摘要
目的:比较系统性红斑狼疮患者(systemic lupus erythematosus,SLE)和正常对照两组间的外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)膜上的Fas(mFas)/FasL(mFasL)的表达水平,分析mFas、mFasL与SLE患者器官/系统损害之间的关系,并探讨mFas、mFasL与患者器官/系统损害的关联是否涉及细胞凋亡。方法:病例选自两所三甲医院住院SLE患者(n=79),以健康志愿者为对照(n=69),参照系统性红斑狼疮疾病活动性指数(SLEDAI)和系统性红斑狼疮损伤指数(SLICC/ACR DI)量表,设计问卷,收集患者的一般情况和器官/系统损害资料。利用流式细胞仪,采用连接素V(Annexin V,AV)和碘化丙啶(propidium iodide,PI)双染法检测研究对象的PBMCs早期凋亡率;运用流式细胞术,检测PBMCs膜上mFas和mFasL的表达水平。结果:SLE患者的PBMCs膜上mFas的表达水平(38.97%±7.64%)高于正常对照(28.82%±4.98%)(t=9.22,P<0.01),与系统性红斑狼疮损伤指数(SLICC/ACR DI)有正相关趋势,但未见统计学意义(rs=0.209,t=1.74,P=0.09),与PBMCs的早期凋亡率(r=0.381,t=3.35,P<0.01)呈显著正相关。进一步分析68例SLE患者mFas与器官/系统损害情况,结果发现SLE患者CNS损害组(n=11)PBMCs的mFas阳性率45.28%±8.71%高于SLE患者非CNS损害组(n=57)37.88%±10.02%(t=2.28,P=0.026);SLE患者肾脏损害组(n=33)PBMCs的mFas阳性表达率42.32%±9.48%亦高于SLE患者非肾脏损害组(n=35)35.62%±11.17%(t=2.65,P=0.009)。患者和对照PBMCs膜上mFasL采用流式细胞术均未能检出。结论:SLE患者的PBMCs膜上mFas与患者的器官/系统损害关系密切。患者的凋亡率升高可能与mFas表达增加有关,而mFas表达升高、凋亡亢进在SLE发病机制中发挥重要作用,mFas可较好反映患者器官/系统损害情况。
Objective：To compare the expression of membrane Fas（mFas） and membrane FasL（mFasL） between the healthy controls and patients with systemic lupus erythematosus（SLE） and analyze the relationship between the mFas,mFasL and the organ or system damage in SLE to define the role of apoptosis in the relationship.Methods：Patients with SLE（n=79） were selected from two hospitals,and normal healthy volunteers（n=69） were recruited as controls.General information and the data of organ or system damage were collected by self-designed questionnaire containing the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index（SLICC/ACR DI）.Annexin V（AV） and propidium iodide（PI） wereused to detect the early apoptosis rate of peripheral blood mononuclear cells（PBMCs） and flow cytometry（FCM） was applied to detect the mFas and mFasL expression on PBMCs.Results：The expressive rate of mFas of patients with SLE（38.97%±7.64%） was higher than that of healthy controls（28.82%±4.98%）（t=9.22,P〈0.01）,and the rate had a significant positive correlation with the early apoptosis rate of PBMCs（r=0.381,t=3.35,P〈0.01） inSLE.There was a positive correlation between the expressive rate of mFas and SLICC/ACR DI（rs=0.209,t=1.74,P=0.09）,but the difference was not statistically significant.Patients with neuropsychiatric（n=11） or renal disease（n=33） had a higher expression of mFas（45.28%±8.71%,42.32%±9.48%,respectively） than those without neuropsychiatric（n=57） or renal disease（n=35）（37.88%±10.02%,35.62%±11.17%,respectively）（t=2.28 and 2.65,P=0.026 and 0.009,respectively）.The expression of mFasL on PBMCs among patients with SLE and controls could not be successfully detected by FCM.Conclusion：The expression of mFas is increased among patients with SLE,and the mFas level have close relationship with the organ or system damage in SLE.The high expression of mFas may be responsible for the high apoptosis rate of PBMCs in SLE,while the high expression of mFas and high apoptosis rate of PBMCs are likely to involve in the pathogenesis of SLE.The level of mFas is a potential predictor for organ or system damage of SLE.
出处
《中国卫生检验杂志》
CAS
2008年第5期773-776,785,共5页
Chinese Journal of Health Laboratory Technology
基金
国家自然科学基金资助(30371247)
安徽省高校省级自然科学研究项目(KJ2007B148)
安徽省高校青年教师科研资助计划(2004jq166
2007jq1067ZD)
安徽医科大学博士科研经费资助计划(XJ200602)
