趋化因子积分是系统性红斑狼疮活动和损伤的生物标志物

Chemokine score is a novel biomarker for lupus patients with active diseases and organ damages

目的探讨趋化因子积分与系统性红斑狼疮（SLE）临床特征的相关性。方法采用实时定量聚合酶链反应（PCR）技术检测60例SLE患者，20例类风湿关节炎（RA）患者及23名健康对照外周血白细胞中7个趋化因子[RANTES、单核细胞趋化因子（MCP）-1、CCL19、MIG、IP-10、CXCL11和白细胞介素（IL）-8]的mRNA表达水平，计算趋化因子积分，并将其与相应的临床资料进行统计学分析。结果趋化因子积分在SLE患者中较疾病和健康对照显著增高（P=0．0112和P=0．0019）；趋化因子积分与SLEDAI积分呈正相关（P=0．0061），与补体C3水平呈负相关（P=0．003）；与无肾炎病史患者相比，趋化因子积分在活动性狼疮肾炎（LN）患者中显著增高，特别在泼尼松用量〈30mg／d时（P=0．0418及P=0．002）；趋化因子积分还与慢性损伤指数（SDI）相关；此外，在抗Sm、抗RNP抗体阳性的患者中也存在趋化因子积分显著升高。结论趋化因子积分与SLE的疾病活动性、脏器损伤的出现和严重程度以及特定的自身抗体表型相关，是SLE新的生物标志物。

Objective To correlate the chemokine score with disease activity, organ damages and clinical features in systemic lupus erythematosus （SLE） patients. Methods Peripheral blood cells obtained from 60 SLE patients, 20 rheumatoid arthritis （RA） patients and 23 healthy donors （HDs） were subjected to real-time PCR to measure the transcriptional levels of seven chemokines （RANTES, MCP-1, CCL19, MIG, IP-10, CXCL11, and IL-8）. Chemokine scores were calculated and were compared between various groups of SLE patients as well as between patients and controls. Results Chemokine scores were significantly elevated in SLE patients compared with RA patients and HDs （P=0.0112 and P=0.0019, respectively）. Chemokine scores were correlated positively with SLEDAI （P=0.0061） and negatively with C3 levels （P=0.003）. Compared to patients without lupus nephritis （LN）, chemokine scores were elevated in SLE patients with active LN, especially when their daily prednisone dosage was less than 30 mg （P=0.0418 and P=0.002, respectively）. Chemokine scores were also associated with cumulative organ damage （SLICC damage index [SDI] 〉 0） and positive anti-Sm and anti-RNP autoantibodies. Conclusion The chemokine score may serve as a new biomarker for disease activity and organ damage in SLE patients.