Alecu M, Coman G, Alecu S
Dermatological Reaseach Center, Scarlat Longhin Hospital for Dermatology, 216, Sos. Serban Vodă, 73202, Bucharest, Romania.
Rom J Intern Med. 2000;38-39:83-8.
In our study we have investigated the presence of apoptotic bodies, soluble FAS receptor and TNF (tumor necrosis factor) in three clinical forms of lupus erythematosus. Determinations were performed in attack period of: systemic lupus erythematosus (SLE) for 20 patients, 20 patients with subacute cutaneous lupus erythematosus (SCLE), 20 patients with chronic discoid lupus erythematosus (DLE). Determinations were performed by ELISA (for apoptotic bodies, kit Boehringer, normal values 400-800 mU), (for sFAS, kit R&D Systems, normal values 4500-17000 pg/ml) (for TNF, ELISA kit R&D Systems, normal values 0.4-3.6 pg/ml). Results in SLE: apoptotic bodies were increased in 16 cases (980-1030); sFAS in 18 cases (17000-24000 pg/ml) TNF was increased in all 20 cases (40-140 pg/ml). In SCLE with multiple cutaneous lesions and without internal organs disturbance the apoptotic bodies were increased in 10 cases (960-1030 pg/ml), sFAS in 9 cases (17000-22000 pg/ml), and TNF alpha in 9 cases. In DLE, apoptotic bodies were increased in 2 patients (980-1010 pg/ml), sFAS in 3 patients (17000-20000 pg/ml) and TNF in 2 patients (20-40 pg/mil). Investigated values were slightly correlated with immune parameters (anti dsDNA antibodies), but they were correlated with the presence of renal disturbances or extension of cutaneous lesions. We consider that the presence of increased apoptotic bodies as a result of peripheral mononuclear cells apoptosis appear as a nauto-limiting mechanism in a pathological immune response. The increase of sFAS in lupus patients serum might be interpreted as an alteration of apoptosis respectively a deficit in apoptosis which has as a first consequence the persistence of B and T lymphocytes, activated, in the pathogen immune response.
在我们的研究中，我们调查了三种临床类型的红斑狼疮中凋亡小体、可溶性FAS受体和肿瘤坏死因子（TNF）的存在情况。对处于发作期的以下患者进行了检测：20例系统性红斑狼疮（SLE）患者、20例亚急性皮肤型红斑狼疮（SCLE）患者、20例慢性盘状红斑狼疮（DLE）患者。检测采用酶联免疫吸附测定法（ELISA）（检测凋亡小体，使用宝灵曼试剂盒，正常值为400 - 800 mU），（检测可溶性FAS，使用R&D Systems试剂盒，正常值为4500 - 17000 pg/ml）（检测TNF，使用R&D Systems ELISA试剂盒，正常值为0.4 - 3.6 pg/ml）。SLE的检测结果：16例患者凋亡小体增加（980 - 1030）；18例患者可溶性FAS增加（17000 - 24000 pg/ml），所有20例患者TNF均增加（40 - 140 pg/ml）。在有多处皮肤损害且无内脏器官受累的SCLE患者中，10例患者凋亡小体增加（960 - 1030 pg/ml），9例患者可溶性FAS增加（17000 - 22000 pg/ml），9例患者肿瘤坏死因子α增加。在DLE患者中，2例患者凋亡小体增加（980 - 1010 pg/ml），3例患者可溶性FAS增加（17000 - 20000 pg/ml），2例患者TNF增加（20 - 40 pg/mil）。所检测的值与免疫参数（抗双链DNA抗体）有轻微相关性，但与肾脏受累情况或皮肤损害范围相关。我们认为，外周单核细胞凋亡导致凋亡小体增加，这似乎是病理性免疫反应中的一种自我限制机制。狼疮患者血清中可溶性FAS增加可能被解释为凋亡改变，即凋亡缺陷，其首要后果是活化的B和T淋巴细胞在致病性免疫反应中持续存在。
