抗中性粒细胞胞浆抗体相关性血管炎患者中MIF及MCP-1的检测及临床意义

The study of MIF and MCP-1 in patients with anti-neutrophil cytoplasmic antibody associated vasculitis

目的探讨抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AASV)患者中巨噬细胞迁移抑制因子(MIF)及单核细胞趋化蛋白(MCP)-1的检测及临床意义。方法采用酶联免疫吸附试验(ELISA)法检测84例AASV患者(疾病组)和60例体检健康者(健康对照组)血清中MIF及MCP-1水平,同时测定疾病组特异性自身抗体及一般实验室指标:肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、尿素氮(BUN)、肌酐(Cr)、补体C3、C4、红细胞沉降率(ESR)、超敏C-反应蛋白(hs-CRP)进行相关性分析。结果疾病组血清中MIF及MCP-1水平明显高于健康对照组;高滴度ANCA患者MIF及MCP-1水平高于阴性及低滴度ANCA患者,差异有统计学意义(P<0.05);高滴度ANCA患者中TNF-α、IL-6、Cr、hs-CRP、髓过氧化物酶(MPO)水平高于阴性及低滴度ANCA患者,差异有统计学意义(P<0.05);疾病组血清中MIF及MCP-1水平均与BUN、Cr、MPO、hs-CRP、TNF-α、IL-6水平呈正相关(r=0.241~0.556,P<0.05),且疾病组血清中MIF与MCP-1水平之间呈正相关(r=0.312,P=0.004)。结论AASV患者血清中MIF及MCP-1水平明显升高,尤其对于高滴度ANCA及肾脏受累严重的患者,MIF及MCP-1水平升高更明显,提示血清中MIF及MCP-1水平在AASV发病机制中有重要作用,可作为AASV病情活动的监测指标。

Objective To investigate the clinical significance of macrophage migration suppressor factor(MIF)and monocyte chemotactic protein(MCP)-1 in anti-neutrophil cytoplasmic antibody(ANCA)associated systemic vasculitis(AASV)patients.Methods The serum levels of MIF and MCP-1 in 84 AASV patients(disease group)and 60 healthy persons(healthy control group)were measured by ELISA methods.At the same time,the specific autoantibodies and general laboratory indexes,namely tumor necrosis factor(TNF)-α,interleukin(IL)-6,urea nitrogen(BUN),creatinine(Cr),complement C3,C4,erythrocyte sedimentation rate(ESR),high sensitive C-reactive protein(hs-CRP)of disease group were determined.Results The serum levels of MIF and MCP-1 in the disease group were significantly higher than those in healthy controls.The levels of MIF and MCP-1 in high titer ANCA patients were higher than those in negative and low titer ANCA patients,and the differences were statistically significant(P<0.05).The levels of TNF-α,IL-6,Cr,hs-CRP and myeloperoxidase(MPO)in patients with high titer ANCA were higher than those in patients with negative and low titer ANCA,and the differences were statistically significant(P<0.05).The levels of MIF and MCP-1 were positively correlated with the levels of BUN,Cr,MPO,hs-CRP,TNF-αand IL-6 in disease group(r=0.241-0.556,P<0.05),and the level of MIF was positively correlated with the level of MCP-1(r=0.312,P=0.004).Conclusion The serum level of MIF and MCP-1 were increased significantly in AASV patients.Especially for the patients with high titer ANCA and with severe renal involvement,the level of MIF and MCP-1 increased more obviously.It is suggested that the serum levels of MIF and MCP-1 play an important role in the pathogenesis of AASV,and can be used as AASV monitoring indicator of disease activity.