系统性红斑狼疮中的淋巴细胞毒性抗体与疾病活动相关，无论是否存在神经精神表现。

Lymphocytotoxic antibodies in systemic lupus erythematosus are associated with disease activity irrespective of the presence of neuropsychiatric manifestations.

作者信息

Magalhães M B, da Silva L M, Voltarelli J C, Donadi E A, Louzada-Junior P

机构信息

Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.

出版信息

Scand J Rheumatol. 2007 Nov-Dec;36(6):442-7. doi: 10.1080/03009740701482768.

DOI:10.1080/03009740701482768

PMID:18092265

Abstract

OBJECTIVES

To evaluate the association of the presence of lymphocytotoxic, anti-beta2-glycoprotein I (anti-beta2-GPI) and anti-ribosomal P (anti-P) antibodies in patients with systemic lupus erythematosus (SLE), presenting or not neuropsychiatric (NP) manifestations, stratified according to the activity of the disease.

METHODS

A total of 138 patients with SLE (59 with active NPSLE, 49 with active non-NPSLE, and 30 with inactive disease) and 57 healthy controls were studied. Disease activity was assessed by the SLE Disease Activity Index (SLEDAI). The presence of lymphocytotoxic antibodies was assessed using a complement-dependent lymphocytotoxicity assay. The presence of anti-beta2-GPI and anti-P antibodies was detected by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Lymphocytotoxic antibodies were detected primarily in patients with active disease, that is in 35 out of 59 (59.3%) NPSLE and 23 out of 49 (46.9%) non-NPSLE patients, whereas only four out of 30 (13.3%) inactive SLE patients and none of the healthy controls exhibited the autoantibody. The frequency of lymphocytotoxic antibodies in active SLE patients, considered as a whole or stratified into NPSLE or non-NPSLE, was significantly increased in relation to inactive SLE patients (p<0.001 for each comparison). No significant difference was observed when comparing active NPSLE with non-NPSLE patients. No associations were observed between the presence of anti-beta2-GPI or anti-P antibodies and the activity of SLE or the presence of lymphocytotoxic antibodies.

CONCLUSIONS

Lymphocytotoxic antibodies occurred more frequently in patients with active SLE than in patients with inactive disease, irrespective of the presence of NP manifestations, a finding that is similar to classical biomarkers of lupus activity (anti-dsDNA and complement). These results indicate that the assessment of the presence of lymphocytotoxic antibodies may be an additional useful tool for the evaluation of SLE activity.

摘要

目的

评估系统性红斑狼疮（SLE）患者中淋巴细胞毒性抗体、抗β2糖蛋白I（抗β2-GPI）抗体及抗核糖体P（抗-P）抗体的存在情况，这些患者伴有或不伴有神经精神（NP）表现，并根据疾病活动度进行分层。

方法

共研究了138例SLE患者（59例活动性神经精神性SLE、49例活动性非神经精神性SLE和30例非活动性疾病患者）以及57名健康对照者。通过SLE疾病活动指数（SLEDAI）评估疾病活动度。使用补体依赖性淋巴细胞毒性试验评估淋巴细胞毒性抗体的存在情况。通过酶联免疫吸附测定（ELISA）检测抗β2-GPI和抗-P抗体的存在情况。

结果

淋巴细胞毒性抗体主要在活动性疾病患者中检测到，即59例神经精神性SLE患者中的35例（59.3%）和49例非神经精神性SLE患者中的23例（46.9%），而30例非活动性SLE患者中只有4例（13.3%）出现该自身抗体，健康对照者均未出现。与非活动性SLE患者相比，活动性SLE患者（整体或分为神经精神性SLE或非神经精神性SLE）中淋巴细胞毒性抗体的频率显著增加（每次比较p<0.001）。比较活动性神经精神性SLE患者与非神经精神性SLE患者时未观察到显著差异。未观察到抗β2-GPI或抗-P抗体的存在与SLE活动度或淋巴细胞毒性抗体的存在之间存在关联。