CAJ | 학술논문

目的检测原发性干燥综合征(pSS)及重叠其他结缔组织病的干燥综合征(SS)患者外周血B淋巴细胞活化因子(BAFF)和外周血B淋巴细胞/唇腺组织中BAFF受体(BAFF-R)的表达,进一步观察和研究BAFF在SS发病过程中的作用,并探讨将唇腺组织BAFF-R水平检测作为SS病理诊断指标的可能性.方法选取确诊pSS患者和与类风湿关节炎(RA)或系统性红斑狼疮(SLE)重叠的SS患者唇腺组织及外周血样本各15例,并选择15例非SS颌面部手术患者的正常唇腺组织及外周血作为对照.同步采用免疫组织化学技术检测唇腺组织BAFF-R表达情况,以流式细胞术检测外周血CDl9~+B淋巴细胞表面BAFF-R的表达水平,采用酶联免疫吸附试验(ELISA)法测定外周血清中可溶性BAFF的水平.采用X~2检验、Fisher确切概率法、单因素方差分析、LSD-t检验进行统计学处理.结果与对照组15例唇腺组织BAFF-R弱阳性着色相比,13例占87%的pSS患者唇腺组织中BAFF-R特异性染色旱强阳性;SS患者外周血中CDl9~+B淋巴细胞膜表面BAFF-R表达和血清中可溶性BAFF均高于对照组[(21.4±4.6)%与(4.0±1.6)%,P<0.01;(7.5±2.3)ng/ml与(2.0±0.8)ng/ml, P<0.01].而15例与RMSLE重叠的ss患者,其唇腺组织的BAFF-R的表达占75%,外周血CD19~B淋巴细胞膜表面BAFF-R的表达为(23.3±5.0)%.其血清中可溶性BAFF的表达为(7.8±1.9)ng/ml均高于对照组(P值均<0.01).但与pSS组相比差异无统计学意义(P值均>0.05).结论 SS患者唇腺组织与外周血中B淋巴细胞膜表面BAFF-R以及血清可溶性BAFF的表达水平均上调.可能通过激活自身反应性B淋巴细胞参与SS的发病过程;检测唇腺组织B淋巴细胞膜表而BAFF-R可能有助于SS的诊断和疾病活动的判定.
목적 검측원발성간조종합정(pSS)급중첩기타결체조직병적간조종합정(SS)환자외주혈B림파세포활화인자(BAFF)화외주혈B림파세포/진선조직중BAFF수체(BAFF-R)적표체,진일보관찰화연구BAFF재SS발병과정중적작용,병탐토장진선조직BAFF-R수평검측작위SS병리진단지표적가능성.방법 선취학진pSS환자화여류풍습관절염(RA)혹계통성홍반랑창(SLE)중첩적SS환자진선조직급외주혈양본각15례,병선택15례비SS합면부수술환자적정상진선조직급외주혈작위대조.동보채용면역조직화학기술검측진선조직BAFF-R표체정황,이류식세포술검측외주혈CDl9~+B림파세포표면BAFF-R적표체수평,채용매련면역흡부시험(ELISA)법측정외주혈청중가용성BAFF적수평.채용X~2검험、Fisher학절개솔법、단인소방차분석、LSD-t검험진행통계학처리.결과 여대조조15례진선조직BAFF-R약양성착색상비,13례점87%적pSS환자진선조직중BAFF-R특이성염색한강양성;SS환자외주혈중CDl9~+B림파세포막표면BAFF-R표체화혈청중가용성BAFF균고우대조조[(21.4±4.6)%여(4.0±1.6)%,P<0.01;(7.5±2.3)ng/ml여(2.0±0.8)ng/ml, P<0.01].이15례여RMSLE중첩적ss환자,기진선조직적BAFF-R적표체점75%,외주혈CD19~B림파세포막표면BAFF-R적표체위(23.3±5.0)%.기혈청중가용성BAFF적표체위(7.8±1.9)ng/ml균고우대조조(P치균<0.01).단여pSS조상비차이무통계학의의(P치균>0.05).결론 SS환자진선조직여외주혈중B림파세포막표면BAFF-R이급혈청가용성BAFF적표체수평균상조.가능통과격활자신반응성B림파세포삼여SS적발병과정;검측진선조직B림파세포막표이BAFF-R가능유조우SS적진단화질병활동적판정.
Objective To clarify the role of BAFF (B-cell activating factor from TNF family, BAFF) in the pathogenesis of pSS (primary Sjogren's syndrome, pSS) and SS overlapped with other connective diseases, and explore the diagnostic value of BAFF-R (BAFF Receptor, BAFF-R) for SS by detecting the expression of BAFF in serum and BAFF-R on peripheral B cells/labial salivary glands from SS patients. Methods The expression of BAFF-R was detected in labial salivary glands and CD19~+ B cells in the peripheral blood from 15 pSS patients and 15 SS overlapped with rheumatoid arthritis (RA) / systemic lupus erythematosus (SLE) by immunohistochemistry and flow cytometry respectively. The concentration of the soluble BAFF in serum was detected by ELISA. The labial salivary glands and the peripheral blood from 15 healthy donors served as controls. Chi-square test, Fisher exact test, oneway-ANOVA and LSD-1 test for statistical anglysis. Results BAFF-R was strongly stained on labial salivary glands from 13/15 pSS-paients (87%), while weakly stained on those of the controls. BAFF-R was also expressed significantly higher in CD19~+ B cells from patients [(21.4±4.6)% vs (4.0±1.6)%, P<0.01 ]. Similar to these, soluble BAFF was highly detected in sera of patients than that of the controls [ (2.0 ± 0.8) ng/ml vs (7.5±2.3) ng/ml, P< 0.01 ]. AS for 15 SS overlapped with RA/SLE-patients, the expression of BAFF-R in labial salivary (75.0%) and in CD19~+B cells (23.3±5.0)%, and the secretion of soluble BAFT in sera (7.8±1.9) ng/ml were all significantly higher than that of controls (P<0.01), while similar to that of pSS patients (P>0.05). Conclusion Our study further clarifies that up-regulation of BAFF and BAFF-R may play an important role in the pathogenesis of SS by activating self-reactive B cells, and we also provide preliminary evidence for the diagnosis of SS by detecting BAFF-R on labial salivary glands.