抗磷脂综合征患者血清sVCAM-1、HMGB1与NLRP3炎症小体信号通路与血栓事件的关系  

Relationship between serum sVCAM-1,HMGB1 and NLRP3 inflammatome signaling pathway and thrombotic events in patients with antiphospholipid syndrome

作　　者：汪学刚 朱欣如 吴艳芬[3] 张晓雪 张鹏辉 WANG Xue-gang;ZHU Xin-ru;WU Yan-fen;ZHANG Xiao-xue;ZHANG Peng-hui(Department of Clinical Laboratory,Shanghai Pudong New Area People's Hospital,Shanghai 201299,CHINA;Department of Clinical Laboratory,Shanghai Pudong New Area Hospital of Traditional Chinese Medicinel,Shanghai 201205,CHINA;Department of Nephrology,Shanghai Pudong New Area People's Hospital,Shanghai 201299,CHINA;Shanghai Key Laboratory of Pathogenic Fungi Medical Testing,Shanghai Pudong New Area People's Hospital,Shanghai 201299,CHINA)

机构地区：[1]上海市浦东新区人民医院检验科,上海201299 [2]上海市浦东新区中医医院检验科,上海201205 [3]上海市浦东新区人民医院肾内科,上海201299 [4]上海市浦东新区人民医院上海市病原真菌医学检验重点实验室,上海201299

出　　处：《海南医学》2024年第11期1623-1628,共6页Hainan Medical Journal

基　　金：上海医学真菌分子生物学重点实验室病原真菌医学检验中心院内开放课题(编号:E19-06);上海市2023年度创新医疗器械应用示范项目(编号:23SHS0650)。

摘　　要：目的探讨抗磷脂综合征(APS)患者血清可溶性血管细胞黏附分子-1(sVCAM-1)、高迁移率族蛋白B1(HMGB1)与NOD样受体P3(NLRP3)炎症小体信号通路和血栓事件的关系。方法选择2021年6月至2023年6月上海市浦东新区人民医院收治的124例APS患者作为APS组和67例健康志愿者作为对照组。检测所有受检者的血清sVCAM-1、HMGB1水平、外周血单个核细胞的NLRP3信使核糖核酸(mRNA)和下游炎症因子白细胞介素(IL)-1β、IL-18水平。采用Pearson相关性分析血清sVCAM-1、HMGB1水平与外周血单个核细胞的NLRP3 mRNA表达、IL-1β和IL-18水平的相关性。根据是否发生血栓事件将APS患者分为血栓组(n=32)和非血栓组(n=90)。采用多因素Logistic回归分析APS患者发生血栓事件的影响因素。采用受试者工作特征曲线(ROC)分析sVCAM-1、HMGB1预测APS患者发生血栓事件的价值。结果APS组患者的血清sVCAM-1、HMGB1、IL-1β和IL-18水平以及外周血单个核细胞的NLRP3 mRNA分别为(806.35±204.75)μg/L、(125.42±24.57)μg/L、(13.62±3.09)pg/mL、(16.24±3.72)pg/mL、1.62±0.42,明显高于对照组的(395.12±77.24)μg/L、(35.01±10.30)μg/L、(3.15±0.67)pg/mL、(4.02±1.13)pg/mL、0.85±0.23,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,APS组患者的血清sVCAM-1、HMGB1水平与外周血单个核细胞的NLRP3 mRNA以及血清IL-1β和IL-18水平均呈正相关(P<0.05);血栓组患者的血清sVCAM-1、HMGB1水平分别为(915.35±70.28)μg/L、(136.42±10.17)μg/L,明显高于非血栓组的(767.59±61.43)μg/L、(121.51±15.03)μg/L,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,3个抗体阳性、高水平sVCAM-1、HMGB1是APS患者发生血栓事件的危险因素(P<0.05);经ROC分析结果显示,血清sVCAM-1联合HMGB预测APS患者血栓事件的曲线下面积(AUC)为0.885,高于单独预测(P<0.05)。结论APS患者血清sVCAM-1、HMGB1水平均增高,且与NLRP3及其下游炎症因子�Objective To investigate the relationship between serum soluble vascular cell adhesion molecule-1(sVCAM-1),high mobility group protein B1(HMGB1)and NOD-like receptor P3(NLRP3)inflammasome signaling pathway and thrombotic events in patients with antiphospholipid syndrome(APS).Methods A total of 124 patients with APS admitted to Shanghai Pudong New Area People's Hospital from June 2021 to June 2023 were selected as the APS group,and 67 healthy volunteers were selected as the control group.The serum sVCAM-1 and HMGB1 levels,peripheral blood mononuclear cells NLRP3 messenger RNA(mRNA)and downstream inflammatory factors interleukin(IL)-1βand IL-18 were detected.Pearson correlation analysis was used to analyzed the correlation between serum sVCAM-1,HMGB1 levels and peripheral blood mononuclear cells NLRP3 mRNA expression,IL-1β,and IL-18 levels.The patients with APS were divided into thrombotic group and non-thrombotic group according to whether thrombotic events occurred.The influencing factors of thrombotic events occurred in the patients with APS were analyzed by multivariate Logistic regression analysis.The value of sVCAM-1 and HMGB1 in predicting thrombotic events occurred in the patients with APS was analyzed by receiver operating characteristic(ROC)curve.Results The serum sVCAM-1,HMGB1,IL-1β,and IL-18 levels and peripheral blood mononuclear cells NLRP3 mRNA in the APS group were(806.35±204.75)μg/L,(125.42±24.57)μg/L,(13.62±3.09)pg/mL,(16.24±3.72)pg/mL,1.62±0.42,significantly higher than(395.12±77.24)μg/L,(35.01±10.30)μg/L,(3.15±0.67)pg/mL,(4.02±1.13)pg/mL,0.85±0.23 in the control group(P<0.05).Pearson correlation analysis showed that serum sVCAM-1 and HMGB1 levels were positively correlated with peripheral blood mononuclear cells NLRP3 mRNA,serum IL-1β,and IL-18 levels in the APS group(P<0.05).Serum sVCAM-1 and HMGB1 levels in the thrombotic group were(915.35±70.28)μg/L,(136.42±10.17)μg/L,which were significantly higher than(767.59±61.43)μg/L,(121.51±15.03)μg/L in the non-thrombotic grou

关 键 词：抗磷脂综合征 可溶性血管细胞黏附分子-1 高迁移率族蛋白B1 NOD样受体P3炎症小体 血栓事件 

分 类 号：R442.8[医药卫生—诊断学]