We report a 12 years old female patient with an overlap syndrome involving autoimmune hepatitis (AIH) and systemic lupus erythematosus (SLE). The patient presented with jaundice, hepatosplenomegaly, malaise, polya...We report a 12 years old female patient with an overlap syndrome involving autoimmune hepatitis (AIH) and systemic lupus erythematosus (SLE). The patient presented with jaundice, hepatosplenomegaly, malaise, polyarthralgia, arthritis and butterfly rash on the face. Laboratory tests revealed severe liver dysfunction, Coombs positive hemolytic anemia and a positive ANA/ anti-dsDNA test. Renal biopsy showed class IIA kidney disease, while liver biopsy showed chronic hepatitis with severe inflammatory activity. The patient satisfied the international criteria for both SLE and AIH. Clinical symptoms and laboratory findings of SLE improved with high dose treatment with corticosteroids and azathioprine, however, remission of the liver disease could not be achieved. Repeat biopsy of the liver after three years of therapy revealed ongoing chronic hepatitis with high level of inflammatory activity. The present case indicates that children with liver dysfunction and SLE should be investigated for AIH. There is much diagnostic and therapeutic dilemma in patients with AIH-SLE overlap syndrome.展开更多
Childhood-onset systemic lupus erythematosus (cSLE) is a severe multisystem autoimmune disease. Renal involvement occurs in the majority of cSLE patients and is often fatal. Renal biopsy is an important investigatio...Childhood-onset systemic lupus erythematosus (cSLE) is a severe multisystem autoimmune disease. Renal involvement occurs in the majority of cSLE patients and is often fatal. Renal biopsy is an important investigation in the management of lupus nephritis. Treatment of renal lupus consists of an induction phase and main-tenance phase. Treatment of childhood lupus nephritis using steroids is associated with poor outcome and excess side-effects. The addition of cyclophosphamide to the treatment schedule has improved disease control. In view of treatment failure using these drugs and a tendency for non-adherence, many newer agents such as immune-modulators and monoclonal antibodies are being tried in patients with cSLE. Trials of these novel agents in the pediatric population are still lacking making a consensus in the management protocol of pediatric lupus nephritis diffcult.展开更多
AIM:To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS:Thirty-five...AIM:To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS:Thirty-five consecutive adult patients with SLE and 35 age-and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed. RESULTS:Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P < 0.0001), withhemangioma being the most commonly observed lesion in the two groups. SLE was associated with the presence of single hemangioma [odds ratios (OR) 5.05; 95% confidence interval (CI) 1.91-13.38] and multiple hemangiomas (OR 4.13; 95% CI 1.03-16.55). Multiple hemangiomas were associated with a longer duration of SLE (9.9 ± 6.5 vs 5.5 ± 6.4 years; P = 0.04). Imaging prior to SLE onset was available in 9 patients with SLE and hemangioma, showing absence of lesions in 7/9. The clinical data of our patients suggest that SLE pos- sibly plays a role in the development of hemangioma. In addition, a Budd-Chiari syndrome associated with nodular regenerative hyperplasia (NRH), and a NRH associated with hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population. CONCLUSION:SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE.展开更多
Systemic lupus erythematosus (SLE) is a typical autoimmune disease involving multiple systems and organs. Ample evidence suggests that autoreactive T cells play a pivotal role in the development of this autoimmune d...Systemic lupus erythematosus (SLE) is a typical autoimmune disease involving multiple systems and organs. Ample evidence suggests that autoreactive T cells play a pivotal role in the development of this autoimmune disorder. This study was undertaken to investigate the mechanisms of interaction between antigen presenting cells (APCs) and an autoreactive T cell (ATLI) clone obtained from lupus-prone BXSB mice. ATLI cells, either before or after 7-ray irradiation, were able to activate naive B cells, as determined by B cell proliferation assays. Macrophages from BXSB mice were able to stimulate the proliferation of resting ATL 1 cells at a responder/stimulator (R/S) ratio of 1/2.5. Dendritic cells (DCs) were much more powerful stimulators for ATLI cells on a per cell basis. The T cell stimulating ability ofmacrophages and B cells, but not DCs, was sensitive to T-ray irradiation. Monoclonal antibodies against mouse MHC-Ⅱ and CD4 were able to block DC-mediated stimulation of ATL 1 proliferation, indicating cognate recognition between ATL 1 and APCs. Our data suggest that positive feedback loops involving macrophages, B cells and autoreactive T cells may play a pivotal role in keeping the momentum of autoimmune responses leading to autoimmune diseases.展开更多
AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 ...AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT). RESULTS: Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sj gren's syndrome (SS) (IgG4: 590 ± 232 mg/L), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/L) had systemic lupus erythematosus (SLE). The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level. CONCLUSION: The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.展开更多
Objective To investigate the expressions of chemokine receptors and interleukin (IL) receptors on the peripheral blood mononuclear cells (PBMCs) from systemic lupus erythematosus (SLE) patients and their correla...Objective To investigate the expressions of chemokine receptors and interleukin (IL) receptors on the peripheral blood mononuclear cells (PBMCs) from systemic lupus erythematosus (SLE) patients and their correlations with clinical features as well as SLE disease activity index (SLEDAI). Methods The mRNA expressions of chemokine receptors and IL receptors on PBMCs of 93 SLE patients and 30 healthy controls were detected by reverse transcription-polymerase chain reaction, including CCR2, CCR3, CCR4, CCR5, CCR6, CCR8, CXCR3, CXCR5, CX3CR1, XCR1, IL-4R, and IL-10R. The clinical features of SLE patients were recorded. The correlations of chemokine receptors and IL receptors mRNA expressions with clinical features as well as SLEDAI were assayed using linear regression analysis. Results The level of CCR5 mRNA in SLE patients (including active and inactive SLE) was signifi- cantly higher than that in healthy controls (P〈0.05), and there was no significant difference between active and inactive patients in this respect (P〉0.05). CX3CR1 mRNA expression significantly increased from healthy control to inactive SLE to active SLE in sequence. The others (except for CCR8, CXCR3, and IL-1 OR) in active SLE patients weresignificantly higher than those in both inactive SLE patients and healthy controls (all P〈0.05). There were positive correlations between SLEDAI and CCR2 (r=0.424, t=4.313, P〈0.001), CCR3 (r=0.518, t=5.410, P〈0.001), CCR4 (r=0.376, t=3.851, P〈0.001), CCR6 (r=0.457, t=4.513,P〈0.001), CXCR5 (r=0.455, t=4.629, P〈0.001), CX3CR1 (r=0.44-5, t=4.523, P〈0.001), as well as XCRI (r=0.540, t=5.445, P〈0.001). And CCR5 mRNA expression level was positively correlated with IL-4R mRNA (r=0.313, t=2.353, P〈0.05). The patients with myositis and cutaneous vasculitis simultaneously showed lower levels of CCR5 and CX3CRI, and CCR5 expression was negatively correlated with the scores of SLEDAI in SLE cases accompanied by photosensitivity (r=0.426, t=- 2.155, P〈0.05). Conclusion Increased expressions of CCR5 and CX3CRI on PBMCs may be indicators in clinical survey for SLE.展开更多
Autoantibodies in systemic lupus erythematosus which cross-react with double stranded DNA and intermediate filament proteins are frequently reported. However, little is Known about the origin and the target of these a...Autoantibodies in systemic lupus erythematosus which cross-react with double stranded DNA and intermediate filament proteins are frequently reported. However, little is Known about the origin and the target of these antibodies. In this paper, a polyspecific monoclonal antibody, XY12, produced by the immunization of genetically non-autoimmune mice with a DNA-protein complex is detailed. Its antigen binding patterns are very similar to the autoantibodies. The data suggest that these autoantibedies may be triggered by a circulating nucleoprotein.展开更多
Objective To determine the frequency and the clinical significance of anticardiolipin antibodies (ACA) in patients with systemic lupus erythematosus( SLE).Methods The serum ACA in 30 patients with SLE and 30 sera from...Objective To determine the frequency and the clinical significance of anticardiolipin antibodies (ACA) in patients with systemic lupus erythematosus( SLE).Methods The serum ACA in 30 patients with SLE and 30 sera from healthy volunteers was detected by the enzyme linked immunosorbend assay (ELISA).Results In normal group the binding index(BI) oflgG, IgM and IgA type of ACA was 1.48 ?展开更多
In this study, we characterized specifically-stained sera from patients with systemic lupus erythematosus (SLE) which had been shown to display the homogeneous or peripheral region of nuclei by indirect immunofluoresc...In this study, we characterized specifically-stained sera from patients with systemic lupus erythematosus (SLE) which had been shown to display the homogeneous or peripheral region of nuclei by indirect immunofluorescence (IIF). By western blotting, we demonstrated that in some cases there was a correlation between the peripheral or homogenous. IIF staining of nuclei by sera from patients with SLE and the presence of autoantibodies to lamins. Here we first report the presence of 2. 2% anti-lamin autoantibodies in the sera among the 174 patients with SLE in China.展开更多
MAKING accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations.The possibility that vasculitis associated with systemic lupus erythematosus(SLE...MAKING accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations.The possibility that vasculitis associated with systemic lupus erythematosus(SLE)and antiphospholipid syndrome(APS)can be misdiagnosed as cysticercosis has not been discussed in the literatures.展开更多
Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures(SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of ...Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures(SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough(5 cases),dyspnoea(3 cases),breathlessness(3 cases),and wheeze(2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease(7 cases),rheumatoid arthritis(3 cases),systemic lupus erythematosus(1 case),asthma(1 case),and thoracic vertebral fracture(13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.展开更多
Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testi...Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testing of 36 patients with SLE were analyzed. Results The sensitivity of the pulmonary involvement by HRCT, plain chest radiography and pulmonary function testing were 88.9%,36.1%,and 33.3%, respectively. Conclusion HRCT played an important role in detecting pulmonary involvemen due to SLE, especially in early and mild cases.展开更多
With the aid of methods of polymerase chain reaction / sequence specific primers (PCR/SSP) and polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP), the allelic polymorphism of HLA-DR and TNFB...With the aid of methods of polymerase chain reaction / sequence specific primers (PCR/SSP) and polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP), the allelic polymorphism of HLA-DR and TNFB loci and susceptibility to systemic lupus erythematosus (SLE) in northern Chinese Han nationality were studied. The genetic analysis of 51 patients with SLE and 106 healthy controls indicated that frequencies of DR2 and DR3 alleles were significantly increased in SLE patients(P< 0.05 and <0. 005, relative risks of 1.77 and 4.01 respectively), which represent candidate susceptible genes or useful marker for SLE. The frequency of DR5 was found to decrease in SLE patients compared with control population (P<0. 025,relative risk = 0. 38). It might be an antagonistic or protective allelle or a marker for such allele. Analysis of 51 patients with SLE and 80 healthy control also revealed that the frequency of TNFB' 2 allele was significantly increased(P<0. 05,RR= 1. 70). Therefore TNFB' 2 gene may also be a susceptibility gene or a marker gene for SLE in northern Chinese Han nationality. It was also investigated the association between HLA-DR,TNF B alleles and Patient plasmic SC5b-9 levels,auto-antibodies (anti-SSA,SSB,Sm,RNP,ds DNA and ANA) and SLE complications (SLE nephritis,SLE pneu-monitis and SLE encephalopathy) ,no relationship was found.展开更多
An improved MEW ( muhiplicative exponent weighting) algorithm, SLE-MEW is proposed for vertical handoff decision in heterogeneous wireless networks. It introduces the SINR( signal to interference plus noise ratio)...An improved MEW ( muhiplicative exponent weighting) algorithm, SLE-MEW is proposed for vertical handoff decision in heterogeneous wireless networks. It introduces the SINR( signal to interference plus noise ratio) effects, LS (least square) and information entropy method into the algorithm. An attribute matrix is constructed considering the SINR in the source network and the equivalent SINR in the target network, the required bandwidth, the traffic cost and the available bandwidth of participating access networks. Handoff decision meeting multi-attribute QoS(quality of serv- ice) requirement is made according to the traffic features. The subjective weight relation of decision elements is determined with LS method. The information entropy method is employed to derive the objective weights of the evaluation criteria, and lead to the comprehensive weight. Finally decision is made using MEW algorithm based on the attribute matrix and weight vector. Four 3GPP( the 3rd generation partnership project) defined traffic classes are considered in performance evaluation. The simulation results have shown that the proposed algorithm can provide satisfactory performance fitting to the characteristics of the traffic.展开更多
Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). M...Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). Methods Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for IT with MTX 10-20?mg plus DXM 10-20?mg. The effects and side effects of IT were closely observed. Results The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving IT improved considerably. Cerebrospinal fluid pressure,protein and WBC levels declined from 201.5±155.4?mm?H2O, 145.2±87.6?mg/dl and 25.1±14.3/mm3 to 128.7±108.1?mm?H2O, 60.8±38.3?mg/dl and 6.8±2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence.Conclusion IT with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.展开更多
Objective To study the effects of dehydroepiandrosterone (DHEA) and/or estradiol (E 2) on apoptosis in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) Methods ...Objective To study the effects of dehydroepiandrosterone (DHEA) and/or estradiol (E 2) on apoptosis in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) Methods The percentage of apoptosis of PBMCs from SLE patients and healthy blood donors were examined by means of AO staining 48?h after culture with DHEA and/or E 2 at physiologic or pathologic concentrations Results The percentage apoptosis of PBMCs from SLE patients is higher than that of healthy blood donors ( P <0 01) E 2, whether at physiological or at pathological concentrations, had no effects on apoptosis of PBMCs from both SLE patients and healthy donors ( P >0 05) Both DHEA and DHEA plus E 2 at physiologic concentrations, had no effect on apoptosis of PBMCs from healthy donors ( P >0 05), but significantly inhibited that of SLE patients ( P <0 05); at pathologic concentrations,they promoted apoptosis of PBMCs from SLE patients as well as healthy blood donors ( P <0 05) There were no significant differences between the effects of DHEA and that of DHEA plus E 2 ( P >0 05) Conclusion DHEA plays an important role in the apoptosis of PBMCs from SLE patients; low serum levels of DHEA may cause accelerated apoptosis展开更多
Objective To investigate the prevalence and features of active human cytomegalovirus (HCMV) infection in children with systemic lupus erythematosus (SLE) and evaluate the diagnostic value of the HCMV using antigenemia...Objective To investigate the prevalence and features of active human cytomegalovirus (HCMV) infection in children with systemic lupus erythematosus (SLE) and evaluate the diagnostic value of the HCMV using antigenemia assay, serum polymerase chain reaction (PCR) and serology test. Methods Twenty-one SLE children undergoing immunosuppressive therapy were enrolled in this study. Immunofluorescence assay, PCR and serology tests were used to determine HCMV pp65 and p72 antigens in leukocytes, HCMV DNA in sera, and HCMV specific IgM and IgG antibodies, respectively. As a control group, twenty-one immunocompetent children with skeletal malformation were involved in this study. Statistical analysis was performed using Chi-square test or Fisher's exact test (Systat, USA), P values less than 0.05 were considered significant.Results Active HCMV infection was diagnosed in 28.6% (6/21) of SLE patients, with none in the control group; the difference between the two groups was significant (P=0.027). Two out of 6 SLE patients developed active HCMV infection before immunosuppressive therapy and the remaining 4 patients developed SLE after immunosuppressive therapy. Among the 21 SLE children, HCMV pp65 antigenemia was detected in 5 patients, p72 antigenemia in 3 patients, serum HCMV DNA in 9 patients, serum HCMV-specific IgM in 2 patients, and IgG in 19 patients. The sensitivity and specificity for diagnosis of active HCMV infection were 83.3% and 100%, respectively for pp65 antigenemia; 50% and 100% for p72 antigenemia; 100% and 80% for serum PCR; 33.3% and 100% for HCMV IgM serology; 50% and 100% for HCMV IgG serology. Conclusions Compared with the control group, active HCMV infection is much more frequent in SLE children, and can occur before treatment with immunosuppressive agents, but most often occur after immunosuppressive therapy. In comparison with the other techniques used in this study, the pp65 antigenemia assay seems to be a better method for the early diagnosis and monitoring of active HCMV infection in children with SLE.展开更多
Objective To determine the in vitro expression of interleukin-12 (IL-12) and its effect on signal transducers and activators of transcription (STAT) signaling molecules in peripheral blood mononuclear cells (PBMCs) in...Objective To determine the in vitro expression of interleukin-12 (IL-12) and its effect on signal transducers and activators of transcription (STAT) signaling molecules in peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE).Methods Peripheral blood mononuclear cells in 39 patients with definite systemic lupus erythematosus and 11 healthy volunteers were collected. Expression of IL-12 P40mRNA in PBMCs was determined with reverse transcription-polymerase chain reaction (RT-PCR). Quantity of IL-12 protein supernatant was measured by enzyme-linked immunosorbent assay (ELISA). The levels of phosphorylated STAT3 and STAT4 signaling molecules in PBMCs were detected by immunoblot. Results Levels of IL-12 protein and mRNA expression in patients with active or inactive SLE were significantly higher than those in controls. Phytohemagglutinin (PHA) may promote the expression of IL-12. IL-12 alone induced the phosphorylation of STAT3 and STAT4 in PBMCs from patients with SLE, especially in active SLE. However it had no obvious effect on normal PBMCs. Phosphorylated STAT3 and STAT4 might be observed in normal PBMCs treated with IL-12 plus PHA.Conclusion IL-12 is produced aberrantly in patients with SLE. IL-12 might exert its biological role in SLE via the aberrantly phosphorylated STAT3 and STAT4 signaling molecules.展开更多
文摘We report a 12 years old female patient with an overlap syndrome involving autoimmune hepatitis (AIH) and systemic lupus erythematosus (SLE). The patient presented with jaundice, hepatosplenomegaly, malaise, polyarthralgia, arthritis and butterfly rash on the face. Laboratory tests revealed severe liver dysfunction, Coombs positive hemolytic anemia and a positive ANA/ anti-dsDNA test. Renal biopsy showed class IIA kidney disease, while liver biopsy showed chronic hepatitis with severe inflammatory activity. The patient satisfied the international criteria for both SLE and AIH. Clinical symptoms and laboratory findings of SLE improved with high dose treatment with corticosteroids and azathioprine, however, remission of the liver disease could not be achieved. Repeat biopsy of the liver after three years of therapy revealed ongoing chronic hepatitis with high level of inflammatory activity. The present case indicates that children with liver dysfunction and SLE should be investigated for AIH. There is much diagnostic and therapeutic dilemma in patients with AIH-SLE overlap syndrome.
文摘Childhood-onset systemic lupus erythematosus (cSLE) is a severe multisystem autoimmune disease. Renal involvement occurs in the majority of cSLE patients and is often fatal. Renal biopsy is an important investigation in the management of lupus nephritis. Treatment of renal lupus consists of an induction phase and main-tenance phase. Treatment of childhood lupus nephritis using steroids is associated with poor outcome and excess side-effects. The addition of cyclophosphamide to the treatment schedule has improved disease control. In view of treatment failure using these drugs and a tendency for non-adherence, many newer agents such as immune-modulators and monoclonal antibodies are being tried in patients with cSLE. Trials of these novel agents in the pediatric population are still lacking making a consensus in the management protocol of pediatric lupus nephritis diffcult.
基金Supported by Department of Internal Medicine,Nephrology and Ageing of University of Bologna,Italy
文摘AIM:To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS:Thirty-five consecutive adult patients with SLE and 35 age-and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed. RESULTS:Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P < 0.0001), withhemangioma being the most commonly observed lesion in the two groups. SLE was associated with the presence of single hemangioma [odds ratios (OR) 5.05; 95% confidence interval (CI) 1.91-13.38] and multiple hemangiomas (OR 4.13; 95% CI 1.03-16.55). Multiple hemangiomas were associated with a longer duration of SLE (9.9 ± 6.5 vs 5.5 ± 6.4 years; P = 0.04). Imaging prior to SLE onset was available in 9 patients with SLE and hemangioma, showing absence of lesions in 7/9. The clinical data of our patients suggest that SLE pos- sibly plays a role in the development of hemangioma. In addition, a Budd-Chiari syndrome associated with nodular regenerative hyperplasia (NRH), and a NRH associated with hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population. CONCLUSION:SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE.
基金supported by grants from the National Key Basic Research Programs(2001CB510007)National Natural Science Foundation of China(30371303).
文摘Systemic lupus erythematosus (SLE) is a typical autoimmune disease involving multiple systems and organs. Ample evidence suggests that autoreactive T cells play a pivotal role in the development of this autoimmune disorder. This study was undertaken to investigate the mechanisms of interaction between antigen presenting cells (APCs) and an autoreactive T cell (ATLI) clone obtained from lupus-prone BXSB mice. ATLI cells, either before or after 7-ray irradiation, were able to activate naive B cells, as determined by B cell proliferation assays. Macrophages from BXSB mice were able to stimulate the proliferation of resting ATL 1 cells at a responder/stimulator (R/S) ratio of 1/2.5. Dendritic cells (DCs) were much more powerful stimulators for ATLI cells on a per cell basis. The T cell stimulating ability ofmacrophages and B cells, but not DCs, was sensitive to T-ray irradiation. Monoclonal antibodies against mouse MHC-Ⅱ and CD4 were able to block DC-mediated stimulation of ATL 1 proliferation, indicating cognate recognition between ATL 1 and APCs. Our data suggest that positive feedback loops involving macrophages, B cells and autoreactive T cells may play a pivotal role in keeping the momentum of autoimmune responses leading to autoimmune diseases.
基金Supported by Grants TáMOP-4.2.1./B-09/1/KONV and 4.2.2-08/1-2008-0002 (partly)
文摘AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT). RESULTS: Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sj gren's syndrome (SS) (IgG4: 590 ± 232 mg/L), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/L) had systemic lupus erythematosus (SLE). The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level. CONCLUSION: The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.
基金Supported by National Natural Science Foundation of China (30170863 and 30771938)Natural Science Foundation of Jiangsu Province (BK2001195)
文摘Objective To investigate the expressions of chemokine receptors and interleukin (IL) receptors on the peripheral blood mononuclear cells (PBMCs) from systemic lupus erythematosus (SLE) patients and their correlations with clinical features as well as SLE disease activity index (SLEDAI). Methods The mRNA expressions of chemokine receptors and IL receptors on PBMCs of 93 SLE patients and 30 healthy controls were detected by reverse transcription-polymerase chain reaction, including CCR2, CCR3, CCR4, CCR5, CCR6, CCR8, CXCR3, CXCR5, CX3CR1, XCR1, IL-4R, and IL-10R. The clinical features of SLE patients were recorded. The correlations of chemokine receptors and IL receptors mRNA expressions with clinical features as well as SLEDAI were assayed using linear regression analysis. Results The level of CCR5 mRNA in SLE patients (including active and inactive SLE) was signifi- cantly higher than that in healthy controls (P〈0.05), and there was no significant difference between active and inactive patients in this respect (P〉0.05). CX3CR1 mRNA expression significantly increased from healthy control to inactive SLE to active SLE in sequence. The others (except for CCR8, CXCR3, and IL-1 OR) in active SLE patients weresignificantly higher than those in both inactive SLE patients and healthy controls (all P〈0.05). There were positive correlations between SLEDAI and CCR2 (r=0.424, t=4.313, P〈0.001), CCR3 (r=0.518, t=5.410, P〈0.001), CCR4 (r=0.376, t=3.851, P〈0.001), CCR6 (r=0.457, t=4.513,P〈0.001), CXCR5 (r=0.455, t=4.629, P〈0.001), CX3CR1 (r=0.44-5, t=4.523, P〈0.001), as well as XCRI (r=0.540, t=5.445, P〈0.001). And CCR5 mRNA expression level was positively correlated with IL-4R mRNA (r=0.313, t=2.353, P〈0.05). The patients with myositis and cutaneous vasculitis simultaneously showed lower levels of CCR5 and CX3CRI, and CCR5 expression was negatively correlated with the scores of SLEDAI in SLE cases accompanied by photosensitivity (r=0.426, t=- 2.155, P〈0.05). Conclusion Increased expressions of CCR5 and CX3CRI on PBMCs may be indicators in clinical survey for SLE.
文摘Autoantibodies in systemic lupus erythematosus which cross-react with double stranded DNA and intermediate filament proteins are frequently reported. However, little is Known about the origin and the target of these antibodies. In this paper, a polyspecific monoclonal antibody, XY12, produced by the immunization of genetically non-autoimmune mice with a DNA-protein complex is detailed. Its antigen binding patterns are very similar to the autoantibodies. The data suggest that these autoantibedies may be triggered by a circulating nucleoprotein.
文摘Objective To determine the frequency and the clinical significance of anticardiolipin antibodies (ACA) in patients with systemic lupus erythematosus( SLE).Methods The serum ACA in 30 patients with SLE and 30 sera from healthy volunteers was detected by the enzyme linked immunosorbend assay (ELISA).Results In normal group the binding index(BI) oflgG, IgM and IgA type of ACA was 1.48 ?
文摘In this study, we characterized specifically-stained sera from patients with systemic lupus erythematosus (SLE) which had been shown to display the homogeneous or peripheral region of nuclei by indirect immunofluorescence (IIF). By western blotting, we demonstrated that in some cases there was a correlation between the peripheral or homogenous. IIF staining of nuclei by sera from patients with SLE and the presence of autoantibodies to lamins. Here we first report the presence of 2. 2% anti-lamin autoantibodies in the sera among the 174 patients with SLE in China.
文摘MAKING accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations.The possibility that vasculitis associated with systemic lupus erythematosus(SLE)and antiphospholipid syndrome(APS)can be misdiagnosed as cysticercosis has not been discussed in the literatures.
文摘Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures(SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough(5 cases),dyspnoea(3 cases),breathlessness(3 cases),and wheeze(2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease(7 cases),rheumatoid arthritis(3 cases),systemic lupus erythematosus(1 case),asthma(1 case),and thoracic vertebral fracture(13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.
文摘Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testing of 36 patients with SLE were analyzed. Results The sensitivity of the pulmonary involvement by HRCT, plain chest radiography and pulmonary function testing were 88.9%,36.1%,and 33.3%, respectively. Conclusion HRCT played an important role in detecting pulmonary involvemen due to SLE, especially in early and mild cases.
文摘With the aid of methods of polymerase chain reaction / sequence specific primers (PCR/SSP) and polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP), the allelic polymorphism of HLA-DR and TNFB loci and susceptibility to systemic lupus erythematosus (SLE) in northern Chinese Han nationality were studied. The genetic analysis of 51 patients with SLE and 106 healthy controls indicated that frequencies of DR2 and DR3 alleles were significantly increased in SLE patients(P< 0.05 and <0. 005, relative risks of 1.77 and 4.01 respectively), which represent candidate susceptible genes or useful marker for SLE. The frequency of DR5 was found to decrease in SLE patients compared with control population (P<0. 025,relative risk = 0. 38). It might be an antagonistic or protective allelle or a marker for such allele. Analysis of 51 patients with SLE and 80 healthy control also revealed that the frequency of TNFB' 2 allele was significantly increased(P<0. 05,RR= 1. 70). Therefore TNFB' 2 gene may also be a susceptibility gene or a marker gene for SLE in northern Chinese Han nationality. It was also investigated the association between HLA-DR,TNF B alleles and Patient plasmic SC5b-9 levels,auto-antibodies (anti-SSA,SSB,Sm,RNP,ds DNA and ANA) and SLE complications (SLE nephritis,SLE pneu-monitis and SLE encephalopathy) ,no relationship was found.
基金National Natural Science Foundation of China (No.60872018 No.60902015)+1 种基金Natural Science Foundation of Education Committee of Jiangsu Province(No.11KJB510014)Scientific Research Foundation of NUPT (No.NY210004)
文摘An improved MEW ( muhiplicative exponent weighting) algorithm, SLE-MEW is proposed for vertical handoff decision in heterogeneous wireless networks. It introduces the SINR( signal to interference plus noise ratio) effects, LS (least square) and information entropy method into the algorithm. An attribute matrix is constructed considering the SINR in the source network and the equivalent SINR in the target network, the required bandwidth, the traffic cost and the available bandwidth of participating access networks. Handoff decision meeting multi-attribute QoS(quality of serv- ice) requirement is made according to the traffic features. The subjective weight relation of decision elements is determined with LS method. The information entropy method is employed to derive the objective weights of the evaluation criteria, and lead to the comprehensive weight. Finally decision is made using MEW algorithm based on the attribute matrix and weight vector. Four 3GPP( the 3rd generation partnership project) defined traffic classes are considered in performance evaluation. The simulation results have shown that the proposed algorithm can provide satisfactory performance fitting to the characteristics of the traffic.
文摘Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). Methods Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for IT with MTX 10-20?mg plus DXM 10-20?mg. The effects and side effects of IT were closely observed. Results The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving IT improved considerably. Cerebrospinal fluid pressure,protein and WBC levels declined from 201.5±155.4?mm?H2O, 145.2±87.6?mg/dl and 25.1±14.3/mm3 to 128.7±108.1?mm?H2O, 60.8±38.3?mg/dl and 6.8±2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence.Conclusion IT with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.
文摘Objective To study the effects of dehydroepiandrosterone (DHEA) and/or estradiol (E 2) on apoptosis in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) Methods The percentage of apoptosis of PBMCs from SLE patients and healthy blood donors were examined by means of AO staining 48?h after culture with DHEA and/or E 2 at physiologic or pathologic concentrations Results The percentage apoptosis of PBMCs from SLE patients is higher than that of healthy blood donors ( P <0 01) E 2, whether at physiological or at pathological concentrations, had no effects on apoptosis of PBMCs from both SLE patients and healthy donors ( P >0 05) Both DHEA and DHEA plus E 2 at physiologic concentrations, had no effect on apoptosis of PBMCs from healthy donors ( P >0 05), but significantly inhibited that of SLE patients ( P <0 05); at pathologic concentrations,they promoted apoptosis of PBMCs from SLE patients as well as healthy blood donors ( P <0 05) There were no significant differences between the effects of DHEA and that of DHEA plus E 2 ( P >0 05) Conclusion DHEA plays an important role in the apoptosis of PBMCs from SLE patients; low serum levels of DHEA may cause accelerated apoptosis
文摘Objective To investigate the prevalence and features of active human cytomegalovirus (HCMV) infection in children with systemic lupus erythematosus (SLE) and evaluate the diagnostic value of the HCMV using antigenemia assay, serum polymerase chain reaction (PCR) and serology test. Methods Twenty-one SLE children undergoing immunosuppressive therapy were enrolled in this study. Immunofluorescence assay, PCR and serology tests were used to determine HCMV pp65 and p72 antigens in leukocytes, HCMV DNA in sera, and HCMV specific IgM and IgG antibodies, respectively. As a control group, twenty-one immunocompetent children with skeletal malformation were involved in this study. Statistical analysis was performed using Chi-square test or Fisher's exact test (Systat, USA), P values less than 0.05 were considered significant.Results Active HCMV infection was diagnosed in 28.6% (6/21) of SLE patients, with none in the control group; the difference between the two groups was significant (P=0.027). Two out of 6 SLE patients developed active HCMV infection before immunosuppressive therapy and the remaining 4 patients developed SLE after immunosuppressive therapy. Among the 21 SLE children, HCMV pp65 antigenemia was detected in 5 patients, p72 antigenemia in 3 patients, serum HCMV DNA in 9 patients, serum HCMV-specific IgM in 2 patients, and IgG in 19 patients. The sensitivity and specificity for diagnosis of active HCMV infection were 83.3% and 100%, respectively for pp65 antigenemia; 50% and 100% for p72 antigenemia; 100% and 80% for serum PCR; 33.3% and 100% for HCMV IgM serology; 50% and 100% for HCMV IgG serology. Conclusions Compared with the control group, active HCMV infection is much more frequent in SLE children, and can occur before treatment with immunosuppressive agents, but most often occur after immunosuppressive therapy. In comparison with the other techniques used in this study, the pp65 antigenemia assay seems to be a better method for the early diagnosis and monitoring of active HCMV infection in children with SLE.
文摘Objective To determine the in vitro expression of interleukin-12 (IL-12) and its effect on signal transducers and activators of transcription (STAT) signaling molecules in peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE).Methods Peripheral blood mononuclear cells in 39 patients with definite systemic lupus erythematosus and 11 healthy volunteers were collected. Expression of IL-12 P40mRNA in PBMCs was determined with reverse transcription-polymerase chain reaction (RT-PCR). Quantity of IL-12 protein supernatant was measured by enzyme-linked immunosorbent assay (ELISA). The levels of phosphorylated STAT3 and STAT4 signaling molecules in PBMCs were detected by immunoblot. Results Levels of IL-12 protein and mRNA expression in patients with active or inactive SLE were significantly higher than those in controls. Phytohemagglutinin (PHA) may promote the expression of IL-12. IL-12 alone induced the phosphorylation of STAT3 and STAT4 in PBMCs from patients with SLE, especially in active SLE. However it had no obvious effect on normal PBMCs. Phosphorylated STAT3 and STAT4 might be observed in normal PBMCs treated with IL-12 plus PHA.Conclusion IL-12 is produced aberrantly in patients with SLE. IL-12 might exert its biological role in SLE via the aberrantly phosphorylated STAT3 and STAT4 signaling molecules.