Soltesz P, Der H, Veres K, Laczik R, Sipka S, Szegedi G, Szodoray P
Third Department of Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
Rheumatology (Oxford). 2008 Nov;47(11):1628-34. doi: 10.1093/rheumatology/ken349. Epub 2008 Sep 9.
To describe how certain peripheral immune parameters reflect the inflammatory alterations in patients with primary APS.
Twenty-eight patients with newly diagnosed primary APS were studied. The control group included 26 patients with stable coronary disease and 38 healthy individuals. Peripheral blood lymphocyte subgroups were quantified, intracellular cytokines were measured by flow cytometry, soluble cytokines and auto-antibodies were assessed using ELISA. Endothelial dysfunction was evaluated by measuring endothelium-dependent (flow-mediated; FMD) vasodilation. Carotid duplex ultrasound was performed to quantify the carotid artery intima-media thickness (IMT). Stiffness parameters, augmentation index (AIx) and pulse wave velocity (PWV) were assessed by TensioClinic technology.
Serum IL-4 and IL-6 levels were significantly higher in APS. CD4+IL10+ and CD8+IL10+ cell percentages in APS were significantly increased compared with controls. Th 0 and T cytotoxic 0 cell percentages were significantly decreased in patients compared with controls. FMD in APS was significantly lower, while IMT was higher than that of controls. FMD showed strong association with stiffness parameters, AIx and PWV. A significant negative linear correlation was detected between PWV and CD8+IL10+ cell percentages and significant positive linear correlation was found between PWV and CD8+IL10- cell percentage.
In APS, the orchestrated pro-inflammatory cascade can eventually result in endothelial dysfunction, leading to the characteristic vascular abnormalities of the disease.
描述某些外周免疫参数如何反映原发性抗磷脂综合征（APS）患者的炎症改变。
对28例新诊断的原发性APS患者进行研究。对照组包括26例稳定型冠心病患者和38名健康个体。对外周血淋巴细胞亚群进行定量分析，采用流式细胞术检测细胞内细胞因子，使用酶联免疫吸附测定法（ELISA）评估可溶性细胞因子和自身抗体。通过测量内皮依赖性（血流介导的；FMD）血管舒张来评估内皮功能障碍。进行颈动脉双功超声检查以量化颈动脉内膜中层厚度（IMT）。采用TensioClinic技术评估僵硬度参数、增强指数（AIx）和脉搏波速度（PWV）。
APS患者血清白细胞介素-4（IL-4）和白细胞介素-6（IL-6）水平显著升高。与对照组相比，APS患者中CD4⁺IL10⁺和CD8⁺IL10⁺细胞百分比显著增加。与对照组相比，患者中Th0和细胞毒性T0细胞百分比显著降低。APS患者的FMD显著降低，而IMT高于对照组。FMD与僵硬度参数、AIx和PWV密切相关。检测到PWV与CD8⁺IL10⁺细胞百分比之间存在显著的负线性相关性，且PWV与CD8⁺IL10⁻细胞百分比之间存在显著的正线性相关性。
在APS中，精心编排的促炎级联反应最终可导致内皮功能障碍，从而引发该疾病的特征性血管异常。
