupus erythematosus (SLE) and to evaluate the correlation between CCL19 expression and clinical features and laboratory parameters, trying to reveal the possible role of CCL19 in the pathogenesis of systemic lupus erythematosus. Methods: The levels of serum CCL19 were measured by enzyme linked immunosorbent assay (ELISA) in 90 patients with SLE and 30 healthy controls. These SLE patients included 75 patients who received treatment with glucocorticoids and disease-modifying anti-rheumatic drug (DMARD) and 15 patients without therapy. The frequencies of peripheral blood B cells and the B cell subsets were assessed in the patients with SLE by flow cytometry. The correlation between the clinical data, laboratory parameters, B cell subset frequencies and serum CCL19 levels were analyzed. Indepen-dent samples t test, paired t test, Pearson and Spearman correlation were used for statistical analyses. Results: The levels of CCL19 were markedly higher in the SLE patients without therapy and the patients with therapy than in the health controls[(596.25±409.19) ng/L and (422.90±395.84) ng/L vs. (157.79±125.23) ng/L, all P<0.001]. Serum CCL19 levels in the SLE patients without therapy were higher than the SLE patients who accepted glucocorticoids and DMARD treatment (P<0.05). The levels of serum CCL19 were positively correlated with anti-double stranded deoxyribonucleic acid (dsDNA), anti-nucleosome antibody (AnuA), IgA, IgG and IgM (r=0.38, P=0.007; r=0.332, P=0.029; r=0.519, P=0.007; r=0.461, P=0.018, respectively). Serum CCL19 levels in the SLE patients with photosensitivity, arthritis and secondary Sjögren’s syndrome were higher than the SLE patients without photosensitivity, arthritis and secondary Sjögren’s syndrome, respectively [(562.25±399.12) ng/L, (565.6±435.24) ng/L and (694.9±531.02) ng/L vs. (394.7±281.42) ng/L, (385.90±325.33) ng/L and (424.8±305.46) ng/L, all P<0.05]. The levels of serum CCL19 were positively correlated with the percentage of CD27-B cells and CD27-IgD-double-negative memory B cells (r=0.519, P=0.007; r=0.461, P=0.018, respectively). However, the levels of serum CCL19 were negatively correlated with the percentage of CD27+ memory B cells and CD27+IgD- switched memory B cells (r=-0.433, P=0.027; r=-0.616, P=0.001, respectively). Conclusion: The increased serum CCL19 levels in SLE patients were associated with the production of autoantibodies, and CCL19 might be involved in the pathogenesis of SLE by disturbing the homeostasis of B cell subsets.

Key words: Lupus erythematosus, systemic, C-C chemokine ligand 19, B cell, Autoantibody

中图分类号: 

  • R593.24
[1] Wahren-Herlenius M, Dorner T. Immunopathogenic mechanisms of systemic autoimmune disease[J]. Lancet, 2013, 382(9894):819-831.
[2] Dorner T, Giesecke C, Lipsky PE. Mechanisms of B cell autoimmunity in SLE[J]. Arthritis Res Ther, 2011, 13(5): 243.
[3] Sanz I. Rationale for B cell targeting in SLE[J]. Semin Immunopathol, 2014, 36(3): 365-375.
[4] Le Y, Zhou Y, Iribarren P, et al. Chemokines and chemokine receptors: their manifold roles in homeostasis and disease[J]. Cell Mol Immunol, 2004, 1(2): 95-104.
[5] Bachmann MF, Kopf M, Marsland BJ. Chemokines: more than just road signs[J]. Nat Rev Immunol, 2006, 6(2): 159-164.
[6] Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum, 1997, 40(9): 1725.
[7] Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000[J]. J Rheumatol, 2002, 29(2): 288-291.
[8] Lipsky PE. Systemic lupus erythematosus: an autoimmune disease of B cell hyperactivity[J]. Nat Immunol, 2001, 2(9): 764-766.
[9] Jacob N, Stohl W. Autoantibody-dependent and autoantibody-independent roles for B cells in systemic lupus erythematosus: past, present, and future[J]. Autoimmunity, 2010, 43(1): 84-97.
[10] Odendahl M, Jacobi A, Hansen A, et al. Disturbed peripheral B lymphocyte homeostasis in systemic lupus erythematosus[J]. J Immunol, 2000, 165(10): 5970-5979.
[11] Rodriguez-Bayona B, Ramos-Amaya A, Perez-Venegas JJ, et al. Decreased frequency and activated phenotype of blood CD27 IgD IgM B lymphocytes is a permanent abnormality in systemic lupus erythematosus patients[J]. Arthritis Res Ther, 2010, 12(3): R108.
[12] Korganow AS, Knapp AM, Nehme-Schuster H, et al. Peripheral B cell abnormalities in patients with systemic lupus erythematosus in quiescent phase: decreased memory B cells and membrane CD19 expression[J]. J Autoimmun, 2010, 34(4): 426-434.
[13] Blair PA, Norena LY, Flores-Borja F, et al. CD19(+)CD24(hi)CD38(hi) B cells exhibit regulatory capacity in healthy individuals but are functionally impaired in systemic Lupus Erythematosus patients[J]. Immunity, 2010, 32(1): 129-140.
[14] Jin L, Weiqian C, Lihuan Y. Peripheral CD24hi CD27 + CD19 + B cells subset as a potential biomarker in naive systemic lupus erythematosus[J]. Int J Rheum Dis, 2013, 16(6): 698-708.
[15] Yu SL, Kuan WP, Wong CK, et al. Immunopathological roles of cytokines, chemokines, signaling molecules, and pattern-recognition receptors in systemic lupus erythematosus[J]. Clin Dev Immunol, 2012, 2012: 715190.
[16] Okamoto H, Kobayashi A, Yamanaka H. Cytokines and chemokines in neuropsychiatric syndromes of systemic lupus erythematosus[J]. J Biomed Biotechnol, 2010, 2010: 268436.
[17] 吴春晨, 何玉玲, 陈朗, 等. CXCL13和CCL19联合诱导的B淋巴细胞白血病细胞抗凋亡作用[J]. 医学研究通讯, 2004, 33(12): 12-14.
[18] Sellam J, Rouanet S, Hendel-Chavez H, et al. CCL19, a B cell chemokine, is related to the decrease of blood memory B cells and predicts the clinical response to rituximab in patients with rheumatoid arthritis[J]. Arthritis Rheum, 2013, 65(9): 2253-2261.
[19] Mathes AL, Christmann RB, Stifano G, et al. Global chemokine expression in systemic sclerosis (SSc): CCL19 expression correlates with vascular inflammation in SSc skin[J]. Ann Rheum Dis, 2014, 73(10): 1864-1872.
[20] Fecteau JF, Cote G, Neron S. A new memory CD27 - IgG + B cell population in peripheral blood expressing VH genes with low frequency of somatic mutation[J]. J Immunol, 2006, 177(6): 3728-3736.
[21] Wei C, Anolik J, Cappione A, et al. A new population of cells lacking expression of CD27 represents a notable component of the B cell memory compartment in systemic lupus erythematosus[J]. J Immunol, 2007, 178(10): 6624-6633.
[22] Klein U, Rajewsky K, Kuppers R. Human immunoglobulin (Ig)M + IgD + peripheral blood B cells expressing the CD27 cell surface antigen carry somatically mutated variable region genes: CD27 as a general marker for somatically mutated (memory) B cells[J]. J Exp Med, 1998, 188(9): 1679-1689.
[23] Jacobi AM, Reiter K, Mackay M, et al. Activated memory B cell subsets correlate with disease activity in systemic lupus erythematosus: delineation by expression of CD27, IgD, and CD95[J]. Arthritis Rheum, 2008, 58(6): 1762-1773.
[24] Nanki T, Takada K, Komano Y, et al. Chemokine receptor expression and functional effects of chemokines on B cells: implication in the pathogenesis of rheumatoid arthritis[J]. Arthritis Res Ther, 2009, 11(5): R149.
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