CAJ | 학술논문

目的：检测原发性干燥综合征（primary Sjogren's syndrome, pSS）患者血清可溶性程序性死亡配体1（sPD-L1）分子的表达，并探讨其临床意义。方法收集61例pSS患者外周血标本，采用ELISA法检测pSS患者及健康对照血清sPD-L1的表达，比较13例初诊pSS患者治疗前后血清sPD-L1表达水平变化，分析其临床意义。结果与健康对照相比，pSS患者血清sPD-L1表达显著升高（0.705±0.051 ng/mL vs 0.366±0.021 ng/mL，P＜0.0001）；pSS患者血清sPD-L1表达水平与ANA滴度、RF、ESR、抗ds-DNA呈正相关（P＜0.05）；活动期的pSS患者血清sPD-L1的表达高于非活动期患者（0.788±0.086 ng/mL vs 0.559±0.042 ng/mL，P=0.022）；伴发多系统损伤pSS患者血清sPD-L1的表达显著高于单纯外分泌腺损伤患者（0.863±0.114 ng/mL vs 0.630±0.114 ng/mL，P=0.022）。治疗后sPD-L1分子的表达无显著变化。结论 pSS患者血清sPD-L1异常高表达，且与疾病活动度、组织损伤密切相关。提示sPD-L1信号可能参与pSS免疫病理进程。
목적：검측원발성간조종합정（primary Sjogren's syndrome, pSS）환자혈청가용성정서성사망배체1（sPD-L1）분자적표체，병탐토기림상의의。방법수집61례pSS환자외주혈표본，채용ELISA법검측pSS환자급건강대조혈청sPD-L1적표체，비교13례초진pSS환자치료전후혈청sPD-L1표체수평변화，분석기림상의의。결과여건강대조상비，pSS환자혈청sPD-L1표체현저승고（0.705±0.051 ng/mL vs 0.366±0.021 ng/mL，P＜0.0001）；pSS환자혈청sPD-L1표체수평여ANA적도、RF、ESR、항ds-DNA정정상관（P＜0.05）；활동기적pSS환자혈청sPD-L1적표체고우비활동기환자（0.788±0.086 ng/mL vs 0.559±0.042 ng/mL，P=0.022）；반발다계통손상pSS환자혈청sPD-L1적표체현저고우단순외분비선손상환자（0.863±0.114 ng/mL vs 0.630±0.114 ng/mL，P=0.022）。치료후sPD-L1분자적표체무현저변화。결론 pSS환자혈청sPD-L1이상고표체，차여질병활동도、조직손상밀절상관。제시sPD-L1신호가능삼여pSS면역병리진정。
Objective To investigate the clinical significance of soluble PD-L1 molecules in patients with primary Sjogren's syndrome (pSS) by defecting its levels in serum samples. Methods Peripheral blood samples of 61 pSS patients and 63 healthy controls were collected in this study. Expressions of soluble PD-L1 in serum from the subjects were detected by enzyme-linked immunosorbent assay (ELISA). Results The expressions of soluble PD-L1 were higher in pSS patients than those in healthy controls (0.705±0.051 ng/mL vs 0.366±0.021 ng/mL, P<0.0001). The expression level of soluble PD-L1 showed positive correlations with ANA, RF, ESR and anti-ds-DNA level. In active pSS patients, soluble PD-L1 expression increased as compared with those in inactive patients (0.788±0.086 ng/mL vs 0.559±0.042 ng/mL, P=0.022). Higher expression of soluble PD-L1 was observed in pSS patients with multiple system damage than those in patients with simple exocrine gland injury (0.863±0.114 ng/mL vs 0.630±0.114 ng/mL, P=0.022). In addition, immunosuppressive therapy didn't reduce the expressions of soluble PD-L1 as compared with pre-therapy levels. Conclusion Expressions of soluble PD-L1 were up-regulated in serum of pSS patients and their expressions were significantly correlated with disease severity and system damage, which suggest that soluble PD-L1 may play a critical role in pathogenesis of pSS.