PD-L1和IFN-ɑ与系统性红斑狼疮患者免疫功能异常的关系研究

Research on relationship between PD-L1,IFN-αand immune dysfunction in patients with systemic lupus erythematosus

目的:探讨PD-L1和IFN-α与系统性红斑狼疮(SLE)患者免疫功能异常的关系。方法:选取2018年1月~2019年12月于我院就诊的SLE患者52例(SLE组)和健康志愿者48例(对照组)。根据抗dsDNA抗体检测结果,将SLE组分为抗dsDNA抗体阳性组(18例)和阴性组(34例)。ELISA检测血清PD-L1和IFN-α,分别采用ELISA法和间接免疫荧光法检测抗dsDNA抗体,流式细胞术检测细胞表面PD-1和PD-L1,速率散射比浊法检测补体C3和C4,免疫比浊法检测CRP。结果:与对照组相比,SLE患者外周血CD4^+T细胞表面PD-1和PD-L1表达上调,阳性组高于阴性组(P<0.01);CD8^+T和CD19^+B细胞表面PD-1表达上调,PD-L1表达下调,阳性组与阴性组比较差异均有统计学意义(P<0.01);与阴性组和对照组相比,阳性组血清PD-L1、补体C3和C4显著降低,而IFN-α、CRP、SLEDAI及抗dsDNA抗体滴度显著增高(P<0.01);SLE患者血清PD-L1与IFN-α、SLEDAI、抗dsDNA抗体滴度和CRP呈显著负相关(r=-0.468,-0.494,-0.493,-0.352,P<0.05),与补体C3和C4呈显著正相关(r=0.498,0.326,P<0.05)。结论:PD-L1和IFN-α异常表达于SLE患者T、B淋巴细胞表面和血清,共同参与细胞及体液免疫功能调节。

Objective:To evaluate the relationship between PD-L1,IFN-αand immune dysfunction in systemic lupus erythematosus(SLE)patients.Methods:52 SLE patients(SLE group)and 48 healthy volunteers coming to our hospital from January 2018 to December 2019 were included.According to results of anti-dsDNA,SLE group was divided into anti-dsDNA positive group(18 cases)and negative group(34 cases).Serum levels of PD-L1 and IFN-αwere detected by ELISA,anti-dsDNA was detected by ELISA and indirect immnofluorescence,PD-1 and PD-L1 expression on cell surface were detected by flow cytometry,complement C3 and C4 were detected by rate scatter ratio,and CRP was detected by immunoturbidimetry.Laboratory datas related to disease activity were collected during the same period.Results:Compared with comtrol,expression of PD-L1and PD-1 on surface of CD4^+T cells were up-regulated,and positive group was higher than negative group(P<0.01).Expression of PD-1 on surface of CD8^+T and CD19^+B cells were increased,while PD-L1 was decreased;Compared with negative group healthy control group,serum level of PD-L1,complement C3 and C4 in positive group were decreased,while IFN-α,CPR,SLEDAI and anti-dsDNA antibody titer were increased(P<0.01);PD-L1 in patients serum was negatively correlated with IFN-α,SLEDAI,anti-dsDNA antibody titer and CRP(r=-0.468,-0.494,-0.493,-0.352,P<0.05),while positively correlated with complement C3 and C4(r=0.498,0.326,P<0.05).Conclusion:PD-L1 and IFN-αare abnormally expressed in cell surface and serum of T and B lymphocyte in SLE patients,to participate in regulation of immune function together.