新型细胞因子Metrnl与系统性红斑狼疮中巨噬细胞极化及其疾病活动度的关联研究

Association of nickel patterning proteins with macrophage polarization and disease activity in systemic lupus erythematosus

目的探讨镍纹样蛋白(Metrnl)在系统性红斑狼疮(SLE)及其严重并发症狼疮性肾炎(LN)患者中的水平,并探讨其与巨噬细胞极化状态及疾病活动度的关联。方法选取2023年6月至2024年5月该院收治的80例SLE患者作为研究对象,分为LN组(40例)和无LN组(40例),另选取同期该院30例年龄、性别匹配的健康体检者作为对照组。采用酶联免疫吸附试验检测Metrnl、M1型标志蛋白(iNOS)、M2型标志蛋白(Arg-1)、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-10水平。采用Pearson相关分析SLE患者Metrnl水平与各项常规实验室指标水平,以及iNOS、Arg-1、TNF-α、IL-10的相关性。采用受试者工作特征(ROC)曲线分析Metrnl在SLE和LN中的诊断价值。结果LN组平均Metrnl水平为(98.35±37.12)pg/mL,明显低于无LN组的(167.89±25.74)pg/mL和对照组的(257.89±22.45)pg/mL,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,SLE患者Metrnl水平与TNF-α水平均呈负相关(r=-0.328,P=0.015),与Arg-1、IL-10水平均呈正相关(r=0.538、0.489,P<0.05)。ROC曲线分析结果显示,Metrnl诊断SLE患者和健康体检者的曲线下面积(AUC)为0.88,灵敏度为90.32%,特异度为76.00%;诊断无LN患者和LN患者的AUC为0.83,灵敏度为87.10%,特异度为73.53%。结论Metrnl在SLE及LN的免疫调控中发挥重要作用,可能通过影响巨噬细胞极化状态调节疾病活动度。SLE患者血清Metrnl水平与炎症因子等临床指标水平均有明显相关性,为其作为评估疾病活动度和治疗反应的潜在生物标志物提供了理论依据。

Objective To investigate the level of nickel patterned protein(Metrnl)in patients with systemic lupus erythematosus(SLE)and its severe complication lupus nephritis(LN),and to explore its correlation with macrophage polarization and disease activity.Methods A total of 80 SLE patients admitted to the hospital from June 2023 to May 2024 were selected as the research objects,and they were divided into LN group(40 cases)and non-LN group(40 cases).In addition,30 age and gender matched healthy people in the hospital during the same period were selected as the control group.The levels of Metrnl,M1 marker protein(iNOS),M2 marker protein(Arg-1),tumor necrosis factor(TNF)-αand interleukin(IL)-10 were detected by enzyme-linked immunosorbent assay.Pearson correlation was used to analyze the correlation between Metrnl level and the levels of routine laboratory indicators,NOS,Arg-1,TNF-α,and IL-10 in SLE patients.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Metrnl in SLE and LN.Results The average Metrnl level in the LN group was(98.35±37.12)pg/mL,which was significantly lower than that in the non-LN group(167.89±25.74)pg/mL and the control group(257.89±22.45)pg/mL,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that Metrnl levels in SLE patients were negatively correlated with TNF-α level(r=-0.328,P=0.015),and positively correlated with Arg-1 and IL-10 levels(r=0.538,0.489,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of Metrnl for diagnosing SLE patients and healthy controls was 0.88,the sensitivity was 90.32%,and the specificity was 76.00%.The AUC for the diagnosis of non-LN patients and LN patients was 0.83,the sensitivity was 87.10%,and the specificity was 73.53%.Conclusion Metrnl plays an important role in the immune regulation of SLE and LN,and may regulate the disease activity by affecting the polarization of macrophages.Serum Metrnl levels in SLE patients are significantly correlated with inflammatory factors and clinical indicators,which provides a theoretical basis for its use as a potential biomarker to evaluate disease activity and treatment response.