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[系统性红斑狼疮和抗磷脂综合征中的可溶性CD40配体]

[Soluble CD40 ligand in systemic lupus erythematosus and antiphospholipid syndrome].

作者信息

Aleksandrova E N, Novikov A A, Popkova T V, Reshetniak T M, Novikova D S, Kliukvina N G, Il'ina A E, Mach E S, Volkov A V, Nasonov E L

出版信息

Ter Arkh. 2006;78(6):35-9.

Abstract

AIM

To investigate a clinical role of soluble (s) CD40 ligand in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).

MATERIAL AND METHODS

A serum concentration of sCD40 ligand was measured with enzyme immunoassay (Bender Medsystems, Austria) in 21 patients with primary antiphospholipid syndrome (PAPS), in 25 patients with secondary APS (SAPS) associated with SLE, in 92 SLE patients and in 16 healthy donors.

RESULTS

A sCD40 ligand concentration in sera of SAPS and SLE patients was significantly higher than in donors. Significant differences by the ligand level between the above patients were not seen. In PAPS sCD40 ligand concentration was normal. Elevated serum concentration of the ligand was observed in 9.5% patients with PAPS, 54.0%--with SAPS, 73.9%--with SLE. This rise in SLE and SAPS was not related with the disease activity or renal damage. Hyperexpression of the ligand in APS was associated neither with thromboses nor with a high concentration of IgG/IgM antibodies to cardiolipin. A direct correlation occurred between sCD40 ligand level and platelet count. In SLE and SAPS elevation of the ligand level correlated with increased thickness of carotid artery intima-media complex, hypercholesterinemia and diastolic dysfunction of left ventricular myocardium.

CONCLUSION

Hyperexpression of sCD40L in SLE and SAPS is associated with developing cardiovascular diseases and atherosclerosis.

摘要

目的

研究可溶性(s)CD40配体在系统性红斑狼疮(SLE)和抗磷脂综合征(APS)中的临床作用。

材料与方法

采用酶免疫分析法(奥地利Bender Medsystems公司)检测21例原发性抗磷脂综合征(PAPS)患者、25例与SLE相关的继发性APS(SAPS)患者、92例SLE患者及16名健康供者血清中sCD40配体的浓度。

结果

SAPS和SLE患者血清中sCD40配体浓度显著高于健康供者。上述患者之间的配体水平未见显著差异。PAPS患者的sCD40配体浓度正常。在PAPS患者中,9.5%的患者血清配体浓度升高;SAPS患者中为54.0%;SLE患者中为73.9%。SLE和SAPS中该配体水平的升高与疾病活动度或肾损害无关。APS中配体的高表达既与血栓形成无关,也与抗心磷脂IgG/IgM抗体的高浓度无关。sCD40配体水平与血小板计数呈直接相关。在SLE和SAPS中,配体水平的升高与颈动脉内膜中层复合体厚度增加、高胆固醇血症及左心室心肌舒张功能障碍相关。

结论

SLE和SAPS中sCD40L的高表达与心血管疾病和动脉粥样硬化的发生有关。

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