系统性红斑狼疮患者Bcl-2蛋白的表达及其临床意义  

Clinical significance and expression of Bcl 2 protein in patients with systemic lupus erythematosus

作　　者：刘亚光[1] 尹培达[1] 赵湘茹[1] 石成钢[1] 孔庆瑜[1] 关伟明[1] 

机构地区：[1]中山医科大学附属第一医院风湿科

出　　处：《中华内科杂志》1999年第2期94-97,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金

摘　　要：目的探讨Ｂｃｌ２蛋白在系统性红斑狼疮（ＳＬＥ）发病机制中的作用及其临床意义。方法以流式细胞仪双标记法和免疫组化方法分别检测３１例ＳＬＥ病人外周血Ｔ、Ｂ细胞和肾组织Ｂｃｌ２蛋白表达。结果活动期ＳＬＥ病人ＣＤ＋３、ＣＤ＋４和ＣＤ＋８Ｔ细胞Ｂｃｌ２蛋白表达明显高于非活动期ＳＬＥ病人和正常对照组。ＣＤ＋１９Ｂ细胞Ｂｃｌ２蛋白表达在各组之间并无统计学差异。ＣＤ＋３Ｔ细胞Ｂｃｌ２蛋白表达的平均荧光强度（ＭＦＩ）与ＳＬＥ疾病活动指数（ＳＬＥＤＡＩ）呈正相关关系（ｒ＝０．８１９５，Ｐ＜０．００１），而与血沉、补体（Ｃ３、Ｃ４）水平及自身抗体（抗核抗体、抗ｄｓＤＮＡ、抗Ｓｍ）阳性率无关。肾小球内Ｂｃｌ２阳性细胞数与肾小球系膜细胞增殖程度和增殖细胞核抗原（ＰＣＮＡ）阳性肾小球内细胞数及２４小时尿蛋白量呈正相关。结论Ｂｃｌ２异常表达在ＳＬＥ疾病活动和肾小球系膜细胞增殖过程中可能起着重要作用，检测ＳＬＥ病人血Ｔ淋巴细胞Ｂｃｌ２的蛋白表达水平可作为ＳＬＥ的疾病活动性指标。Objective To investigate the pathogenesis and clinical evaluation for expression of Bcl 2 in lymphocytes and renal tissues of 31 patients with systemic lupus erythematosus (SLE). Methods Bcl 2 protein levels in T, B cells and renal tissues were examined by two colour cytofluorography, and immunohistochemical staining (LSAB method) respectively. Results Compared with inactive SLE patients and normal controls, a proposition of T cells (including CD + 3, CD + 4 and CD + 8 subgroups) expressing Bcl 2 protein increased significantly in active SLE patients. However, Bcl 2 protein levels are not statistically different in CD + 19 B cells among all groups. Mean fluorescence intensity (MFI) levels of Bcl 2 protein on CD + 3 T cells was positively related to SLE disease activity index (SLEDAI) among the SLE patients, which wasn't related to ESR, complement (C 3,C 4) and autoantibody (ANA ,anti dsDNA, anti Sm) positivity. The population of Bcl 2 positive intraglomerular cells was correlated significantly with the grade of mesangial cell increase and the number of proliferating cell nuclear antigen (PCNA) positive glomerular cells, and 24 hour urinary protein. Conclusion Overexpression of apoptosis related Bcl 2 protein might play an important rule in the prolonged proliferation of mesangial cells and glomerular hypercellularity and in the active period of SLE patients, Bcl 2 expression levels of peripheral blood T lymphocytes might serve as an active index for SLE.

关 键 词：红斑狼疮 系统性 脱噬作用 BCL-2基因 

分 类 号：R593.241[医药卫生—内科学]