单核细胞趋化蛋白-4在系统性红斑狼疮中的表达及临床意义

Expression of Monocyte Chemoattractant Protein-4 in Patients with Systemic Lupus Erythematosus and Its Clinical Significance

目的研究C-C亚族趋化因子单核细胞趋化蛋白-4(MCP-4/CCL13)在系统性红斑狼疮(SLE)患者外周血的表达水平,并分析MCP-4的水平与狼疮肾炎的关系,以探讨MCP-4在SLE发病机制中可能起的作用。方法选取2007年9月-2010年8月在四川大学华西医院和宜宾市第一人民医院诊断明确的SLE及类风湿关节炎(RA)患者各40例。另收入正常健康对照组(20例),应用酶联免疫吸附试验定量方法测定SLE组、RA患者和正常健康对照者血清中MCP-4的水平,SLE患者根据有无肾脏受累分为非狼疮肾炎组和狼疮肾炎组,其中非狼疮肾炎组20例,狼疮肾炎组20例,并分析SLE组血清MCP-4水平是否与抗核抗体、补体C3、C4等指标及SLE疾病活动指数SLEDAI评分相关性,血清MCP-4水平采用方差分析、LSD-t检验和Spearman相关进行统计分析。结果血清MCP-4水平SLE组为(216.32±12.65)pg/mL,RA组为(203.79±18.64)pg/mL,正常健康对照组为(125.13±11.08)pg/mL。SLE组、RA组血清MCP-4水平与正常健康对照组相比均有统计学意义(P<0.05),SLE组与RA组比较血清MCP-4水平无统计学意义(P>0.05);SLE患者中狼疮肾炎组与非狼疮肾炎组比较血清MCP-4水平无统计学意义(P>0.05)。SLE组血清MCP-4水平与抗核抗体、补体C3、C4等指标及SLEDAI评分无相关性。结论 MCP-4在SLE组患者血清中表达增高,MCP-4可能参与了SLE的发病过程,可能成为SLE新的血清学有用指标并作为治疗的靶点。

Objective To study the expression of C-C chemokines monocyte chemoattractant protein-4（MCP-4/CCL13） in the serum of patients with systemic lupus erythematosus（SLE） and the relationship between MCP-4 level and lupus nephritis,in order to investigate the possible function of MCP-4 in the onset of SLE.Methods Eighty patients diagnosed to have SLE or rheumatism arthritis（RA） in West China Hospital and the First People＇s Hospital of Yibin between September 2007 and August 2010 were included in our study.There were three groups of subjects in our experiment： control group（n=20）,SLE group（n=40）,and RA group（n=40）.MCP-4 level in patients of all the three groups were measured with ELISA method.SLE patients were further divided into lupus nephritis group（n=20） and non-lupus nephritis group（n=20） based on the fact whether kidney was involved.The correlation between MCP-4 level and ANA,C3,C4,SLEDAI score was analyzed for patients in the SLE group.Statistical methods included analysis of variance,LSD test and Spearman correlation analysis.Results Concentrations of MCP-4/CCL13 in patients from the SLE,RA,and control group were respectively（216.32 ± 12.65） pg/mL,（203.79±18.64） pg/mL,and（125.13 ± 11.08） pg/mL,and the concentration in the SLE and RA group was significantly higher than that in the control group（P0.05）.There was no significant difference in MCP-4/CCL13 serum concentration between the SLE group and the RA group（P0.05）.There was no correlation between MCP-4 and ANA,C3,C4,the SLEDAI score.Conclusions The expression of MCP-4/CCL13 in serum from SLE patients is higher than normal controls.MCP-4 may play an important role in the pathogenesis of SLE and it can be regarded as a useful serum marker for SLE.