系统性红斑狼疮患者外周血T、B细胞自噬水平及其临床意义  

Levels of autophagy in T cells and B cell of patients with systemic lupus erythematosus and its clinical significance

作　　者：陈燕文[1] 王超[2] 王旭光[3] 冯永民[1] 安宁[1] 吴洪銮 李尚妹[1] 陶静莉[1] 刘伟敬[1] 刘华锋[1] 潘庆军[1] 

机构地区：[1]广东医学院附属医院肾脏疾病研究所,湛江524001 [2]沈阳医学院附属第二医院肾内科,沈阳110000 [3]广东医学院附属医院临床研究中心,湛江524001

出　　处：《中国免疫学杂志》2015年第10期1380-1384,1388,共6页Chinese Journal of Immunology

基　　金：国家自然科学基金(No.81202346;30971370;81270798);湛江市科技计划项目(2013B01040)资助

摘　　要：目的:探讨系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者外周血T、B淋巴细胞自噬水平及其临床意义。方法:入组就诊前4周内未用药的SLE患者68例;用流式细胞术检测23例正常人和68例经激素和免疫抑制剂治疗前后的SLE患者外周血T、B淋巴细胞的自噬水平及其变化情况,并分析其与补体C3、SLEDAI评分和血清Anti-ds DNA水平的相关性。结果:治疗前SLE患者T淋巴细胞自噬水平显著高于正常人,活动组(SLEDAI score≥10)SLE患者显著高于稳定组(SLEDAI score<10),且活动组中初发组(即首次确诊)显著高于复发组(P均<0.05)。而SLE患者B淋巴细胞自噬水平显著低于正常人,活动组SLE患者显著低于稳定组,且活动组中初发组显著低于复发组(P均<0.05)。相关性分析发现,SLE患者T淋巴细胞自噬水平与SLEDAI评分呈正相关(rs=0.289,P<0.05),B淋巴细胞自噬水平与血清补体C3水平呈正相关(rs=0.371,P<0.01)。经激素和免疫抑制剂治疗5 d后,SLE患者预后良好组(SLEDAI降低≥4分)的T淋巴细胞自噬水平即可显著降低(P<0.05);治疗3 d后,SLE患者预后良好组的B淋巴细胞自噬水平即可显著升高(P<0.05);预后不良组治疗前后T、B淋巴细胞的自噬水平变化无统计学意义。结论:SLE患者外周血T、B淋巴细胞自噬水平异常,其变化与疾病活动度相关,有望作为疾病活动度指标和潜在的临床治疗靶标。Objective：To investigate levels of autophagy in T cells and B cell of patients with systemic lupus erythematosus （ SLE） and its clinical significance.Methods： 68 SLE patients without treatment within 4 weeks were enrolled in this study.We accessed the levels of autophagy in T cells and B cells of 23 healthy controls and 68 patients before and after treatment by flow cytometry,and analyzed their correlations with serum levels of C3 and anti-dsDNA antibodies,SLEDAI score,et al.Results： Before treatment,a significantly increased levels of LC3-Ⅱ was observed in SLE patients than healthy controls, the active group （ SLEDAI score≥10） was significantly higher than the stable group（SLEDAI score〈10）,and the newly diagnosed group was significantly higher than the recurrent group（all P〈0.05）.While the levels of LC3-Ⅱ was decreased in B lymphocytes in SLE patients,the active group was significantly lower than stable group,and the active group was significantly lower than the newly diagnosed group（all P〈0.05）. Correlation analysis found that,a positively correlation was observed for the levels of LC3-Ⅱwith SLEDAI score in T lymphocyte（ rs=0.289,P〈0.05）,and the levels of C3 were positively correlated the levels of LC3-Ⅱ in B lymphocyte（rs=0.371,P〈0.01）.After treatment for five days, levels of autophagy in T lymphocytes of SLE patients with good prognosis （ SLEDAI score decreased ≥4 ） significantly decreased（P〈0.05）.Also,three days after treatment,levels of autophagy in B lymphocytes of SLE patients with good prognosis were increased significantly （ P〈0.05 ） .However, SLE patients with poor prognosis had no such difference （ P〈0.05 ） . Conclusion：Levels of autophagy in T and B lymphocytes of SLE patients are abnormal compared to healthy controls,and these changes are associated with disease activity.Also,these changes are expected to be the indicators of disease activity and potential therapeutic targets in SLE.

关 键 词：系统性红斑狼疮 T细胞 B细胞 自噬 LC3-Ⅱ 

分 类 号：R392[医药卫生—免疫学]