Chan R W Y, Lai F M M, Li E K M, Tam L S, Chung K Y, Chow K M, Li P K T, Szeto C C
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Lupus. 2006;15(5):262-7. doi: 10.1191/0961203306lu2287oa.
Mononuclear cells play a cardinal role in the pathogenesis of systemic lupus erythematosus (SLE). A high urine cytology score has been reported to be associated with lupus nephritis in relapse. The objective of this study was to examine the urinary mononuclear cell population of patients with lupus nephritis, and explore its correlation with lupus disease activity. We studied 12 patients with active lupus nephritis, 17 patients with lupus nephritis in remission, 12 SLE patients with no history of renal disease and 13 healthy subjects. Clinical disease activity was quantified by the SLE Disease Activity Index (SLEDAI). Mononuclear cell species in the urinary sediment were examined by immunocytochemistry. Patients with active lupus nephritis had significantly more mononuclear cells in the urinary sediment. The number of CD3+ cell was significantly elevated in the active lupus nephritis than the others (P < 0.001), while there was no significant difference in the number of CD20+ and CD56+ cell among patient groups. The total urinary mononuclear cell correlated significantly with the overall SLEDAI score (r = 0.58, P < 0.001) as well as the renal score (r = 0.57, P < 0.001). The number of urinary CD3+, but not CD20+ or CD56+, cell significantly correlated with the overall SLEDAI score (r = 0.46, P = 0.003) as well as the renal score (r = 0.40, p = 0.011). In nine patients with renal biopsy, the histological activity index correlated with the total urinary mononuclear cell (r = 0.75, P = 0.02), CD3+ (r = 0.69, P = 0.04) and CD20+ cell (r = 0.69, P = 0.04). We conclude that urinary mononuclear cell was markedly elevated in patients with active lupus, and the urinary mononuclear cell count correlated significantly with the SLEDAI score and histological activity. CD3+ and CD20+ cells are the major component of urinary mononuclear cell in SLE patients and their number correlates with lupus disease activity.
单核细胞在系统性红斑狼疮（SLE）的发病机制中起主要作用。据报道，高尿细胞学评分与狼疮性肾炎复发相关。本研究的目的是检查狼疮性肾炎患者的尿单核细胞群，并探讨其与狼疮疾病活动的相关性。我们研究了12例活动性狼疮性肾炎患者、17例缓解期狼疮性肾炎患者、12例无肾脏疾病史的SLE患者和13名健康受试者。临床疾病活动度通过SLE疾病活动指数（SLEDAI）进行量化。通过免疫细胞化学检查尿沉渣中的单核细胞种类。活动性狼疮性肾炎患者尿沉渣中的单核细胞明显更多。活动性狼疮性肾炎患者的CD3+细胞数量明显高于其他组（P < 0.001），而各患者组间CD20+和CD56+细胞数量无显著差异。尿单核细胞总数与总体SLEDAI评分（r = 0.58，P < 0.001）以及肾脏评分（r = 0.57，P < 0.001）显著相关。尿CD3+细胞数量，而非CD20+或CD56+细胞数量，与总体SLEDAI评分（r = 0.46，P = 0.003）以及肾脏评分（r = 0.40，P = 0.011）显著相关。在9例进行肾活检的患者中，组织学活动指数与尿单核细胞总数（r = 0.75, P = 0.02）、CD3+（r = 0.69, P = 0.04）和CD20+细胞（r = 0.69, P = 0.04）相关。我们得出结论，活动性狼疮患者尿单核细胞明显升高，尿单核细胞计数与SLEDAI评分和组织学活动显著相关。CD3+和CD20+细胞是SLE患者尿单核细胞的主要成分，其数量与狼疮疾病活动相关。
