系统性红斑狼疮患者外周血B细胞中PD-L1的表达及临床意义
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摘要
目的探讨系统性红斑狼疮(SLE)患者外周血中B细胞表达程序性死亡分子配体1(PD-L1)的水平与狼疮病情活动程度及肾脏损伤程度的关系。方法选择2015年5月至2017年5月期间50例在该院诊断为SLE的患者作为研究对象,并以20例健康体检人群为对照组,所有患者均进行狼疮活动度评分,采用流式细胞仪检测B细胞中PD-L1表达水平,探讨SLE患者B细胞PD-L1与患者病情活动评分及肾脏损伤的关系。结果 SLE活动期患者CD19+占B细胞总数的比例为(11.35±3.65)%,PD-L1在CD19+B细胞表达的阳性率为(2.47±0.89)%,明显高于非活动期患者及对照组,差异有统计学意义(P<0.05);根据CD19+和CD19+/PD-L1的中位数水平将患者分为低水平和高水平组,CD19+高水平和CD19+/PD-L1高水平的患者肾损伤的发生率明显更高,CD19+/PD-L1、狼疮性肾炎(LN)Ⅳ期是患者肾功能不全发生的独立危险因素。结论 SLE患者外周CD19+/PD-L1的水平显著增加并与疾病的活动程度及肾脏损伤密切相关,是患者肾功能不全的独立危险因素。
Objective To investigate the relationship between the levels of programmed death ligand 1(PDL1)on circulating B cells and disease severity as well as renal injury of patients with systemic lupus erythematosus(SLE).Methods 50 patients with SLE were enrolled from May 2015 to May 2017,and 20 healthy individuals were enrolled as the control group.All patients were scored for their disease severity and renal injury.The expression of PD-L1 on circulating B cells were evaluated by flow cytometery.Results In the group of patients with active SLE,the percentage of CD19+in B cells was(11.35±3.65)% and the percentage of in CD19+B cells was(2.47±0.89)%,both of which were significantly higher than that in the group of patients with non-active SLE and control group(P<0.05).In addition,patients with SLE were divided into lower group and higher group according to the median percentage of CD19+and CD19+/PD-L1 Bcells.The incidence of kidney lesion was robustly increased in the high group,and CD19+/PD-L1 Bcells,LN Ⅳ were independent risk factors of renal insufficiency in lupus nephritis.Conclusion The level of peripheral CD19+/PDL1 in SLE patients increased significantly and was closely related to the activity degree and renal injury of the disease,which was an independent risk factor for renal insufficiency in patients.
Objective To investigate the relationship between the levels of programmed death ligand 1(PDL1)on circulating B cells and disease severity as well as renal injury of patients with systemic lupus erythematosus(SLE).Methods 50 patients with SLE were enrolled from May 2015 to May 2017,and 20 healthy individuals were enrolled as the control group.All patients were scored for their disease severity and renal injury.The expression of PD-L1 on circulating B cells were evaluated by flow cytometery.Results In the group of patients with active SLE,the percentage of CD19+in B cells was(11.35±3.65)% and the percentage of in CD19+B cells was(2.47±0.89)%,both of which were significantly higher than that in the group of patients with non-active SLE and control group(P<0.05).In addition,patients with SLE were divided into lower group and higher group according to the median percentage of CD19+and CD19+/PD-L1 Bcells.The incidence of kidney lesion was robustly increased in the high group,and CD19+/PD-L1 Bcells,LN Ⅳ were independent risk factors of renal insufficiency in lupus nephritis.Conclusion The level of peripheral CD19+/PDL1 in SLE patients increased significantly and was closely related to the activity degree and renal injury of the disease,which was an independent risk factor for renal insufficiency in patients.
引文
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[11]叶莉莉,徐星铭.狼疮性肾炎患者HMGB1和RAGE的表达及意义[J].安徽医科大学学报,2015,50(4):533-536.
[12]夏琼,徐星铭.CXCL16及CXCL10在狼疮性肾炎患者中的表达及与疾病活动的相关性[J].安徽医科大学学报,2014,49(4):491-494.
[13]李海英,左灿,王艳兰,等.血清胱抑素C及同型半胱氨酸和视黄醇结合蛋白联合检测在狼疮性肾炎诊断中的意义[J].广东医学,2014,35(6):864-866.
[14]谭德敏,向阳,谭千林.狼疮性肾炎患者外周血树突状细胞功能的研究[J].中国免疫学杂志,2016,32(4):570-572.
[15]周世菊,宋庆银,吴玉梅,等.来氟米特与环磷酰胺治疗狼疮性肾炎的对比研究[J].中国生化药物杂志,2015,35(3):100-102.
[2]王元元.SLE患者外周血T淋巴细胞PD-1分子,单个核细胞PD-L1分子的表达[D].合肥:安徽医科大学,2011.
[3]张之蕙.活血养阴方对狼疮性肾炎的治疗及对血清/尿液巨噬细胞移动抑制因子水平的影响[D].苏州:苏州大学,2009.
[4]雷向宏,涂卫平,秦晓华.狼疮性肾炎患者尿蛋白对HK-2细胞NF-κB、TNF-α、IL-6表达的影响及意义[J].山东医药,2009,49(7):38-40.
[5]赵欢.PD-1在冠心病患者外周血T细胞表达的意义及辛伐他汀的调节作用[D].广州:南方医科大学,2010.
[6]吴萍萍,沈冬,郭云娣,等.SLE患者外周血单核细胞PDL2分子的表达及其临床意义[J].中国免疫学杂志,2017,33(3):414-417.
[7]孟凡鹏,徐雯.B细胞免疫耐受缺陷与SLE的最新研究进展[J].国际免疫学杂志,2015,38(4):358-361.
[8]彭传梅,高辉,付晓野,等.云南汉族人群Tim-1基因多态性与系统性红斑狼疮关联性研究[J].中国实验诊断学,2014,18(12):1961-1965.
[9]邢桂芝,石哲群,褚金龙,等.自身抗体检测对系统性红斑狼疮的诊断价值分析[J].中国实验诊断学,2014,18(8):1321-1323.
[10]陈杰,胡娜,苏斌涛,等.系统性红斑狼疮患者血清中Tim-1蛋白水平及其基因多态性[J].中国免疫学杂志,2014,30(1):114-116.
[11]叶莉莉,徐星铭.狼疮性肾炎患者HMGB1和RAGE的表达及意义[J].安徽医科大学学报,2015,50(4):533-536.
[12]夏琼,徐星铭.CXCL16及CXCL10在狼疮性肾炎患者中的表达及与疾病活动的相关性[J].安徽医科大学学报,2014,49(4):491-494.
[13]李海英,左灿,王艳兰,等.血清胱抑素C及同型半胱氨酸和视黄醇结合蛋白联合检测在狼疮性肾炎诊断中的意义[J].广东医学,2014,35(6):864-866.
[14]谭德敏,向阳,谭千林.狼疮性肾炎患者外周血树突状细胞功能的研究[J].中国免疫学杂志,2016,32(4):570-572.
[15]周世菊,宋庆银,吴玉梅,等.来氟米特与环磷酰胺治疗狼疮性肾炎的对比研究[J].中国生化药物杂志,2015,35(3):100-102.