系统性红斑狼疮患者血清25-羟维生素D3水平与调节性T细胞亚群的关系  

Relationship between serum 25-dihydroxy vitamin D3 levels and regulatory T cell subsets in patients with systemic lupus erythematosus

作　　者：高瑛瑛[1] 王雪琴[1] GAO Ying-ying;WANG Xue-qin(Department of Rheumatology,the First People's Hospital of Nantong,Nantong226000,China)

机构地区：[1]南通市第一人民医院风湿免疫科,南通226000

出　　处：《现代免疫学》2020年第6期501-505,共5页Current Immunology

基　　金：2019年南通市市级科技计划项目(MS12019015)。

摘　　要：为探讨SLE患者外周血25-羟维生素D3[25-dihydroxy vitamin D3,25(OH)D3]水平下降与血清炎性因子、Treg亚群比例以及SLE疾病活动指数(SLE disease activity index,SLEDAI-2K)之间的相关性,选取40例SLE患者作为研究对象,20例健康者为健康对照组。运用化学发光免疫分析法检测外周血25(OH)D3水平,ELISA检测外周血IFN-α、TNF-α及IL-6水平,FCM检测外周血Treg亚群(CD4^+CD25^+Foxp3^+Treg)的比例。结果显示,SLE组患者外周血炎性因子IFN-α、TNF-α及IL-6水平明显高于健康对照组(P<0.000 1),外周血25(OH)D3水平明显低于健康对照组(P<0.001)。SLE组患者血清炎性因子与SLEDAI-2K呈显著正相关,25(OH)D3水平分别与SLEDAI-2K及24 h尿蛋白呈显著负相关(P<0.000 1)。活动期SLE组与临床缓解SLE组患者外周血CD4^+CD25^+Foxp3^+Treg的比例较健康对照组显著下降(P<0.000 1),且与SLEDAI-2K、24 h尿蛋白、血清IFN-α水平呈显著负相关,与25(OH)D3水平呈显著正相关(P<0.000 1)。提示SLE患者25(OH)D3减少与SLE疾病活动度增加直接相关,同时与患者血清中炎性因子分泌增加及CD4^+CD25^+Foxp3^+Treg亚群比例下降有关;25(OH)D3的缺乏可能通过影响炎性因子表达,对外周血Treg亚群的数量和功能产生抑制,从而参与SLE病情的发生、发展。To explore the relationship between 25-dihydroxy vitamin D3 [25(OH)D3] and serum inflammatory factors, Treg subsets and SLE disease activity index(SLEDAI-2 K) in SLE, a total of 40 patients with SLE and 20 heathy controls were selected. The levels of serum 25(OH) D3,IFN-α,TNF-α and IL-6 were detected by chemiluminescence immunoassay and ELISA. FCM was used to detect the percentage of CD4^+CD25^+Foxp3^+Treg in peripheral blood. In SLE patients, the levels of serum IFN-α,TNF-α and IL-6 were increased, while the level of serum 25(OH) D3 was significantly lower than that of the healthy controls(P<0.000 1). There was a significant positive correlation between inflammatory factors serum levels and SLEDAI-2 K and a significant negative correlation between 25(OH) D3 serum levels and SLEDAI-2 K or 24-hour urinary protein(P<0.000 1). The percentage of CD4^+CD25^+Foxp3^+Treg in active SLE group and remission SLE group was lower than that in health controls(P<0.000 1). The expression rate of CD4^+ CD25^+ Foxp3^+ Treg was negatively correlated with SLEDAI, 24-hour urinary protein and serum TNF-α, and a positive correlation was observed between 25(OH) D3 and CD4^+CD25^+Foxp3^+Treg(P<0.000 1). In conclusion, the decreased levels of 25(OH) D3 and CD4^+CD25^+Foxp3^+Treg in SLE patients can be used as an indicator of disease activity and prognosis in SLE. Vitamin D may be related to the pathogenesis of SLE.

关 键 词：系统性红斑狼疮 25-羟维生素D3 干扰素Α 调节性T细胞 

分 类 号：R392.11[医药卫生—免疫学]