CD4+/CD8+比值异常系统性红斑狼疮患者PD-L1和IFN-α血清水平检测及其临床意义
| 作者: |
1廖永强,
1夏洪娇,
1刘剑荣,
1彭可君,
2王桂良,
2胡建康
1 萍乡市人民医院检验科，江西 萍乡 337000 2 萍乡市人民医院风湿免疫科，江西 萍乡 337000 |
| 通讯: |
廖永强
Email: lyq1984think@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.08.005 |
| 基金: | 江西卫生和计划生育委员会科技计划项目(20141693)。 |
摘要
目的：通过检测CD4+/CD8+比值异常的系统性红斑狼疮(systemic lupus erythematosus，SLE)患者血清程序性凋亡受体配体1(programmed cell death ligand 1，PD-L1)和α-干扰素(interferon-α，IFN-α)水平，探讨PD-L1和IFN-α与SLE患者CD4+/CD8+比值异常的关系。方法：73例SLE患者以CD4+/CD8+参考范围(1.5~2.5)为标准，分为CD4+/CD8+倒置组(29例)，CD4+/CD8+升高组(17)例，CD4+/CD8+正常组(27例)，另选取20位健康体检者为健康对照组；采用流式细胞术检测SLE患者CD3+CD4+和CD3+CD8+T细胞，ELISA法检测血清PD-L1，IFN-α和抗dsDNA抗体水平，分析PD-L1，IFN-α与抗dsDNA抗体的相关性。结果：CD4+/CD8+倒置和升高组补体C3和C4水平显著低于其余二组(均P<0.01)。CD4+/CD8+倒置和升高组C-反应蛋白(C-reactive protein，CRP)水平显著高于正常组和健康组(均P<0.01)，而升高组CRP水平显著高于倒置组(P<0.01)。CD4+/CD8+倒置及升高组SLE患者抗dsDNA抗体滴度、SLE疾病活动度评分(SLE disease activity index，SLEDAI)明显高于正常和健康组(均P<0.01)。CD4+/CD8+倒置和升高组PD-L1，IFN-α水平均显著高于健康组(均P<0.05)；倒置组PD-L1，IFN-α水平均显著高于正常组，而升高组IFN-α与正常组差异无统计学意义(P>0.05)。CD4+/CD8+倒置和升高组SLE患者血清PD-L1和IFN-α均与抗dsDNA抗体滴度成正相关(均P<0.01)。CD4+/CD8+异常组SLE患者病原体感染率显著高于其余二组(均P<0.01)。结论：病原体感染是SLE患者CD4+/CD8+比值异常的直接原因，CD4+/CD8+异常SLE患者血清PD-L1和IFN-α水平均升高且与抗dsDNA抗体呈正相关，提示PD-L1和IFN-α调节T细胞活化共同参与免疫过程。
关键词：
系统性红斑狼疮；CD4+/CD8+异常；程序性凋亡受体配体1；α-干扰素
Detection of serum PD-L1 and IFN-α levels and its clinical significance in patients with systemic lupus erythematosus with abnormal CD4+/CD8+ ratio
CorrespondingAuthor: LIAO Yongqiang Email: lyq1984think@163.com
DOI: 10.3978/j.issn.2095-6959.2018.08.005
Foundation: This work was supported by the Health and Family Planning Commission Science and Technology Project of Jiangxi Province, China (20141693).
Abstract
Objective: To discuss the relationship between serum level of programmed cell death 1 ligand 1 (PD-L1), interferon-α (IFN-α) and abnormal ratio of CD4+/CD8+ ratio in patients with systemic lupus erythematosus (SLE). Methods: A total of 73 cases of SLE patients were divided into CD4+/CD8+ inversion, CD4+/CD8+elevated, CD4+/CD8+ normal group, and the cases were 29, 17, 27 respectively; moreover, 20 healthy persons were collected as the control group. CD3+CD4+and CD3+CD8+T cells in SLE patients were detected by flow cytometry. The serum levels of PD-L1, IFN-α and anti-dsDNA antibodies were detected by ELISA, and the correlation between PD-L1, IFN-α and anti dsDNA antibody was analyzed. Results: The serum levels of complement C3 and C4 in CD4+/CD8+ inversion and elevated group were significantly lower than the other two groups (all P<0.01). The serum levels of C-reactive protein (CRP) in the inversion and uprising groups were significantly higher than healthy and normal group (P<0.05), and the inversion group was significantly lower than the uprising group (P<0.05). The titers of anti-dsDNA antibody and SLE disease activity index (SLEDAI) in CD4+/CD8+ inversion and elevation SLE patients were significantly higher than the healthy and normal groups (all P<0.05). The serum levels of PD-L1 and INF-α in CD4+/CD8+ inversion and the uprising group were significantly higher than the healthy control group (P<0.05). PD-L1 and INF-α serum levels in the CD4+/CD8+ inversion group were significantly higher than the normal group (P<0.01), but INF-α serum level in the uprising group had no statistical significance compared with the normal group (P>0.05). PD-L1 and IFN-α serum levels were positively correlated with anti dsDNA antibody titers in CD4+/CD8+ inversion and elevated SLE patients (all P<0.01). The infection rates of SLE in CD4+/CD8+ abnormal group were significantly higher than other two groups (all P<0.01). Conclusion: The pathogen infection is the direct cause of the abnormal CD4+/CD8+ ratio in SLE patients. PD-L1 and IFN-α serum levels in CD4+/CD8+ abnormal group were elevated and positively correlated with anti dsDNA antibody, suggesting that PD-L1 and IFN-α could regulate the activation of T cells and participate in the immune process together.
Keywords：
systemic lupus erythematosus; CD4+/CD8+ abnormal; programmed cell death 1 ligand 1; interferon-α