[1]冉 涛,潘 锋,王永红,等.系统性红斑狼疮患者血清sMICA，sMICB 水平与自身抗体表达及疾病活动度的相关性研究[J].现代检验医学杂志,2024,39(04):100-104+149.[doi:10.3969/j.issn.1671-7414.2024.04.018]
　RAN Tao,PAN Feng,WANG Yonghong,et al.Correlation among Serum sMICA, sMICB Levels, Autoantibody Expression and Disease Activity in Patients with Systemic Lupus Erythematosus[J].Journal of Modern Laboratory Medicine,2024,39(04):100-104+149.[doi:10.3969/j.issn.1671-7414.2024.04.018]
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系统性红斑狼疮患者血清sMICA，sMICB 水平与自身抗体表达及疾病活动度的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年04期
页码:
100-104+149
栏目:
论著
出版日期:
2024-07-15

文章信息/Info

Title:
Correlation among Serum sMICA, sMICB Levels, Autoantibody Expression and Disease Activity in Patients with Systemic Lupus Erythematosus
文章编号:
1671-7414（2024）04-100-06
作者:
冉 涛; 潘 锋; 王永红; 庞 会; 文 峰; 陈 旭; 夏家财
（重庆大学附属黔江医院检验科，重庆 409000）
Author(s):
RAN Tao;  PAN Feng;  WANG Yonghong;  PANG Hui;  WEN Feng;  CHEN Xu;  XIA Jiacai
（Department of Clinical Laboratory, Qianjiang Hospital Affiliated to Chongqing University, Chongqing 409000, China）
关键词:
系统性红斑狼疮; 自身抗体; 可溶性MHC-I 类链相关蛋白A; 可溶性MHC-I 类链相关蛋白B; 自然杀伤细胞
分类号:
R593.241；R446.62
DOI:
10.3969/j.issn.1671-7414.2024.04.018
文献标志码:
A
摘要:
目的 探讨循环可溶性MHC-I 类链相关蛋白A[soluble major histocompatibility complex class I-related chain A，sMICA）、可溶性MHC-I 类链相关蛋白B（soluble major histocompatibility complex class I-related chain B，sMICB] 与系统性红斑狼疮（systemic lupus erythematosus，SLE）疾病活动性、自身抗体的关系。方法 选择2020 年1 月～ 2023 年1 月重庆大学附属黔江医院收治的156 例SLE 患者（SLE 组）和门诊体检中心体检的103 例健康志愿者（对照组）。根据SLE 疾病活动度评分（SLE disease activity index，SLEDAI）将SLE 患者分为轻度活动组（n=43）、中度活动组（n=69）和重度活动组（n=44）。检测血清sMICA，sMICB 水平以及自身抗体、外周血NK 细胞占比，Spearman 或Pearson 分析sMICA，sMICB 与评分、自身抗体、外周血NK 细胞占比的相关性，受试者工作特征（ROC）曲线用来分析sMICA 和sMICB 诊断SLE 活动度的价值。结果 SLE 组血清sMICA（173.65±23.92 pg/ml），sMICB（96.35±15.74pg/ml）水平高于对照组（32.51±6.27 pg/ml，12.03±2.47 pg/ml），外周血CD3-CD56 ＋NK 细胞（12.02%±2.65%）占比低于对照组（18.35%±3.71%），差异具有统计学意义（t=58.498，53.897，-16.010，均P ＜ 0.05）。重度活动组血清sMICA，sMICB 水平高于中度活动组和轻度活动组（t=8.192，12.352；19.652，23.742，均P ＜ 0.05），外周血CD3-CD56＋NK 细胞占比低于中度活动组和轻度活动组（t=8.154，10.658，均P ＜ 0.05），差异具有统计学意义。不同疾病活动SLE 患者抗‐dsDNA 抗体、抗核抗体、抗核小体抗体和抗组蛋白抗体阳性率比较，差异具有统计学意义（χ2=8.795，7.216，7.539，8.946，均P ＜ 0.05）。SLE 患者血清sMICA，sMICB 水平与SLEDAI 评分、抗‐dsDNA抗体、抗核抗体、抗核小体抗体、抗组蛋白抗体呈正相关（r=0.206 ～ 0.402，均P ＜ 0.05），与外周血CD3-CD56 ＋NK 细胞占比呈负相关（r=-0.563，-0.427，均P ＜ 0.05）。sMICA 和sMICB 诊断SLE 重度活动的曲线下面积为0.652，0.704，联合sMICA，sMICB 诊断SLE 重度活动的曲线下面积为0.812，高于单独诊断（Z=3.050，2.346，均P ＜ 0.05）。结论 SLE 患者血清sMICA 和sMICB 水平增高，且与SLE 自身抗体阳性率增加、外周血NK 细胞占比降低、疾病活动性增强有关，可作为SLE 的潜在标志物。
Abstract:
Objective To investigate the relationship among circulating soluble major histocompatibility complex class I-related chain A (sMICA), soluble major histocompatibility complex class I-related chain B (sMICB), the activity of systemic lupus erythematosus (SLE) and autoantibodies. Methods A total of 156 SLE patients (SLE group) and 103 healthy volunteers (control group) who underwent physical examination in outpatient physical examination center were selected from the Qianjiang Hospital Affiliated to Chongqing University from January 2020 to January 2023. According to SLE disease activity score (SLEDAI), these SLE patients were divided into mild activity group (n=43), moderate activity group (n=69), and severe activity group (n=44). Serum levels of sMICA and sMICB, and the proportion of autoantibodies and peripheral blood NK cells were detected. Spearman or Pearson method was used to analyze the correlation among sMICA, sMICB, score, autoantibodies and peripheral blood NK cells proportion. Receiver operating characteristics (ROC) curve was used to evaluate the value of sMICA and sMICB in the diagnosis of SLE activity. Results Serum sMICA (173.65±23.92 pg/ml) and sMICB (96.35±15.74 pg/ml) levels in SLE group were higher than those in control group（32.51±6.27 pg/ml，12.03±2.47 pg/ml），while the proportion of CD3- CD56+NK cells（12.02%±2.65%） in peripheral blood was lower than that in control group（18.35%±3.71%），and the differences were statistically significant (t=58.498，53.897，-16.010，all P < 0.05). Serum sMICA and sMICB levels in severe active group were higher than those in moderately active group and mildly active group （t=8.192，12.352；19.652，23.742， all P<0.05), and the proportion of CD3-CD56+NK cells in peripheral blood was lower than that in moderate and mild active groups (t=8.154，10.658，P<0.05). The differences in positive rates of anti-dsDNA antibody, anti-nuclear antibody, antinucleosome antibody and anti-histone antibody in SLE patients with different disease activities were significant (χ2=8.795, 7.216, 7.539, 8.946, all P<0.05). Serum sMICA and sMICB levels in SLE patients were positively correlated with SLEDAI score, antidsDNA antibody, anti-nuclear antibody, anti-nucleosome antibody and anti-histone antibody (r=0.206 ～ 0.402，all P<0.05)， and negatively correlated with the proportion of CD3-CD56+NK cells in peripheral blood (r=-0.563，-0.427， all P<0.05). The areas under the curve of SLE in severe active group diagnosed by sMICA and sMICB alone were 0.652 and 0.704, respectively. The area under the curve of SLE in severe active group diagnosed by sMICA and sMICB combined with SLE was 0.812, which was higher than that by the single diagnosis (Z=3.050，2.346，all P<0.05). Conclusion The increased serum sMICA and sMICB levels in SLE patients were associated with the increased positive rate of SLE autoantibodies, the decreased proportion of NK cells in peripheral blood and the enhanced disease activity, which could be used as potential markers of SLE.

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备注/Memo

备注/Memo:
基金项目：重庆市黔江区科技计划项目（黔科计2022058）。
作者简介：冉涛（1988-），男，本科，副主任技师，研究方向：免疫学，E-mail：12583083@qq.com。
通讯作者：夏家财（1989-），男，本科，主管检验师，研究方向：微生物与免疫。 E-mail：72474067@qq.com。
更新日期/Last Update: 2024-07-15