补体C1q及抗C1q抗体在狼疮肾炎发病机制中的作用  

The roles of complement 1q and anti-C1q autoantibodies in pathogenesis of lupus nephritis

作　　者：张奉春[1] 周滨[1] 董怡[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院风湿免疫科,100730

出　　处：《中华医学杂志》2005年第14期955-959,共5页National Medical Journal of China

摘　　要：目的探讨狼疮肾炎患者血清补体C1q及抗C1q自身抗体(C1qAb)水平与狼疮肾炎患者肾脏病理的相关性,以及补体C1q及C1qAb在狼疮肾炎发病机制中的可能作用。方法应用单向免疫扩散法检测狼疮肾炎患者40例及非狼疮肾炎患者40例血清C1q,应用酶联免疫吸附法检测血清C1qAb。应用肾活体组织检查和原位末端脱氧核糖核苷酸转移酶标记法检测肾脏中凋亡细胞及凋亡小体的沉积。结果血清补体C1q水平,狼疮肾炎患者为(130±50)mg/L,非狼疮肾炎患者为(170±70)mg/L;血清C1qAb水平(P/N值),狼疮肾炎患者为7±4,非狼疮肾炎患者为4±3。狼疮肾炎患者血清C1qAb与补体C1q之间呈显著负相关(PearsonR=-0.567,P<0.01)。血清C1q水平的降低及C1qAb水平的升高与肾脏中补体C1q、IgG及C3的沉积显著正相关,与肾脏组织中有明显凋亡细胞及凋亡小体沉积显著正相关。结论血清C1qAb及C1q的异常可能参与了狼疮肾炎的发病,其可能机制为,促进补体C1q介导的免疫复合物在肾脏组织中沉积;促进凋亡细胞及凋亡小体在肾脏组织中沉积。Objective To analyze the correlation of serum levels of complement 1q(C1q) and anti-C1q autoantibodies(C1qAb)with renal pathology in lupus nephritis (LN) and to explore the probable mechanism of C1q and C1qAb in the development of systemic lupus erythematosus (SLE), especially LN. Methods The serum samples of 80 SLE patients, 40 LN patients and 40 non-LN patients, were collected to detect the level of C1q with single radial immunodiffusion and the level of C1qAb with enzyme-linked immunosorbent assay. Renal biopsy was conducted in 25 of the 32 LN patients so as to observe the deposition of apoptotic cells and apoptotic bodies in the glomeruli with TdT-mediated dUTP nick end labeling. Results The serum level of C1q was (130±50)mg/L in the LN patients, significantly lower than that in the non-LN patients [(170±70)mg/L, P=0.004]. The serum level of C1qAb (P/N value) was 7±4 in the LN patients, significantly higher than that in the non-LN patients (4±3, P<0.001). The correlation coefficient between C1qAb and C1q in the LN patients was -0.567 (P<0.01), showing a significant negative correlation. The correlation coefficient between C1qAb and C1q in the non-LN patients was -0.509 (P=0.001), showing a significant negative correlation. The serum C1q level of the typeⅣ LN patients was significantly lower than that in the typeⅠ LN patients, and the serum C1qAb level of the type Ⅳ LN patients was significantly higher than that in the typeⅠLN patients (P<0.05). The serum C1q was significantly lower in the LN patients with renal C1q deposition (++) than in the LN patients with renal C1q deposition (+), however, the serum C1qAb was significantly higher in the LN patients with renal C1q deposition (++) than in the LN patients with renal C1q deposition (+) (both P<0.05).The serum C1q level was significantly lower in the LN patients with positive IgG deposition than in the LN patients with negative IgG deposition and the serum C1qAb level was significantly higher in the LN patients with positive IgG deposition than in

关 键 词：补体C1Q 狼疮肾炎 发病机制 C1Q抗体 单向免疫扩散法 酶联免疫吸附法 肾活体组织检查 血清C1q 凋亡小体 凋亡细胞 肾脏组织 核糖核苷酸 免疫复合物 肾脏病理 自身抗体 抗C1q 方法应用 酶标记法 P/N值 可能机制 正相关 

分 类 号：R593.242[医药卫生—内科学]