摘要
Objective To evaluate the association of the level of urine and serum soluble interleukin 2 receptor (sIL 2R) with disease activity and response to cyclosporine A (CsA) therapy in patients with lupus nephritis (LN). Methods Sixteen hospitalized patients with LN were studied. At admission, fifteen patients had type Ⅳ LN and one had type Ⅴ LN. All patients received CsA 6 mg/kg per day for 6 8 weeks, then tapered off gradually to 2 mg/kg per day. The levels of urinary and serum sIL 2R were determined by enzyme linked immunosorbent assay (ELISA). Serum antinuclear antibody (ANA), anti dsDNA antibody (A ds DNA), complement C3 and C4, total IgG, creatinine, urinary red blood cells and protein excretion, and lympocyte subpopulations in the peripheral blood were also measured before and after CsA treatment. Results In LN patients, both urinary (534±101 U/ml) and serum SIL 2R levels (326±148 U/ml) were higher than those in normal controls. These findings were associated with higher levels of peripheral bood CD4+ and CD8+ lymphocytes (29.3±4.24 and 28.6±9.12%), higher titer of serum anti ds DNA, lower levels of serum complement C3 and C4 (0.98± 0.23 and 0.24±0.12 g/L), as well as more proteinuria (Upro 2.99±0.76 g/24 hrs) and hematuria (URBC 83.9±95.2 10 4/ml). These abnormalities were gradually ameliorated by CSA therapy. the changes in the levels of both serum (116±58.6 U/ml) and urine (136±43.2 U/ml) SIL 2R induced by CsA (at 8 weeks) were correlated with the changes in the levels of CD4+ and CD8+ cells (23.2±3.30 and 26.7±3.54%), degrees of immune abnormalities (serum C3 and C4 1.28±0.14 and 0.42±0.06 g/L), and renal injuries (Upro 1.07±0.46 g/24hrs, URBC 5.82±3.15 10 4/ml). Conclusions These results suggest that serum and urinary sIL 2R are sensitive markers for the disease activity in patients with LN. CsA, a powerful immunosuppressive agent, significantly improves both immunologic disorders and renal functional impairments, the mechanism of which on patients with LN appears to inhibit the lymphocyte activation in the peripheral blood and renal tissues as indicated by the decrease in sIL 2R levels.
Objective To evaluate the association of the level of urine and serum soluble interleukin 2 receptor (sIL 2R) with disease activity and response to cyclosporine A (CsA) therapy in patients with lupus nephritis (LN). Methods Sixteen hospitalized patients with LN were studied. At admission, fifteen patients had type Ⅳ LN and one had type Ⅴ LN. All patients received CsA 6 mg/kg per day for 6 8 weeks, then tapered off gradually to 2 mg/kg per day. The levels of urinary and serum sIL 2R were determined by enzyme linked immunosorbent assay (ELISA). Serum antinuclear antibody (ANA), anti dsDNA antibody (A ds DNA), complement C3 and C4, total IgG, creatinine, urinary red blood cells and protein excretion, and lympocyte subpopulations in the peripheral blood were also measured before and after CsA treatment. Results In LN patients, both urinary (534±101 U/ml) and serum SIL 2R levels (326±148 U/ml) were higher than those in normal controls. These findings were associated with higher levels of peripheral bood CD4+ and CD8+ lymphocytes (29.3±4.24 and 28.6±9.12%), higher titer of serum anti ds DNA, lower levels of serum complement C3 and C4 (0.98± 0.23 and 0.24±0.12 g/L), as well as more proteinuria (Upro 2.99±0.76 g/24 hrs) and hematuria (URBC 83.9±95.2 10 4/ml). These abnormalities were gradually ameliorated by CSA therapy. the changes in the levels of both serum (116±58.6 U/ml) and urine (136±43.2 U/ml) SIL 2R induced by CsA (at 8 weeks) were correlated with the changes in the levels of CD4+ and CD8+ cells (23.2±3.30 and 26.7±3.54%), degrees of immune abnormalities (serum C3 and C4 1.28±0.14 and 0.42±0.06 g/L), and renal injuries (Upro 1.07±0.46 g/24hrs, URBC 5.82±3.15 10 4/ml). Conclusions These results suggest that serum and urinary sIL 2R are sensitive markers for the disease activity in patients with LN. CsA, a powerful immunosuppressive agent, significantly improves both immunologic disorders and renal functional impairments, the mechanism of which on patients with LN appears to inhibit the lymphocyte activation in the peripheral blood and renal tissues as indicated by the decrease in sIL 2R levels.
