Jacobi A M, Rohde W, Ventz M, Riemekasten G, Burmester G R, Hiepe F
Department of Medicine, Charité University Hospitals, Berlin, Germany.
Lupus. 2001;10(8):554-61. doi: 10.1191/096120301701549688.
Recent accumulated evidence suggests that prolactin (PRL) is an important immunomodulator and plays a part in the pathogenesis of systemic lupus erythematosus (SLE). The current study assessed the frequency of hyperprolactinaemia in patients with SLE and its association with defined clinical manifestations or serological abnormalities. PRL levels were analysed in 60 patients with SLE including a follow-up of 20 patients, 18 patients with rheumatic autoimmune diseases other than SLE (AID) and in 47 normal healthy subjects (NHS) using ELISA. Clinical manifestations and disease activity (ECLAM) were recorded. Autoantibodies (anti-dsDNA, anti-CL) were determined by standard techniques. In all, 28.3% of the patients with SLE had raised serum PRL. Their PRL levels (17.4+/-15.1 ng/ml, P<0.0001) and those of patients with AID (13.1+/-10.3 ng/ml, P<0.001) were significantly higher compared to NHS (6.3+/-3.2 ng/ml). Anti-dsDNA (r(s) = 0.3, P = 0.04) and anti-CL antibody titres (IgG; r(s) = 0.3, P = 0.03) correlated with PRL level. Furthermore, elevated erytthrocyte sedimentation rate (ESR), anaemia, decrease in C3, fatigue, fever and renal involvement were associated with hyperprolactinaemia. These results were confirmed by follow-up examinations. Moderate hyperprolactinaemia is present in a subset of patients with SLE and serum PRL correlates with clinical and serological disease activity.
最近积累的证据表明,催乳素(PRL)是一种重要的免疫调节剂,在系统性红斑狼疮(SLE)的发病机制中起作用。本研究评估了SLE患者高催乳素血症的发生率及其与特定临床表现或血清学异常的关联。采用酶联免疫吸附测定法(ELISA)分析了60例SLE患者(包括20例进行随访)、18例除SLE外的风湿性自身免疫性疾病(AID)患者和47例正常健康受试者(NHS)的PRL水平。记录了临床表现和疾病活动度(欧洲狼疮活动度测量指标,ECLAM)。通过标准技术检测自身抗体(抗双链DNA、抗心磷脂抗体)。总体而言,28.3%的SLE患者血清PRL升高。与NHS(6.3±3.2 ng/ml)相比,他们的PRL水平(17.4±15.1 ng/ml,P<0.0001)以及AID患者的PRL水平(13.1±10.3 ng/ml,P<0.001)显著更高。抗双链DNA(rs = 0.3,P = 0.04)和抗心磷脂抗体滴度(IgG;rs = 0.3,P = 0.03)与PRL水平相关。此外,红细胞沉降率(ESR)升高、贫血、C3降低、疲劳、发热和肾脏受累与高催乳素血症相关。这些结果通过随访检查得到证实。部分SLE患者存在中度高催乳素血症,血清PRL与临床和血清学疾病活动度相关。