抗中性粒细胞胞质髓过氧化物酶抗体相关性血管炎周围血中性粒细胞CD35表达的变化及意义  

A preliminary study on the change and significance of CD35 expression on the neutrophils of per-ipheral blood from patient with myeloperoxidase-antineutrophil cytoplasmic antibody associated vas culitis

作　　者：何倩[1] 张蕾[1] 郑美娟[1] 帅宗文[1] 陈珊宇[1] 胡子盈 He Qian;Zhang Lei;Zheng Meijuan;Shuai Zongwen;Chen Shanyu;Hu Ziying(Department of Rheumatology and Immunology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Chin)

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022

出　　处：《中华风湿病学杂志》2018年第4期251-256,共6页Chinese Journal of Rheumatology

基　　金：中华医学会临床医学科研专项资金项目（08010290107）

摘　　要：目的初步探讨抗中性粒细胞胞质髓过氧化物酶抗体相关性血管炎（MPO-AAV）患者外周血中性粒细胞CD35表达的变化及其与临床疾病活动性间的关系。方法选择40例初诊未治的活动性MPO-AAV患者为病例组，记录患者伯明翰血管炎活动度积分（BVAS），40名健康志愿者为对照组，采用流式细胞术检测2组受试者外周血中性粒细胞CD35和MPO的表达水平，ELISA法检测外周血抗中性粒细胞胞质髓过氧化物酶抗体（MPO-ANCA）、补体B因子活化片段a（Ba）及MPO水平，采用t检验、非参数检验及Spearman相关分析比较2组受试者的检测结果，分析病例组内各检测指标间及检测指标与BVAS间的关系。结果与健康对照组比较，病例组患者外周血中性粒细胞膜CD35及MPO表达水平均增高[分别为（2 014±968）与（1 454±511），t=3.024，P=0.002和（709±244）与（580±158），t=2.806，P〈0.01]，而胞质内MPO表达水平显著降低[（1 525±1 033）与（3 196±2 126），t=-4.468，P〈0.01]。病例组血清Ba和MPO水平明显高于对照组{分别为[37.89（26.17，63.14）]μg/L与[27.99（18.64，46.52）]μg/L，Z=-2.521，P=0.012和[546.16（450.55，729.96）]U/L与[327.93（279.02，365.10）]U/L，Z=7.121，P〈0.01}。病例组中性粒细胞膜CD35表达水平分别与周围血中性粒细胞计数、血清Ba及BVAS呈正相关（分别为r=0.573，P〈0.01；r=0.433，P=0.005和r=0.368，P=0.020）；中性粒细胞胞内MPO水平与周围血MPO水平呈负相关（r=-0.458，P=0.003）；MPO-ANCA与BVAS呈正相关（r=0.351，P=0.026）。结论MPO-AAV患者中性粒细胞膜CD35的增强表达，可能保护中性粒细胞不被激活的补体旁路破坏，导致更多的中性粒细胞参与MPO-AAV发病，抑制CD35表达可能是MPO-AAV新的潜在治疗途径之一。ObjectiveTo investigate the change of CD35 expression on neutrophils in the peripheral blood and the relationship between the change and disease activity in patient with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis （MPO-AAV） .MethodsForty untreated patients with active MPO-AAV （patient group） and forty healthy volunteers （control group） were enrolled into this study, and Bermingham vasculitis activity score （BVAS） for every patient was recorded. Flow cytometry （FCM） was employed to detect the CD35 and MPO expression on the neurtrophil, and enzyme linked immunosorbent assay （ELISA） was taken to test the levels of autoantibody against MPO-Antineutrophil cytoplasmic antibody （MPO-ANCA）, fragment a from the activated complement factor B （Ba） and MPO in peripheral blood from both group.All test results were compared between the 2 groups by t test, Non-parametric test, Spearman correlation analysis. In addition, the relations among the laboratory results and the relationship between BVAS and the laboratory results were analyzed respectively.ResultsCompared with the control group, the expression level, which was represented as mean flourscence indensity （MFI）, of CD35 and neutrophil membrane MPO on peripheral blood neutrophils was significantly increased [（2 014±968） vs （1 454±511）, t=3.024, P=0.002 and（709±244） vs （580±158）, t=2.806, P〈0.01, respectively], and the MPO expression level in neutrophils was significantly lower [（1 525±1 033） vs （3 196±2 126）, t=-4.468, P〈0.01]. Ba and MPO levels in serum of the patient group was significantly higher than that in the control group [37.89（26.17, 63.14） μg/L vs 27.99（18.64, 46.52） μg/L, Z=-2.521, P=0.012 and 546.16（450.55,729.96） U/L vs 327.93（279.02, 365.10） U/L, Z=7.121, P〈0.01, respectively]. In patient group, the expression level of CD35 had a significant positive relationship with peripheral blood neutrophil count （r=0.573, P〈0.01）, serum Ba （r=0

关 键 词：抗中性粒细胞胞质抗体相关性系统性血管炎 受体 补体3b 抗体 抗中性白细胞胞质 过氧化物酶 

分 类 号：R593.2[医药卫生—内科学]