血清可溶性PD-L1与白癜风临床相关性研究

Associations between the serum soluble programmed death ligand⁃1(sPD⁃L1)and clinical characteristics of vitiligo

目的 探讨血清可溶性程序性死亡配体1(sPD-L1)与白癜风相关临床特征的联系,并探索其临床意义。方法 收集白癜风患者(n=38)及正常对照者(n=38)的外周静脉血,采用ELISA法检测血清中sPD-L1的含量,分析其与白癜风临床表现的关系。结果 白癜风患者血清sPD-L1含量高于对照组[19.40(11.00~32.60)pg/mL vs. 16.20(9.10~19.90)pg/mL,P=0.043]。Logistic回归模型提示血清sPD-L1>17.80 pg/mL者发生白癜风的风险增加3.46倍(OR=3.46,95%CI:1.32~9.05);白癜风患者血清sPD-L1含量与皮损面积(r=0.336,P=0.039)及发病年龄(r=0.347,P=0.033)呈正相关;快速进展期的白癜风患者血清sPD-L1含量高于非快速进展期的患者[23.16(8.39,99.84)pg/mL vs. 12.89(2.38,72.91)pg/mL,P=0.026];多因素线性回归分析提示白癜风患者的发病年龄与病情活动度是血清sPD-L1含量的影响因素。结论 血清sPD-L1升高是发生白癜风的危险因素,且血清sPD-L1水平与白癜风的发病年龄、病情活动度呈正相关,提示sPD-L1可能参与白癜风的免疫发病机制,并与病情活动度有关。

Objective To analyze the association between serum soluble programmed death ligand⁃1(sPD⁃L1)expression levels and the clinical characteristics of vitiligo.Methods A total of 38 patients with vitiligo and 38 healthy controls were enrolled.Serum sPD⁃L1 level was determined by enzyme⁃linked immunosorbent assay(ELISA)and analyzed in terms of the characteristics of vitiligo.Results The serum sPD⁃L1 levels in patients with vitiligo were significantly upregulated compared with those in the healthy controls[19.40(11.00,32.60)pg/mL vs.16.20(9.10,19.90)pg/mL,P=0.043].Logistic regression analysis revealed that serum sPD⁃L1 level higher than 17.80 pg/mL is a risk factor for vitiligo(odds ratio=3.46,95%confidence interval:1.32,9.05).Serum sPD⁃L1 level was positively correlated with the lesion area(r=0.336,P=0.039)and age at disease onset(r=0.347,P=0.033).Serum sPD⁃L1 levels in patients with rapidly progressive vitiligo were higher than in those with non⁃rapidly progressive vitiligo[23.16(8.39,99.84)pg/mL vs.12.89(2.38,72.91)pg/mL,P=0.026].Muti⁃variant linear regression analysis revealed that the disease activity and age of onset of vitiligo influenced the serum level of sPD⁃L1.Conclusions Elevated serum sPD⁃L1 was a risk factor for vitiligo.Serum sPD⁃L1 was positively correlated with age of onset of vitiligo and disease activity,and may be involved in the immune pathogenesis of vitiligo and the disease activity.