系统性红斑狼疮患者血清异常表达的细胞因子检测筛选及临床意义  

Identification and clinical significance of abnormally expressed serum cytokines in patients with systemic lupus erythematosus

作　　者：任纪刚 张小敏 刘畅 任鹤菲 周琳 REN Ji-gang;ZHANG Xiao-min;LIU Chang;REN He-fei;ZHOU Lin(Department of Laboratory Medicine,The Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学第二附属医院(上海长征医院)检验科,上海200003

出　　处：《现代免疫学》2025年第1期14-21,共8页Current Immunology

基　　金：国家自然科学基金面上项目(81772283)。

摘　　要：为筛选系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清异常表达最为显著的细胞因子并探讨其临床意义,采用液相芯片技术筛查45种细胞因子组成谱在上海长征医院收治的SLE患者和健康对照者血清中的表达差异,ELISA验证其差异最显著的几种,并分析它们与患者SLE病情活动、实验室指标及肾脏受累程度的相关性。结果显示,45种细胞因子谱上在SLE患者血清中表达差异最为显著的有4种,进一步验证发现SLE患者的血清IL-6、IL-10、IL-1受体拮抗剂(IL-1 receptor antagonist,IL-1Ra)和IFN-γ诱导蛋白10(IFN-γ-inducible protein 10,IP-10)水平均显著高于对照者(均P<0.05);血清IL-10、IL-1Ra水平还与SLE患者的SLE疾病活动指数2000(SLE disease activity index 2000,SLEDAI-2K)评分正相关(均P<0.01);且SLE患者的血清IL-10水平与IgG、ESR均正相关(均P<0.05),血清IL-1Ra水平与补体C3、C4水平负相关(均P<0.05);SLE患者的血清IL-1Ra水平还与24 h尿液总蛋白定量(total protein in urine within 24 hours,TPU)呈正相关(P<0.001)。上述结果提示,SLE患者血清中存在多种细胞因子的异常表达,其中IL-10、IL-1Ra血清水平与SLE疾病活动程度有关,IL-1Ra还可能与SLE的肾脏受累有关,检测这些指标的变化可为SLE的临床诊疗和病情监测提供依据。This study aimed to screen and identify abnormally expressed cytokines in the serum of patients with SLE and to explore their clinical significance.Liquid-phase microarray technique was used to detect the expression differences of 45 cytokines spectrum in 3 SLE patients and 3 healthy individuals.Subsequently,ELISA was used to verify the most differentially expressed cytokines in 54 SLE patients and 28 healthy individuals,and their correlations with SLE disease activity index 2000(SLEDAI-2K)score,typic laboratory indicators and renal involvement were studied.The results showed that a total of 15 cytokines were highly expressed in the sera of SLE patients,and 4 most significant differentially expressed cytokines were picked out based on the fold differences.Further testing found that the serum levels of IL-6,IL-10,IL-1 receptor antagonist(IL-1Ra)and IFN-γ-inducible protein 10(IP-10)were significantly higher in SLE patients than in healthy controls(all with P<0.05).Among them the serum levels of IL-10 and IL-1Ra were positively correlated with the SLEDAI-2K score in SLE patients.In addition,serum IL-10 levels were positively correlated with serum IgG and ESR,while the serum IL-1Ra levels were negatively correlated with complement C3 and complement C4(all with P<0.05).Furthermore,the serum IL-1Ra levels were positively correlated with total protein in urine within 24 hours(TPU)in SLE patients(P<0.001).Collectively,above data indicates that multiple cytokines were abnormally expressed in SLE patients.The serum levels of IL-10 and IL-1Ra are related to the disease activity of SLE,and the serum IL-1Ra could be associated with SLE renal involvement.Detection of these indicators may provide proofs for clinical diagnosis,treatment,and monitoring of SLE.

关 键 词：系统性红斑狼疮 细胞因子 疾病活动 生物标志物 

分 类 号：R392.7[医药卫生—免疫学]