系统性红斑狼疮患者外周血浆细胞样树突状细胞的变化及意义

The change of plasmacytoid dendritic cells in peripheral blood of systemic lupus erythematosus patients and its significance

目的:探讨系统性红斑狼疮(SLE)患者外周血中浆细胞样树突状细胞(p DC)及干扰素-α(INF-α)水平的变化及意义。方法:选取SLE患者60例(SLE组)和正常健康人30名(对照组),利用流式细胞术检测外周血p DC在各组的相对计数;ELISA法测定血清中INF-α的浓度。结果:SLE患者外周血p DC相对计数显著低于对照组(P<0.01)。活动期SLE患者外周血p DC相对计数明显低于稳定期患者(P<0.01)。抗ds DNA抗体阳性的SLE患者外周血p DC的相对计数低于抗ds DNA抗体阴性的患者(P<0.01);SLE患者外周血p DC相对计数与ds DNA定量和ANA定量均呈明显负相关关系(P<0.01);SLE患者外周血p DC相对计数在P0抗体、抗U1RNP抗体、抗Sm抗体、抗组蛋白抗体、抗核小体抗体、抗SSA/Ro60抗体、抗SSA/Ro52抗体、抗SSB抗体阳性组和阴性组间差异均无统计学意义(P>0.05)。肾脏病变阳性组的SLE患者外周血p DC相对计数低于阴性组患者(P<0.01);血液系统损害阳性组的SLE患者外周血p DC相对计数低于血液系统阴性组患者(P<0.01);SLE患者外周血p DC相对计数在颊部红斑、光过敏、口腔溃疡、关节炎阳性组与阴性组间的差异均无统计学意义(P>0.05)。SLE患者外周血p DC相对计数与红细胞沉降率、C反应蛋白、免疫球蛋白G、免疫球蛋白A、补体3、补体4及系统性红斑狼疮疾病活动度评分均无相关关系(P>0.05)。SLE患者血清中IFN-α水平均显著高于对照组(P<0.01)。结论:SLE患者外周血p DC相对计数显著降低,SLE的p DC相对计数与病情相关,检测p DC相对计数可作为临床判断SLE病情活动的参考指标。

Objective： To explore the levels of plasmacytoid dendritic cells（ p DC） and interferon-α（ INF-α） in peripheral blood of patients with systemic lupus erythematosus（ SLE）,and its significance. Methods： Sixty patients with SLE and 30 healthy people were divided into the SLE group and control group,respectively. The relative amounts of p DC in two groups were measured by flow cytometry,and the serum levels of INF-α was detected by enzyme linked immunosorbent assay. Results： The relative amount of p DC in peripheral blood of patients with SLE was significantly lower than that in control groups（ P〈0. 01）. The relative amounts of p DC in peripheral blood in patients with active SLE was significantly lower than that in patients with stable SLE（ P〈0. 01）. The relative amount of p DC in peripheral blood in SLE patients with positive anti-ds DNA antibody was lower than that in SLE patients with negative anti-ds DNA antibody（ P〈0. 01）. The relative amount of p DC in peripheral blood in SLE patients was significantly negative correlation with the quantification of ds DNA and ANA（ P〈0. 01）. The differences of anti-P0 antibody,anti-U1 RNP antibody,anti-Smith antibody,anti-histone antibody,anti-nucleosome antibody,anti-SSA / Ro60 antibody,anti-SSA / Ro52 antibody and anti-SSB antibody between positive group and negative group were not statistically significant（ P〈0. 05）. The relative amount of p DC in peripheral blood in SLE patients with positive renal lesion was lower that in SLE patients with negative renal lesion（ P〉0. 01）. The relative amount of p DC in peripheral blood in SLE patients with positive hematologic damage was lower that in SLE patients with negative hematologic lesion（ P〈0. 01）. The differences of malar erythema,hypersensitivity to light,oral ulcersor and arthritis between positive group and negative group were not statistically significant（ P〈0. 05）. The relative amount of p DC in peripheral blood in SLE patients was correlation without erythrocyte sedimentation rate,C-reactive protein and immunoglobulin G and immunoglobulin,C3,C4 and activity scores of SLE（ P〈0. 05）. The serum level of IFN-α in patients with SLE was significantly higher than that in control group（ P〈0. 01）. Conclusions： The relative count of p DC in peripheral blood of SLE patients significantly decreases,which is correlation with disease,and a reference in clinical judgment of SLE disease activity.