凋亡相关分子sFas与SLE患者器官/系统损害的关联研究  

Association of serum soluble Fas,apoptosis and 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] 苏虹[2] 黄朝辉[1] 戴宏[3] 李向培[4] 陶金辉[4] 叶冬青[2] 张学军[5] 

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230022 [4]安徽医科大学附属省立医院风湿免疫科,合肥230001 [5]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3期385-389,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可溶性Fas(sFas)的表达水平,分析sFas与SLE患者器官/系统损害之间的关系,并探讨sFas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=68),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,收集患者的一般情况和器官/系统损害资料。利用流式细胞仪,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PB-MCs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sFas的表达水平。结果:SLE患者组(n=68)的血清sFas表达水平(6876.27±1979.38 pg/ml)高于正常对照组(3275.08±1023.01 pg/ml)(t=13.405,P<0.01),与SLE-DAI(r=0.274,t=2.86,P=0.005)和SLICC/ACR DI(rs=0.437,t=3.95,P<0.01)均呈正相关,与PBMCs的早期凋亡率也呈正相关(r=0.395,t=3.49,P<0.01)。CNS损害SLE组(n=11)的血清sFas水平9576.60±3654.70 pg/ml高于非CNS损害SLE组(n=57)6629.37±2372.30 pg/ml(q=6.42,P<0.05),并且两者均高于正常对照组(n=69)3275.08±1023.01 pg/ml(F=75.10,P<0.01,q=13.93,P<0.05;q=13.45,P<0.05)。肾脏损害SLE组(n=33)的血清sFas水平10968.45±4814.60 pg/ml高于非肾脏损害SLE组(n=35)6502.78±3971.00 pg/ml(q=8.20,P<0.05),并且两者均高于正常对照组(n=69)3275.08±1023.01 pg/ml(F=66.33,P<0.01,q=16.20,P<0.05;q=6.93,P<0.05)。浆膜炎SLE组(n=6)的血清sFas水平10376.69±4149.50 pg/ml高于非浆膜炎SLE组(n=62)6718.34±2351.80 pg/ml(q=6.30,P<0.05),并且两者均高于正常对照组(n=69)3275.08±1023.01 pg/ml(F=75.71,P<0.01,q=12.28,P<0.05;q=14.48,P<0.05)。结论:SLE患者的外周血清可溶性sFas的表达水平增加,且血清可溶性sFas与患者的器官/系统损害关系密切。sFas表达升高、凋亡亢进在SLE发病机制中发挥重要作用,sFas可较好反映患者器官/系Objective：To compare the expression of serum soluble Fas （sFas） and serum soluble FasL （sFasL） between the healthy controls and patients with systemic lupus erythematosus （SLE）, to analysis the relationship of the sFas, sFasL and the organ or system damage in SLE, and to define the role of apoptosis in the relationship. Methocls：SLE patients （n = 68 ） were selected from two hospitals, and normal healthy volunteers （n = 69 ） were recruited as controls. General information and the data of organ or system damage were collected by self - designed questionnaire 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 apeptosis rate of peripheral blood mononuelear cells （PBMCs）. ,Serum sFas and sFasL were measured using Sandwich - ELISA. Results： Patients with SLE had a higher level of sFas （ n = 68, 6876. 27 ± 1979. 38 pg/ml） compared to healthy controls （n =69,3275.08 ± 1023.01 pg/ml） （t = 13.405, P 〈0. 01 ）, and the level had a positive correlation with SLEDAI （ r = 0. 274, t = 2. 86, P = 0. 005 ）, SLICC/ACR DI （ rs = 0. 437, t = 3. 95, P 〈 0. 01 ）, as well as the early apoptnsis rate of PBMCs （ r = 0. 395, t = 3.49, P 〈 0. 01 ） in SLE. The association between the serum sFas levels and various organ and tissue damages was also investigated. There was a significant difference in the serum sFas levels between patients with and without CNS disease （9576. 60 ±3654. 70 pg/ml, 6629. 37 ±2372. 30 pg/ml; q =6. 42, P 〈0. 05）. Similarly, we observed a significant difference in the serum sFas levels between patients with and without renal disease （ 10968. 45 ± 4814. 60 pg/ml, 6502. 78 ±3971.00 pg/ml; q =8. 20, P 〈0. 055）. The same was true when patients with and without serositis （10376. 69 ±4149. 50 pg/ml, 6718.34 ± 2351.80 pg/ml ; q = 6. 30, P 〈 0. 05 ） were analyzed. Conclusion ：The exp

关 键 词：红斑狼疮 系统性 细胞凋亡 抗原 CD95 

分 类 号：R593[医药卫生—内科学]