IL-33/ST2比值与红斑狼疮肾脏慢性损伤严重程度的相关性研究  

IL-33/ST2 axis in systemic lupus erythematosus in relation to chronic kidney injury and disease activity

作　　者：霍永宝 陶怡[1] 陈斯玲 王羿升[2,3] 黄灿辉[1] 黄文辉[1] 黄成辉[1] 于水莲[1] 

机构地区：[1]广州医科大学附属第二医院风湿免疫科,广东广州510260 [2]广州医科大学附属第二医院科研管理科,广东广州510260 [3]广州医科大学附属第二医院统计学教研室,广东广州510260

出　　处：《中国病理生理杂志》2017年第9期1696-1702,共7页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.81300585);广东省自然科学基金资助项目(No.2015A030313477);广东省公益研究与能力建设专项资金项目(No.2014A020212322)

摘　　要：目的:探讨新型内源性警报素白细胞介素33(interleukin-33,IL-33)/致癌性抑制因子2(suppression of tumorigenicity 2,ST2)途径与系统性红斑狼疮(systemic lupus erythematosus,SLE)肾脏损害及疾病活动度的相关性。方法:ELISA检测50例SLE患者和30例健康对照者(healthy control,HC)血清的可溶性ST2(soluble ST2,s ST2)和IL-33浓度。结果:SLE患者的血清sST2、IL-33浓度及IL-33/sST2比值均显著高于HC。SLE患者的血清s ST2浓度与红细胞沉降率(erythrocyte sedimentation rate,ESR)、SLE疾病活动度指数(SLE disease activity index,SLEDAI)、24 h尿蛋白、甘油三酯呈正相关,与补体C3呈负相关,线性回归示SLEDAI及甘油三酯作为主要因素影响sST2水平升高(R^2=0.432)。SLE患者血清IL-33浓度与SLEDAI、ESR、24 h尿蛋白、慢性肾脏病(chronic kidney disease,CKD)分期、甘油三酯呈正相关,与C3、C4、估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)、白蛋白呈负相关,线性回归示SLEDAI、C3及e GFR作为主要因素影响IL-33水平升高(R^2=0.380)。SLE患者的血清IL-33/s ST2比值与SLEDAI、eGFR呈正相关,与病程、起病年龄、激素用量、CKD分期、血肌酐、C3、C4、白蛋白呈负相关,回归分析提示IL-33/s ST2比值与CKD分期及白蛋白水平相关(R2=0.442),尤以CKD的相关性较强,该比值随CKD分期的加重而降低,当CKD分期为3级以上时IL-33/s ST2比值显著下降。结论:IL-33/ST2参与SLE发病,血清IL-33和s ST2均能一定程度地反映病情,s ST2较IL-33与疾病活动度关联性更强;IL-33和s ST2不能直接反映SLE的肾脏受累,但与间接反映SLE肾损伤的24 h尿蛋白及其它危险因素有关;IL-33/s ST2比值的降低提示SLE肾脏的慢性、中重度损害。AIM： To elucidate the association between chronic kidney injury and interleukin-33（IL-33; an alarmin）/suppression of tumorigencity 2（ST2） in patients with systemic lupus erythematosus（ SLE）. METHODS： Serum levels of IL-33 and soluble ST2（ sST2） were assessed by ELISA in 50 SLE patients and 30 healthy controls（ HC）.RESULTS： The levels of IL-33 and sST2,and IL-33/sST2 ratio were significantly higher in SLE patients than those in the HC. The IL-33 and sST2 levels were positively associated with SLE disease activity index（ SLEDAI）,erythrocyte sedimentation rate（ ESR）,proteinuria and triglyceride,but negatively associated with complement C3. IL-33/sST2 ratio was positively associated with SLEDAI and estimated glomerular filtration rate（ eGFR）. Independent explanatory variables associated with high IL-33/sST2 included chronic kidney disease（ CKD） staging and albumin（ R^2= 0. 442）,especially CKD staging. CONCLUSION： Elevated serum sST2 and IL-33 levels in SLE patients are correlated with disease activity and risk factors of kidney injury. IL-33/sST2 ratio may serve as a potential biomarker for chronic kidney injury in SLE patients.

关 键 词：白细胞介素33 致癌性抑制因子2 警报素 系统性红斑狼疮 

分 类 号：R593.2[医药卫生—内科学]