AhR与IL-22在系统性红斑狼疮患者中的表达及其临床意义

Expressions and clinical significance of AhR and IL-22 in patients with systemic lupus erythematosus

为探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血IL-22、芳香烃受体(aryl hydrocarbon receptor,AhR)的蛋白及mRNA表达水平,并分析IL-22、AhR与SLE疾病活动度评分(SLE disease activity index,SLEDAI)的相关性,采用ELISA检测43例SLE患者(活动期25例,非活动期18例)和41例健康对照者外周血IL-22、AhR蛋白表达水平;qRT-PCR检测SLE患者、健康对照者及31例类风湿关节炎(rheumatoid arthritis,RA)患者PBMC中IL-22和AhR mRNA表达水平;Spearman分析SLE患者IL-22和AhR的蛋白、mRNA水平分别与SLEDAI的相关性;ROC曲线分析抗dsDNA抗体、IL-22、AhR蛋白水平在SLE中的联合诊断效果。结果显示,SLE患者IL-22、AhR蛋白和mRNA水平均高于健康对照组(P<0.001),且活动期组均高于非活动期组(P<0.05)。SLE与RA患者比较,IL-22 mRNA水平升高更显著(P<0.05)。Spearman分析显示,SLE患者IL-22、AhR蛋白和mRNA水平均与SLEDAI呈正相关(P<0.01)。IL-22、AhR蛋白水平联合抗dsDNA抗体诊断SLE的AUC为0.986,敏感性和特异性分别高达90.7%和97.6%。该研究提示,SLE患者IL-22、AhR蛋白及mRNA水平均显著高于健康人,且均与SLEDAI呈正相关,血清IL-22、AhR联合抗dsDNA抗体诊断效果较好,有助于提高SLE的临床诊断水平。

This study aims to investigate the protein and mRNA expressions of IL-22 and aryl hydrocarbon receptor(AhR)in the peripheral blood of patients with systemic lupus erythematosus(SLE),and to analyze the correlation between IL-22 and AhR and SLE disease activity index(SLEDAI).The expression levels of IL-22 and AhR protein in the peripheral blood of 43 SLE patients(25 in active stage and 18 in inactive stage)and 41 healthy controls were measured by ELISA.The expression levels of IL-22 and AhR mRNA in PBMC of SLE patients,healthy controls,and 31 rheumatoid arthritis(RA)patients by qRT-PCR.Spearman analysis was used to calculate the correlations of IL-22 and AhR protein and mRNA levels with the SLEDAI in SLE patients.ROC curve was used to analyze the combined diagnostic effect of anti-dsDNA antibody,IL-22,and AhR protein levels in SLE.The results showed that the levels of IL-22,AhR protein and mRNA were higher in SLE patients than those in healthy controls(P<0.001),and they were all higher in the active phase than in the inactive phase(P<0.05).IL-22 expressions were significantly elevated in SLE patients compared to RA patients(P<0.05).Spearman analysis showed that IL-22,AhR protein and mRNA levels were all positively correlated with SLEDAI in SLE patients(P<0.01).The AUC of combined diagnosis of IL-22,AhR,and anti-dsDNA antibody for SLE was 0.986,with a sensitivity and specificity of 90.7%and 97.6%,respectively.In conclusion,the protein and mRNA levels of IL-22,AhR in SLE patients are significantly higher than those in healthy subjects and are positively correlated with SLEDAI.The diagnosis of serum IL-22 and AhR combined with anti-dsDNA antibody has higher accuracy and may improve the clinical diagnosis of SLE in the future.