系统性红斑狼疮患者血清干扰素诱导蛋白10的表达水平及临床意义

Serum level of interferon-inducible protein 10 and its clinical significance in patients with systemic lupus erythematosus

目的探讨趋化因子干扰素诱导蛋白10(IP-10)在系统性红斑狼疮(SLE)患者血清中的表达水平及其对SLE的临床诊断价值。方法采用ELISA法检测96例SLE患者以及30例正常对照组血清中IP-10表达水平,比较分析其与SLE病情活动指数(SLEDAI评分)、疾病活动性指标抗双链DNA(dS-DNA)抗体、抗C1q抗体、补体C3、C4水平、24 h尿蛋白定量(24 h UPQ)、超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)的相关性,以及通过检测Th1型细胞因子干扰素γ(IFN-γ)和Th2型细胞因子白介素-4(IL-4)来判断其在调节炎症免疫反应中的作用。结果总体SLE患者IP-10水平显著高于正常对照组,疾病活动狼疮肾炎(LN)组IP-10水平明显高于疾病活动非肾损伤组和疾病稳定组,差异有统计学意义(P<0.01),而疾病稳定LN组与疾病活动无肾损伤组间IP-10水平差异无统计学意义。在疾病活动期中,IP-10水平与SLEDAI评分、dS-DNA、hs-CRP呈明显正相关(P<0.01),与C3呈负相关(P<0.01),与C4、24 h UPQ、ESR无相关性,而在SLE肾损伤中,无论是活动期还是稳定期IP-10水平均和C1q呈正相关(P<0.05);SLE患者中IFN-γ、IL-4水平均明显高于正常对照组,IP-10与IFN-γ水平及IL-4/IFN-γ比值在疾病活动和稳定时均呈正相关(P<0.01),而与IL-4仅在疾病稳定时呈正相关(P<0.01)。结论 IP-10通过介导Th1型炎症免疫反应在SLE中发挥重大作用,其表达水平与SLE疾病活动性密切相关,尤其对狼疮肾炎及狼疮活动的早期监测具有重要意义。

Objective To explore the expression level of interferon-inducible protein 10（IP-10） and its clinical diagnostic significance in patients with systemic lupus erythematosus（SLE）.Methods Using ELISA to detect the serum expression level of IP-10 in 96 patiens with SLE and 30 healthy controls.The relationship between the activity of the pathogenetic condition（SLEDAI score）,anti-dS DNA antibody,anti-C1q antibody,complement C3,C4,hs-CRP,24 h urine protein quantitation（24 h UPQ）,ESR and serum IP-10 level were analyzed.To distinguish the effect of IP-10 in the regulation of inflammatory immune response by detecting IFN-γ of Th1 cytokines and IL-4 of Th2 cytokines.Results The overall levels of serum IP-10 in SLE patients increased markedly than that in normal control group.IP-10 levels in the active lupus nephritis patients were obviously higher than that in active no-renal involvement group and stabilization patients（P0.01）.However,IP-10 levels in active no-renal involvement group had no statistical significance with stabilization lupus nephritis patients.In the active patients,the level of serum IP-10 showed significant positive correlations with SLEDAI,dS-DNA,hs-CRP and negative correlation with serum C3 level（P0.01）and no correlation with C4,24 h UPQ,ESR,but in the renal involvement patients,no matter how the patients lie in active or in stabilization stage.The level of serum IP-10 showed significant positive correlations with C1q（P0.05）.The levels of serum IFN-γ,IL-4 in SLE patients was increased markedly than that in normal control group.In the active and stabilization patients,the level of IP-10 all showed significant correlations with IFN-γ and IL-4/IFN-γ（P0.01）.The level of IP-10 only showed significant correlations with IL-4 in stabilization patients（P0.01）.Conclusion IP-10 plays an important role in the diagnosis and early monitor of the activity of SLE,especially in the patients with lupus nephritis by mediating the inflammatory immune response of Th1.