狼疮肾炎患者血清sTRAIL及其受体DR4升高

Rising level of serum sTRAIL and its recipient DR4 in patients with lupus-nephritis

目的 :检测狼疮肾炎 (LN)患者血清可溶型TRAIL(sTRAIL)及其受体DR4 /DR5升高水平 ,探讨其与LN疾病的关系 .方法 :应用夹心酶联免疫吸附法 (ELISA) ,检测经临床及肾活检确诊为LN患者 2 7例和健康人 30例血清sTRAIL及其受体DR4 /DR5水平 ,同时检测LN患者补体C3,C4及循环免疫复合物 (CIC) ,采用狼疮活动指数 (SLEDAI)评价疾病活动性 ,sTRAIL与补体C3,C4 ,CIC及SLEDAI进行秩相关分析 .结果 :LN患者病理学诊断符合 .与对照组比较血清sTRAIL[μg·L-1 ,1 .839(3.31 3)vs 0 .733(0 .4 89) ,P≈ 0 .0 0 0 ],可溶型DR4 [μg·L-1 ,0 .1 0 7(0 .76 4 )vs0 .0 38(0 .0 32 ) ,P≈ 0 .0 0 0 ],而DR5未见明显升高 ,但sTRAIL与补体C3,C4 ,CIC和SLEDAI无明显相关 (P >0 .0 5 ) .结论 :LN患者血清sTRAIL及其受体DR4水平高于正常人 。

AIM: To find the relationship between lupus nephritis (LN) and the rising level of soluble TRAIL (sTRAIL) and its receptor DR4/DR5 in the serum. METHODS: The levels of sTRAIL, its receptor DR4/DR5, alexin C3 and C4, and circulating immune complexes (CIC) in the serum of 57 subjects were measured using ELISA. Among the 57 patients, 27 subjects in the experimental group, who were clinically diagnosed by biopsy as LN, and 30 were healthy subjects were in the control group. Rank correlation analyses were performed among these variables respectively. The relativity of LN activity and serum sTRAIL level was evaluated according to SLEDAI index. RESULTS: LN was confirmed by pathological examination. The median serum sTRAIL level in experimental group was much higher than that in control group [μg·L -1 , 1.839 (3.313) vs 0.733 (0.489) , P ≈ 0.000]. The median soluble DR4 level in experimental group was much higher than that in control group [μg·L -1 ,0.107 (0.764) vs 0.038 (0.032), P ≈0.000], but DR5 level of the control group was not significantly higher than that of the experimental group. However, there was no significant correlation of sTRAIL and alexin C3, C4, CIC and SLEDAI ( P >0.05) between the two groups. CONCLUSION: The abnormal rising of serum sTRAIL and its receptor DR4 level in LN patients may be due to the abnormal apoptosis in lesion site.