IgG型、IgM型及IgA型抗ds-DNA抗体与SLE的相关性

Correlations between IgG,IgM and IgA anti-ds-DNA antibodies and systemic lupus erythematosus

目的分析抗双链DNA(ds-DNA)抗体3种亚型(IgG型、IgM型及IgA型)与系统性红斑狼疮(SLE)疾病活动度及典型临床表现的关系。方法采用酶联免疫吸附试验(ELISA)检测202例SLE患者血清IgG型、IgM型及IgA型抗ds-DNA抗体水平,分析其与系统性红斑狼疮疾病活动指数(SLEDAI)及15项临床表现的关系。结果 SLE组血清IgG型、IgM型、IgA型抗ds-DNA抗体水平明显高于正常对照组(P<0.01)。SLE组3种抗ds-DNA抗体水平由低到高依次为IgM型、IgA型、IgG型,各型之间差异均有统计学意义(P<0.01)。SLE活动组IgG型、IgM型、IgA型抗ds-DNA抗体水平均明显高于SLE缓解组(P<0.01),但2个组之间3种抗ds-DNA抗体阳性率差异均无统计学意义(P>0.05)。Spearman相关分析显示SLE患者IgG型、IgM型、IgA型抗ds-DNA抗体定性结果与SLEDAI评分均呈正相关(rs值分别为0.446、0.249、0.507,P<0.01)。抗核小体抗体阳性、抗核抗体阳性、蛋白尿、补体降低、外周关节炎、颊部红斑和脱发7项临床表现与IgG型抗ds-DNA抗体有关(P<0.05、P<0.01)。抗核小体抗体阳性、补体降低、白细胞减少、胸膜炎、发热5项临床表现与IgM型抗ds-DNA抗体有关(P<0.05、P<0.01)。抗核小体抗体阳性、抗核抗体阳性、补体降低、外周关节炎和白细胞减少5项临床表现与IgA型抗ds-DNA抗体有关(P<0.05、P<0.01)。结论 IgG型、IgA型抗dsDNA抗体与SLE疾病活动状况密切相关,而IgM型抗ds-DNA抗体在SLE中的作用较弱。SLE患者抗核小体抗体及补体降低2种临床表现与3种抗ds-DNA抗体亚型均有关。

Objective To investigate the correlations of 3 subtypes(IgG,IgM and IgA)of anti-doublestranded DNA(ds-DNA)antibodies with the disease activity of systemic lupus erythematosus(SLE)and SLE clinical phenotypes.Methods A total of 202 SLE patients were enrolled.The 3 subtypes(IgG,IgM and IgA)of anti-ds-DNA antibodies were determined by enzyme-linked immunosorbent assay(ELISA),and the correlations of IgG,IgM and IgA anti-ds-DNA antibodies with 15 clinical phenotypes and systemic lupus erythematosus disease activity index(SLEDAI)were evaluated.Results The levels of IgG,IgM and IgA anti-ds-DNA antibodies in SLE group were higher than those in healthy control group(P<0.01).The levels of IgM,IgA and IgG anti-ds-DNA antibodies in SLE group were from low to high in turn(P<0.01),which were higher in SLE active group than those in SLE remission group(P<0.01).However,the positive rates of IgG,IgM and IgA anti-ds-DNA antibodies between the 2 groups had no statistical significance(P>0.05).Spearman correlation analysis showed that there were positive correlations of IgG,IgM and IgA anti-ds-DNA antibodies with SLEDAI in SLE group(rs=0.446,0.249 and 0.507,P<0.01).Clinical phenotypes,including anti-nucleosome antibody positive,anti-nuclear antibody positive,proteinuria,complement decreasing,peripheral arthritis,malar rash and alopecia,were correlated with IgG anti-ds-DNA antibody(P<0.05,P<0.01).Anti-nucleosome antibody positive,complement decreasing,leukopenia,pleuritis and fever were correlated with IgM anti-ds-DNA antibody(P<0.05,P<0.01).Anti-nucleosome antibody positive,anti-nuclear antibody positive,complement decreasing,peripheral arthritis and leukopenia were correlated with IgA anti-ds-DNA antibody(P<0.05,P<0.01).Conclusions The levels of IgG and IgA anti-ds-DNA antibodies are correlated with the disease activity of SLE,while IgM has less effect in SLE.Clinical phenotypes such as antinucleosome antibody positive and complement decreasing show correlations with the 3 subtypes.