自身免疫疾病血清中4种细胞因子检测的临床应用初探  

Preliminary study on the clinical application of four cytokines in serum of autoimmune diseases

作　　者：李薇[1] 吴子燕[1] 毛镭篥[1] 张鑫垚 晏颂欣 徐洪琳 奉福泰 张蜀澜[2] 李永哲[1] Li Wei;Wu Ziyan;Mao Leili;Zhang Xinyao;Yan Songxin;Xu Honglin;Feng Futai;Zhang Shulan;Li Yongzhe(Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Rheumatology and Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730 [2]中国医学科学院北京协和医院风湿免疫科,北京100730

出　　处：《中华检验医学杂志》2023年第11期1173-1179,共7页Chinese Journal of Laboratory Medicine

基　　金：国家重点发展计划(2018YFE0207300);国家自然科学基金(81871302);中央高水平医院临床科研业务(2022-PUMCH-B-124)。

摘　　要：目的本研究旨在系统评价细胞因子在成人斯蒂尔病(AOSD)、大动脉炎(TA)等自身免疫疾病(AID)中的临床应用价值。本研究为一项回顾性的病例对照研究。方法调取北京协和医院检验科2019年1月至2022年8月的834例AID患者常规项目肿瘤坏死因子-α(TNF-α),白介素6(IL-6),IL-8、IL-10检测数据,同时检测30名健康对照(HC)血清中细胞因子4项水平。同时将AOSD、TA、系统性红斑狼疮(SLE)、白塞综合征(BS)疾病分为活动亚组和非活动亚组。另对SLE的两个重要的器官受累(肾脏、神经系统)进行亚组分析。统计分析使用GraphPad Prism 9和R 4.2.2软件。组间差异比较使用非参数检验(Kruskal-Wallis H检验,Mann-Whitney U检验),并使用Dunn法来校正多重检验可能带来的假阳性。结果比较IL-6在各组中的水平,除了BS组和抗磷脂综合征(APS)组,其余各个AID组和HC组相比,AID组血清IL-6水平均高于HC组[3.85(2.00,8.55)pg/ml],其中ANCA相关血管炎(AAV)组[3.85(2.00,8.55)pg/ml],特发性炎性肌病(IIM)组[7.80(2.50,6.50)pg/ml],IgG4相关性疾病(IgG4RD)组[3.65(2.08,12.83)pg/ml],类风湿关节炎(RA)组[5.50(2.20,16.10)pg/ml],SLE组[4.70(2.75,16.55)pg/ml],干燥综合征(SS)组[3.20(2.00,8.90)pg/ml],系统性硬化症(SSc)组[2.70(2.00,8.90)pg/ml],TA组[3.40(2.00,6.50)pg/ml],其他疾病组[4.40(2.00,11.10)pg/ml],尤其是AOSD组[15.20(2.10,39.20)pg/ml],校正后差异均具有统计学意义(P c<0.05)。同时,AOSD组和HC组相比,血清TNF-α[7.40(5.60,10.95)pg/ml]、IL-10[5.00(5.00,7.58)pg/ml]水平高于HC组[(7.15(5.93,8.00)pg/ml,5.00(5.00,5.00)pg/ml],校正后差异有统计学意义(P c<0.05)。活动期的AOSD、BS、SLE、TA患者血清中IL-6、IL-8水平较非疾病活动组呈现升高趋势,且差异均有统计学意义(P均<0.05)。另外,狼疮肾炎亚组较非狼疮肾炎亚组,血清中IL-8水平显著升高,差异有统计学意义(P<0.05)。同时,神经精神狼疮亚组较非神经精神狼疮亚组血清中IL-6、IL-8、TNF-Objectives the purpose of this study was to systematically evaluate the clinical value of cytokines in autoimmune diseases(AID).It was a kind of complex disease,and its pathogenesis involved cytokines,autoantibodies,immune cells and other immune factors.Especially some AID,such as Adult still′s disease(AOSD)and Takayasu arteritis(TA),had no specific biomarkers at present.This study was a retrospective case-control study.Methods the data of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)in 834 AID patients from January 2019 to August 2022 were collected,and the serum levels of those cytokines in 30 healthy controls(HC)were detected at the same time.And AOSD,TA,systemic lupus erythematosus(SLE)and Behcet′s syndrome(BS)were divided into active group and inactive group.In addition,we also made a subgroup analysis of two important organs involved in SLE(kidney and nervous system).GraphPad Prism 9 and R 4.2.2 software were used.Nonparametric tests(Kruskal-Wallis H test,Mann-Whitney U test)were used to compare the differences among groups,and Dunn′s method was used to correct the false positive caused by multiple tests.Results To compare the level of IL-6 in each group,except Behcet syndrome(BS)group and antiphospholipid syndrome(APS)group,the serum IL-6 level of AID group was higher than that of HC group,with antineutrophil cytoplasmic antibodies associated vasculitis(AAV)[3.85(2.00,8.55)pg/ml],idiopathic inflammatory myopathies(IIM)[7.80(2.50,6.50)pg/ml],IgG4-related disease(IgG4RD)[3.65(2.08,12.83)pg/ml],rheumatoid arthritis(RA)[5.50(2.20,16.10)pg/ml],SLE[4.70(2.75,16.55)pg/ml],Sjögren syndrome(SS)[3.20(2.00,8.90)pg/ml],systemic sclerosis(SSc)[2.70(2.00,8.90)pg/ml],TA[3.40(2.00,6.50)pg/ml],other AID diseases[4.40(2.00,11.10)pg/ml],especially AOSD[15.20(2.10,39.20)pg/ml].After correction,the differences were statistically significant(P c<0.05).At the same time,the levels of serum TNF-α[7.40(5.60,10.95)pg/ml]and IL-10[5.00(5.00,7.58)pg/ml]in AOSD group were sign

关 键 词：自身免疫疾病 细胞因子类 白细胞介素6 

分 类 号：R593.2[医药卫生—内科学] R446.6[医药卫生—临床医学]