外周血清抗核小体抗体家族分子表达水平与SLE患者器官/系统损害的关联研究  

Association of expression of serum antinucleosome antibody family with indices of the damage of organ or system in systemic lupus erythematosus

作　　者：郝加虎[1] 张志华[2] 张国庆[2] 刘慧慧[2] 黄朝辉[1] 刘浏[1] 潘发明[2] 戴宏[3] 叶冬青[2] 张学军[4] 

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥230032 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032 [3]安徽医科大学第一附属医院肾脏内科,合肥230032 [4]安徽医科大学皮肤病研究所,合肥230022

出　　处：《中国卫生检验杂志》2008年第4期618-621,676,共5页Chinese Journal of Health Laboratory Technology

基　　金：国家自然科学基金资助(30371247);安徽省高校省级自然科学研究项目(KJ2007B148);安徽省高校青年教师科研资助计划项目(2004jq166;2007jq1067ZD);安徽医科大学博士科研经费资助计划项目(XJ200602)

摘　　要：目的:比较系统性红斑狼疮患者(systemic lupus erythematosus,SLE)和正常对照两组间的血清抗核小体抗体家族分子(antinucleosome antibody family)(包括抗核小体抗体、抗-dsDNA抗体、抗组蛋白抗体)的表达水平;分析抗核小体抗体家族分子与SLE患者器官/系统损害之间的关系,并探讨血清抗核小体抗体家族分子与患者器官/系统损害的关联是否涉及细胞凋亡。方法:病例选自两所三甲医院住院SLE患者(n=76),以健康志愿者为对照(n=69);参照系统性红斑狼疮疾病活动性指数(SLEDAI)和系统性红斑狼疮损伤指数(SLICC/ACR DI)量表,设计问卷,调查患者的一般情况、实验室检查结果和器官/系统损害情况;运用流式细胞术,采用连接素V(Annexin V,AV)和碘化丙啶(propidium iodide,PI)双染法检测研究对象的外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)的早期凋亡率;以双抗夹心酶联免疫吸附实验测定研究对象外周血抗核小体抗体家族分子的表达水平。结果:SLE患者的血清抗核小体抗体(95.826±94.084 IU/ml)、抗-dsDNA抗体(280.551±305.954 IU/ml)、抗组蛋白抗体(58.557±66.833 IU/ml)的阳性率分别为68.42%、53.95%、44.74%,高于正常对照组(分别为10.106±0.5348 IU/ml,20.034±12.075 IU/ml,9.290±1.281 IU/ml)。SLE患者血清抗核小体抗体与抗组蛋白抗体(r=0.852,t=13.985,P=0.000)、抗-dsDNA抗体(r=0.788,t=11.028,P=0.000)、SLICC/ACR DI(rs=0.552,t=4.23,P=0.000)和PBMCs早期凋亡率(r=0.341,t=3.404,P=0.001)之间均呈正相关。SLE患者血清抗-dsDNA抗体与抗组蛋白抗体(r=0.797,t=11.358,P=0.000)、SLICC/ACR DI(rs=0.428,t=3.86,P=0.000)和PBMCs早期凋亡率(r=0.385,t=3.917,P=0.000)之间呈正相关。SLE患者血清抗组蛋白抗体与SLICC/ACR DI(rs=0.390,t=3.74,P=0.000)和PBMCs早期凋亡率(r=0.277,t=2.702,P=0.008)之间呈正相关。SLE患者非蛋白尿组(n=14)和蛋白尿组(n=62)的血清抗核小体抗体(分别为63.074±15.478 IU/ml、103.221±24.773 IU/ml)�Objective：To compare the expression of serum nucleosome and the antinucleosome antibody family [ antinucleosome antibodies, anti - double - stranded DNA （ anti - dsDNA） antibodies and antihistone antibodies] by enzymelinked immunosorbent assay between the healthy controls and patients with systemic lupus erythematosus （SLE） to analye the relationship of the serum soluble nucleosome, the antinucleosome antibody family and the organ or system damage in SLE, and to define the role of apoptosis in the relationships. Methods ： Seventy - six SLE inpatients were selected from two hospitals, and normal healthy volunteers were recruited as controls （n =69）. General information and the data of organ or system damage were collected by self-designed question- naire containing the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index（ SLICC! ACR DI）. Annexin V （AV） and propidium iodide （PI） were used to detect the early apoptosis rate of peripheral blood mononuclear cells（PBMCs）. Serum soluble nucleosome levels as well as antinucleosome antibodies, anti- doublestranded DNA antibodies, and antihistone antibodies activities were assessed by Sandwich - enzyme - linked immunosorbent assay （ELISA）. Resuits：Higher levels of antinucleosome antibodies 95. 826± 94. 084 IU/ml, anti - dsDNA antibodies 280. 551 ± 305.954 IU/ml and antihistone antibodies 58. 557 ± 66. 833 IU/ml were found in SLE patients compared with those in normal healthy controls （ 10. 106 ±0. 5348 IU/ml, 20. 034± 12.075 IU/ml, 9. 290 ± 1. 281 IU/ml, respectively）. The levels of serum antinucleosome antibodies had a positive correlation with antihistone antibodies（ r = 0. 852 ,t = 13.985 ,P = 0. 000） , anti - dsDNA antibodies（ r = 0. 788,t = 11. 028,P =0. 000）, SLICC/ACR DI（r =0. 552,t =4. 23,P =0. 000）, as well as the early apoptosis rate of PBMCs （ r = 0. 341, t = 3. 404, P = 0. 001 ） in SLE. The levels of serum anti - dsDNA antibodies had a positive correlatio

关 键 词：细胞凋亡 红斑狼疮 系统性 抗核小体抗体家族 

分 类 号：R593.24[医药卫生—内科学]