转化生长因子βⅡ型受体在狼疮肾炎患者外周血单个核细胞表达的意义

Expression of TβⅡ mRNA in PBMCs of patients with lupus nephritis

目的 探讨狼疮肾炎（LN）患者外周血单个核细胞（PBMCs）转化生长因子βⅡ型受体（TβRⅡ）mRNA表达水平及其与疾病活动性的关系。方法 应用反转录-聚合酶链反应（RT—PCR）法检测44例LN患者（均为活动期患者）、21例其他非LN患者和40名健康对照组PBMCs中TβRⅡmRNA的表达水平，LN患者中未使用与使用激素和（或）免疫抑制剂患者分别为16例和28例。结果 LN患者PBMC中TβRⅡmRNA水平1．7±1．0显著低于非LN组4．0±3．1及健康对照组4．1±2．5（P〈0．01）；LN患者中未使用激素和（或）免疫抑制剂组TβRⅡmRNA的表达水平1．3±1．0低于用药组2．0±0．9（P〈0．05）：LN患者PBMCs中的TβRⅡmRNA表达水平与系统性红斑狼疮疾病活动指数（SLEDAI）评分标准（r=-0．309，P〈0．05）及抗双链DNA抗体（r=0．401，P〈0．01）呈显著负相关，与补体C3呈显著正相关（r=0．621。P〈0．01）。结论 LN患者PBMCs中的TβRⅡmRNA表达水平降低，TβRⅡ参与了LN的发病过程，并与疾病的活动性显著相关；应用激素和（或）免疫抑制剂可以提高TβRⅡmRNA的表达，减轻炎症损害。

Objective To investigate the association of TGF-β receptor type Ⅱ （TβⅡ ） mRNA with lupus nephritis （LN） and disease activity by testing its expression level in peripheral blood mononuclear cells （PBMCs）. Methods Forty-four patients with LN were included in this study. They were all had active LN. Tweaty-eight LN patients were taking glucocorticoids and/or immunosuppressive agents and sixteen had never taken steroids or immunosuppressive agents. The expression levels of TβⅡ mRNA were semi-quantitatively determined by reverse transcription-polymerase chain reaction （RT-PCR）. Results The expression levels of TβⅡ mRNA in PBMCs from LN patients （ 1.7±1.0）were lower than those of non-lupus nephritis （4.0±3.1） and healthy subjects （4.1±2.5）, （P〈0.01）. The difference of the expression levels between patients who took and had never taken glucocorticoids and/or immunosuppressive drugs was significantly statistically （P〈0.05）. The expression levels of TβⅡ mRNA in PBMCs of patients with LN were correlated significantly with the systemic lupus erythematosus disease activity index （SLEDAI） scores （r=-0.309, P〈0.05）, titers of antidsDNA antibody （r=-0.401, P〈0.01 ）and serum complement C3 level （r=0.621, P〈0.01 ）. Conclusion This study suggests that TβⅡ may be involved in the development of LN, and the TβⅡ mRNA expression levels in PBMCs from patients with SLE are significantly correlated with LN activity. Glucocorticoids or immunosuppressive drugs can increase the expression levels of TβⅡ mRNA and ameliorate renal damage.