系统性红斑狼疮患者血浆sHLA-G表达及其影响因素分析  

Expression of Plasma Soluble HLA-G and Factors Involving Influencing its Expression Levels in Patients with Systemic Lupus Erythematosus

作　　者：吴凤霞[1] 武丽君[2] 罗雄燕[1] 杨明辉[1] 刘宁涛[3] 库尔班江[2] 谢传美[1] 宋小芸[2] 唐中[1] 张国元[1] 周京国[1] 赵岩[4] 曾小峰[4] 袁国华[1] 

机构地区：[1]川北医学院风湿免疫研究所,南充637000 [2]新疆维吾尔自治区人民医院风湿科 [3]四川省遂宁市中心医院风湿科 [4]北京协和医院风湿科

出　　处：《医学研究杂志》2010年第3期52-55,共4页Journal of Medical Research

基　　金：卫生部重大疾病研究资助项目(2008BA159B02)

摘　　要：目的检测系统性红斑狼疮(SLE)患者血浆可溶性HLA-G(sHLA-G)水平,并分析HLA-G基因多态性、病情及药物治疗对其表达的影响。方法酶联免疫吸附法(ELISA)检测其中96例SLE患者及74名正常人血浆sHLA-G水平。聚合酶链式反应(PCR)检测HLA-G 14bp插入/缺失多态性基因,收集记录SLE疾病活动性指数(SLEDAI)和药物治疗情况,并分析基因多态性、病情及药物治疗对sHLA-G表达的影响。结果血浆sHLA-G水平在SLE患者为230.2±192.2U/ml,显著高于健康体检者的118.3±38.1U/ml(P=0.0001);HLA-G 14bp插入/缺失多态性位点和基因型在血浆sHLA-G水平增高和正常SLE患者中的分布无显著性差异(P>0.05);但血浆sHLA-G水平增高的SLE患者较血浆sHLA-G水平正常患者病情更重(P=0.027),易出现中枢神经系统受累(P=0.007)。激素、免疫抑制剂及抗疟药等不同药物治疗在血浆sHLA-G水平增高和正常SLE患者间亦无统计学差异(P>0.05)。结论 SLE患者血浆sHLA-G水平增高,而且与SLE病情较重、中枢神经系统受累有关,提示sHLA-G在SLE病理过程中可能发挥重要作用。Objective To determine plasma soluble HLA - G （ sHLA - G） levels in patients with systemic lupus erythematosus （ SLE）, and to analyze factors involving influencing its expression levels. Methods Plasma samples were collected from 96 SLE patients and 74 healthy controls, and soluble HLA -G （sHLA -G） levels were determined by enzyme -linked immunosorbent assay. Polymerase chain reaction （PCR） was performed to detect the genotypes of HLA - G 14bp ins/del polymorphism. Individual clinical information, including drug therapy, was collected in detail from SLE patients, and the disease activity was assessed by the disease activity index for lupus patients （SLEDAI）. Results Plasma concentration of sHLA - G was significantly higher in SLE patients than that in healthy controls [ （211.8 ±182.5）U/ml vs （118.3 ±38.1 ）U/ml, P = 0. 0001 ）. No significant difference was found in HLA -G 14bp ins/del allelic frequencies and genotype distributions between SLE patients with increased sHLA - G level and patients with normal sHLA - G level （ P 〉 0.05 ）. However, the patients with increased levels of sHLA - G had higher incidence of central nervous system involvement （ P = 0. 007） and more severe disease activity （P = 0. 027） in comparison with patients with normal plasma sHLA - G levels. Finally, the expression of plasma sHLA - G was not influenced by the treatment with glucocorticoids, immunosuppressive agents or antimalarials. Conclusion The increased production of sHLA - G indicates that sHLA - G may play an important role in the pathogenesis of SLE. The expression of sHLA - G may be associated with disease activity and severity of lupus patients, but be independence of HLA - G 14bp ins/del polymorphism and drug treatment.

关 键 词：系统性红斑狼疮 人白细胞抗原G sHLA—G基因多态性 

分 类 号：R758.62[医药卫生—皮肤病学与性病学]