中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2014年
5期
336-340,后插2
,共6页
张思功%王国春%彭清林%王艳%周航%卢昕
張思功%王國春%彭清林%王豔%週航%盧昕
장사공%왕국춘%팽청림%왕염%주항%로흔
红斑狼疮,系统性%狼疮肾炎%中性粒细胞胞外网状陷阱%循环游离DNA%低密度粒细胞
紅斑狼瘡,繫統性%狼瘡腎炎%中性粒細胞胞外網狀陷阱%循環遊離DNA%低密度粒細胞
홍반랑창,계통성%랑창신염%중성립세포포외망상함정%순배유리DNA%저밀도립세포
Lupus erythematosus,systemic%Lupus nephritis%Neutrophil extracellular traps%Circulating cell-free DNA%Low-density granulocytes
目的 探讨SLE患者血浆游离DNA(cfDNA)水平与LN的相关性,分析患者血浆cfDNA升高的可能原因.方法 实验纳入了54例SLE患者和43名健康对照者.SLE患者中,37例合并有LN,26例为活动性LN患者,11例为缓解期LN患者.血浆cfDNA的测定采用Picogreen试剂盒;低密度粒细胞(LDGs)的测定采用流式细胞术.采用单因素相关及多元线性回归分析LN与cfDNA的关系并分析cfDNA升高的影响因素.结果 SLE组的cfDNA水平显著高于健康对照组[(237±40) ng/ml和(188±41) ng/ml,P＜0.01].在SLE中,LN组的cfDNA水平显著高于非LN组[(247±47) ng/ml和(214±31) ng/ml,P=0.028);而且活动性LN的cfDNA水平明显高于缓解期LN[(254±50) ng/ml和(216±29) ng/ml,P=0.035).进一步分析发现SLE患者血浆cfDNA水平与尿蛋白定量(24 h)呈正相关(r=0.350,P=0.013),与血清白蛋白(r=-0.500,P＜0.01)和内生肌酐清除率(Ccr)(r=-0.354,P=0.044)呈负相关.LDGs在SLE患者中的比例显著高于健康对照组[(8.3±12.9)％和(1.2±0.7)％,P=0.004],并且与血浆cfDNA水平呈正相关(r=0.636,P=0.002);中性粒细胞计数与cfDNA呈正相关(r=0.599,P＜0.01).结论 LDGs和中性粒细胞过度形成中性粒细胞胞外网状陷阱(NETs)是SLE患者cfDNA水平升高的主要原因之一.血浆cfDNA的水平与LN的活动性相关,提示NETs标记物和活动性LN存在联系,更特异的血清NETs标记物有望成为活动性LN的临床标志.
目的 探討SLE患者血漿遊離DNA(cfDNA)水平與LN的相關性,分析患者血漿cfDNA升高的可能原因.方法 實驗納入瞭54例SLE患者和43名健康對照者.SLE患者中,37例閤併有LN,26例為活動性LN患者,11例為緩解期LN患者.血漿cfDNA的測定採用Picogreen試劑盒;低密度粒細胞(LDGs)的測定採用流式細胞術.採用單因素相關及多元線性迴歸分析LN與cfDNA的關繫併分析cfDNA升高的影響因素.結果 SLE組的cfDNA水平顯著高于健康對照組[(237±40) ng/ml和(188±41) ng/ml,P＜0.01].在SLE中,LN組的cfDNA水平顯著高于非LN組[(247±47) ng/ml和(214±31) ng/ml,P=0.028);而且活動性LN的cfDNA水平明顯高于緩解期LN[(254±50) ng/ml和(216±29) ng/ml,P=0.035).進一步分析髮現SLE患者血漿cfDNA水平與尿蛋白定量(24 h)呈正相關(r=0.350,P=0.013),與血清白蛋白(r=-0.500,P＜0.01)和內生肌酐清除率(Ccr)(r=-0.354,P=0.044)呈負相關.LDGs在SLE患者中的比例顯著高于健康對照組[(8.3±12.9)％和(1.2±0.7)％,P=0.004],併且與血漿cfDNA水平呈正相關(r=0.636,P=0.002);中性粒細胞計數與cfDNA呈正相關(r=0.599,P＜0.01).結論 LDGs和中性粒細胞過度形成中性粒細胞胞外網狀陷阱(NETs)是SLE患者cfDNA水平升高的主要原因之一.血漿cfDNA的水平與LN的活動性相關,提示NETs標記物和活動性LN存在聯繫,更特異的血清NETs標記物有望成為活動性LN的臨床標誌.
목적 탐토SLE환자혈장유리DNA(cfDNA)수평여LN적상관성,분석환자혈장cfDNA승고적가능원인.방법 실험납입료54례SLE환자화43명건강대조자.SLE환자중,37례합병유LN,26례위활동성LN환자,11례위완해기LN환자.혈장cfDNA적측정채용Picogreen시제합;저밀도립세포(LDGs)적측정채용류식세포술.채용단인소상관급다원선성회귀분석LN여cfDNA적관계병분석cfDNA승고적영향인소.결과 SLE조적cfDNA수평현저고우건강대조조[(237±40) ng/ml화(188±41) ng/ml,P＜0.01].재SLE중,LN조적cfDNA수평현저고우비LN조[(247±47) ng/ml화(214±31) ng/ml,P=0.028);이차활동성LN적cfDNA수평명현고우완해기LN[(254±50) ng/ml화(216±29) ng/ml,P=0.035).진일보분석발현SLE환자혈장cfDNA수평여뇨단백정량(24 h)정정상관(r=0.350,P=0.013),여혈청백단백(r=-0.500,P＜0.01)화내생기항청제솔(Ccr)(r=-0.354,P=0.044)정부상관.LDGs재SLE환자중적비례현저고우건강대조조[(8.3±12.9)％화(1.2±0.7)％,P=0.004],병차여혈장cfDNA수평정정상관(r=0.636,P=0.002);중성립세포계수여cfDNA정정상관(r=0.599,P＜0.01).결론 LDGs화중성립세포과도형성중성립세포포외망상함정(NETs)시SLE환자cfDNA수평승고적주요원인지일.혈장cfDNA적수평여LN적활동성상관,제시NETs표기물화활동성LN존재련계,경특이적혈청NETs표기물유망성위활동성LN적림상표지.
Objective To explore the correlations between elevated cfDNA with lupus nephritis and indentify the influencing factors of cfDNA in systemic lupus erythematosus (SLE).Methods Fifty four patients with SLE [37 patients with lupus nephritis (LN) and 43 age-and sex-matched healthy controls] were included in the study.In 37 LN patients,26 patients were at active stage,and 11 patients were in remission.cfDNA concentration was measured with Picogreen Kit and low-density granulocytes (LDGs) was tested by flowcytometer.Correlation and regression analysis were performed to discover whether cfDNA is related to LN and identify the influencing factor of cffDNA.Results The cfDNA in SLE group was (237±40) ng/ml,which was significantly higher than that in healthy control group (188±41 ng/ml,P＜0.01).cfDNA in LN group was significantly higher than that in patients without LN (NLN) (247±47 ng/ml vs 214±31 ng/ml,P=0.028).cfDNA in patients with active LN was significantly higher than that in patient with inactive LN (RLN) (254±50 ng/ml vs 216±29 ng/ml,P=0.035).In SLE group,cfDNA was positively correlated with quantitative 24-hour urinary protein (r=0.350,P=0.013) and reversely correlated with albumin (r=-0.500,P＜0.01) and endogenous creatinine clearance rate (Ccr) (r=-0.354,P=0.044).Percentage of LDGs in peripheral blood mononuclear ceils (PBMCs) of the SLE group was (8.3± 12.9)％,significantly was higher than that in healthy controls [(1.2±0.7)％,P=0.004].The cfDNA was positively correlated with LDGs (r=0.636,P=0.002) and neutrophils (r=0.599,P＜0.01).Conclusion NETs excessively released by neutrophils as well as LDGs may be one of the main reasons for elevated cfDNA level in SLE.cfDNA level is associated with LN activity,suggesting that there is a intrinsic link between NETs-related biomarkers and active LN and that more specific biomarkers of NETs may become a clinical biomarker for active LN.
