摘要
背景:转化生长因子β1是重要的免疫调节因子已被证实,但有关其与系统性红斑狼疮之间的关系还不很清楚。目的:检测转化生长因子β1在系统性红斑狼疮患者血清及骨髓基质细胞培养液中的水平。设计:病例-对照分析。对象:选择2006-02/2007-02中山大学附属第五医院门诊及住院的系统性红斑狼疮患者55例,其中5例同意行骨髓像检查的重度系统性红斑狼疮患者合并中度贫血,经实验室检查符合慢性病贫血;应用SLEDAI评分标准对患者活动度进行评估,轻度13例、中度22例、重度20例。以同期自愿献血的健康者24例作为对照组,其中4例经临床表现及实验室诊断为缺铁性贫血。方法:所有受试者晨起空腹抽取静脉血2mL,离心后取上清液,-20℃保存待测。采用密度梯度离心和贴壁筛选法对5例贫血系统性红斑狼疮患者和4例缺铁性贫血患者骨髓基质细胞进行分离培养,制备骨髓基质细胞培养上清液待测。主要观察指标:采用双抗体酶联免疫吸附法检测各组血清标本、骨髓基质细胞培养上清液标本中的转化生长因子β1水平,及其与SLEDAI积分、血沉、补体C3的相关性。结果:与对照组比较,系统性红斑狼疮组血清转化生长因子β1水平明显降低(P<0.01);且轻、中、重度系统性红斑狼疮患者血清转化生长因子β1水平逐渐降低(P<0.05)。与对照组比较,系统性红斑狼疮组骨髓基质细胞培养上清液中转化生长因子β1水平明显降低(P<0.01)。系统性红斑狼疮患者血清转化生长因子β1水平与SLEDAI积分呈负相关(r=-0.862,P<0.01),与疾病同期活动指标血沉呈负相关(r=-0.56,P<0.05),与补体C3呈正相关(r=0.78,P<0.05)。结论:系统性红斑狼疮骨髓基质细胞分泌转化生长因子β1存在异常,并且转化生长因子β1可能参与了系统性红斑狼疮的发病及转归,对判断其病情活动度及研究系统性红斑狼疮的发病机制有一定临床意义。
BACKGROUND： It has been verified that transforming growth factor β 1 （TGF- β 1） is important immune regulatory factor, but the correlation of TGF- β 1 to systemic lupus erythematosus is not clear. OBJECTIVE： To investigate TGF- β 1 level in serum and bone marrow matrix cell culture fluid in patients with systemic lupus erythematosus. DESIGN： Case-control analysis. PARTICIPANTS： A total of 55 patients or inhospital with systemic lupus erythematosus were enrolled at the Out-patient clinic of the Fifth Affiliated Hospital, Sun Yat-sen University from February 2006 to February 2007. Five patients combined with moderate anaemia agreed to receive myelogram examination. These five patients were diagnosed as having anemia of chronic disease. Using SLEDAI score, patients＇ range of motion was assessed, resulting in mild in 13 cases, moderate in 22 cases and severe in 20 cases. Twenty-four persons, who voluntarily devote blood, were served as controls. Of them, four patients were diagnosed as having iron deficiency anemia after clinical manifestation observation and laboratory diagnosis. METHODS： 2 mL of venous blood was collected from each fasting testee. After centrifugation, supernatant was obtained and stored at -20 ℃ for usage. Using density gradient centrifugation and adherence method, bone marrow stromal cells were isolated from five patients with anemic systemic lupus erythematosus and four patients with iron deficiency anemia to prepare supernatant of bone marrow stromal cells. MAIN OUTCOME MEASURES： Using double antibody sandwich enzyme-linked immunoadsorbent assay, TGF- β 1 levels were examined in serum samples and superuatant of bone marrow stromal cells in each group; the correlation of TGF- β 1 to SLEDAI integral, sedimentation and complement C3. RESULTS： Compared with the control group, serum TGF- β 1 levels significantly reduced in the systemic lupus erythematosus group （P 〈 0.01 ）. Serum TGF- β 1 levels gradually decreased in the mild, moderate and severe systemic lupus erythematosus patients （P 〈 0.05）. Compared with the control group, TGF- β 1 levels in supernatant of bone marrow stromal cells significantly decreased in the systemic lupus erythematosus group （P 〈 0.01 ）. Serum TGF- β 1 levels were negatively correlated to SLEDAI integral in the systemic lupus erythematosus group （r = 0.862, P 〈 0.01）, and negatively associated with erythrocyte sedimentation of activity index （r=-0.56, P 〈 0.05）, but positively correlated to complement C3 （r = 0.78, P 〈 0.05）. CONCLUSION： TGF- β 1 from bone marrow matromal cells in systemic lupus erythematosus patients is abnormal. TGF- β 1 maybe participates in the onset and turnover of systemic lupus erythematosus and has clinical significances on adjusting range of motion of patients＇ condition and studying the onset mechanism of systemic lupus erythematosus.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第38期7535-7538,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
珠海市科技项目(PC20052010)~~
