摘要
系统性红斑狼疮(SLE)是一全身性多器官受累的自身免疫性疾病,发病机理未明。本课题从分子生物学和细胞生物学角度进行研究,发现抗DNA免疫复合物(抗DNAICs)与狼疮性肾炎(LN)发病密切相关,能促系膜细胞产生白介素6(IL6),对疾病的活动性、疗效判断有一定价值。在细胞因子与LN的相关性研究中,发现可溶性白介素2受体(sIL2R)、肿瘤坏死因子α(TNFα)、IL6及内皮素(ET)等与SLE的活动性明显相关,而且在国内外首次发现巨噬细胞移动抑制因子(MIF)与SLE活动性及肾损害密切相关。此外,红细胞免疫功能障碍及淋巴细胞凋亡也参与LN的发病。在临床研究方面,本课题除对LN进行研究外,对狼疮脑、血液危象及肺胸膜病变等也作了深入研究,并发现SLE并发溢乳现象,证明与泌乳素(PRL)增高有关;肾活检对LN的诊断、疗效及预后的评价有重要意义。皮质激素联合环磷酰胺冲击(CTXIV)是治疗LN及其它内脏损害的有效的成功的疗法。本课题还研究小剂量环孢素A(CsA)治疗LN,取得良好疗效;静脉输注大剂量免疫球蛋白(IVIG)治疗危重SLE是一有效的抢救措施。对SLE的预后因素也作了观察和分析。
Systemic Lupus erythematosus (SLE) is an autoimmune disease characterized by multiple system injury. The pathogenesis of SLE has not yet been elucidated. Previously, by using molecular biology and cytobiology method, we have carried out serial studies which showed that DNAantiDNA immune complexes(DNAantiDNA ICs) could enhance interleukin6(IL6) production by mesangial cells and plays an important role in the pathogenesis of lupus nephritis(LN). This suggests that DNAantiDNA ICs may be valuable in the evaluation of disease activity and treatment of LN. The activity of LN was also found to be significantly correlated with soluble interleukin2 receptor (sIL2R), tumor necrosis factorα(TNFα),IL6 and endothelin(ET).We first reported that macrophage migration inhibitory factor (MIF) is associated with renal injury and activity of SLE. We also found that disorder of erythrocyte immune function and the apoptosis of lymphocytes took part in the pathogenesis of LN. In clinical studies,we studied not only LN but also neuropsychiatric lupus, blood crisis, pulmonary and pleural involvement of SLE, SLE with galactorrhea which is showed to be associated with the increased of serum prolactin level. We have shown that renal biopsy has a significant value for the diagnosis, treatment and prognosis of LN. We also shown that combined steroid and intravenous cyclophosphamide pulse therapy(TVCTX) is an effective and successful therapeutic strategy for LN and other organ injury. In other clinical studies we showed that low dose cyclosporin A(CsA) is effective in the treatment of LN and high dose introvenous immunoglobulin (IVIG) is a valuable rescuing measure for severe SLE patients. In addition, we studied and evaluated prognostic factors in SLE.
出处
《中山医科大学学报》
CSCD
1998年第2期81-85,共5页
Academic Journal of Sun Yat-sen University of Medical Sciences
基金
国家教委博士点基金