SLE患儿外周血TLR-4、HMGB1的表达及临床意义

Expression of TLR-4 and HMGB1 in peripheral blood of children with SLE and its clinical significance

目的探讨Toll样受体4(TLR-4)、高迁移率族蛋白B1(HMGB1)在儿童系统性红斑狼疮(SLE)中的临床意义。方法选取40例SLE患儿(SLE组),以15名体检健康儿童作为正常对照组。将系统性红斑狼疮疾病活动度指数(SLEDAI)评分≥10分的患儿作为活动期组(20例),SLEDAI评分<10分的患儿作为稳定期组(20例),根据有无合并肾炎分为狼疮性肾炎组(24例)和非肾炎组(16例)。检测所有对象血清白细胞介素(IL)-17、IL-23、HMGB1、TLR-4水平。采用Pearson相关分析评估各项指标之间的相关性。结果SLE组血清IL-17、IL-23、HMGB1及TLR-4水平均高于正常对照组(P<0.05)。SLE活动期组血清IL-17、IL-23、HMGB1及TLR-4水平均高于稳定期组(P<0.05)。狼疮性肾炎组血清IL-17、IL-23、HMGB1及TLR-4水平均高于非肾炎组(P<0.05)。HMGB1与TLR-4、IL-17、IL-23均呈正相关(r值分别为0.424、0.563、0.498,P<0.05)。IL-17与SLEDAI评分呈正相关(r=0.726,P<0.05)。IL-23与SLEDAI评分、IgM、IgG、C反应蛋白(CRP)呈正相关(r值分别为0.615、0.321、0.465、0.587,P<0.05),与C3、C4呈负相关(r值分别为-0.461、-0.399,P<0.05)。HMGB1与抗双链DNA(dsDNA)抗体、抗Sm抗体、IgM、IgG呈正相关(r值分别为0.727、0.659、0.487、0.550,P<0.05),与C3呈负相关(r=-0.367,P<0.05)。TLR-4与SLEDAI评分、抗dsDNA抗体、CRP、IgM呈正相关(r值分别为0.762、0.721、0.614、0.636,P<0.05),与C3、C4呈负相关(r值分别为-0.520、-0.434,P<0.05)。结论TLR-4、HMGB1与儿童SLE的发生、发展有一定关系,且对提示SLE患儿肾脏损伤也有一定作用。

Objective To investigate the roles of Toll-like receptor 4(TLR-4)and high mobility group protein B1(HMGB1)in peripheral blood of children with systemic lupus erythematosus(SLE).Methods Totally,40 children with SLE(SLE group)and 15 healthy children(control group)were enrolled.SLE group was classified into active group(20 cases)with systemic lupus erythematosus disease activity index(SLEDAI)score≥10 and stable group(20 cases)with SLEDAI score<10,and according to presence or absence of nephritis,they were classified into nephritis group(24 cases)and non-nephritis group(16 cases).Serum interleukin(IL)-17,IL-23,HMGB1 and TLR-4 were determined.Pearson correlation analysis was used to analyze the correlations.Results Serum levels of IL-17,IL-23,HMGB1 and TLR-4 in SLE group were higher than those in control group(P<0.05).Serum levels of IL-17,IL-23,HMGB1 and TLR-4 in active group were higher than those in stable group(P<0.05).Serum levels of IL-17,IL-23,HMGB1 and TLR-4 in nephritis group were higher than those in non-nephritis group(P<0.05).HMGB1 was positively correlated with TLR-4,IL-17 and IL-23(r=0.424,0.563,0.498 and 0.745,P<0.05).IL-17 was positively correlated with SLEDAI score(r=0.726,P<0.05).IL-23 was positively correlated with SLEDAI score,IgM,IgG and C-reactive protein(CRP)(r=0.615,0.321,0.465 and 0.587,P<0.05).There was a negative correlation between C3 and C4(r=-0.461 and-0.399,P<0.05).HMGB1 was positively correlated with anti-double-stranded DNA(dsDNA)antibody,anti-Sm antibody,IgM and IgG(r=0.727,0.659,0.487 and 0.550,P<0.05).There was a negative correlation with C3(r=-0.367,P<0.05).TLR-4 was positively correlated with SLEDAI score,anti-dsDNA antibody,CRP and IgM(r=0.762,0.721,0.614 and 0.636,P<0.05).There was a negative correlation between C3 and C4(r=-0.520 and-0.434,P<0.05).Conclusions TLR-4 and HMGB1 are related to the occurrence and development of SLE in children,and they also play roles in renal injury in children with SLE.