Nielsen Christoffer T, Østergaard Ole, Stener Line, Iversen Line V, Truedsson Lennart, Gullstrand Birgitta, Jacobsen Søren, Heegaard Niels H H
Statens Serum Institut, Copenhagen, Denmark.
Arthritis Rheum. 2012 Apr;64(4):1227-36. doi: 10.1002/art.34381. Epub 2012 Jan 11.
To quantify immunoglobulin and C1q on circulating cell-derived microparticles (MPs) in patients with systemic lupus erythematosus (SLE) and to determine whether immunoglobulin and C1q levels are correlated with clinical and serologic parameters.
Sixty-eight clinically well-characterized SLE patients, 38 healthy controls, 6 patients with systemic sclerosis (SSc), and 6 patients with rheumatoid arthritis (RA) were included. The numbers of annexin V-binding MPs displaying IgG, IgM, or C1q were enumerated by flow cytometry. MP protein levels were determined by mass spectrometry in clinically defined subsets of SLE patients and controls. The MP IgG load was determined by flow cytometric analysis of all samples from SLE patients and healthy controls.
SLE patients had significantly increased total and relative numbers of IgG-positive MPs (P = 0.0004), with a much higher average IgG load per MP (P < 0.0001) than healthy controls. Quantitative mass spectrometry of purified MPs verified significantly increased IgG, IgM, and C1q levels in SLE patients. In RA and SSc patients, the average IgG load per MP was significantly lower than in SLE patients (P = 0.006 and P = 0.05, respectively). Also, the IgM load and C1q load per MP were significantly higher in SLE patients than in the control groups (P < 0.05), except for IgM in the RA group. IgG-positive MPs were significantly associated with the presence of anti-double-stranded DNA, anti-extractable nuclear antigen, and antihistone antibodies, with total IgG, and with decreased leukocyte counts. Average IgG load per MP was associated with lower concentrations of MPs, the presence of anti-C1q antibodies, and complement consumption.
Our findings indicate that circulating cell-derived MPs in SLE patients carry increased loads of IgG, IgM, and C1q and that IgG MPs are associated with autoantibodies and complement activation. The findings link immunologic reactions on MPs with the etiology of SLE.
对系统性红斑狼疮(SLE)患者循环中细胞来源的微粒(MPs)上的免疫球蛋白和C1q进行定量,并确定免疫球蛋白和C1q水平是否与临床及血清学参数相关。
纳入68例临床特征明确的SLE患者、38例健康对照、6例系统性硬化症(SSc)患者和6例类风湿关节炎(RA)患者。通过流式细胞术计数显示IgG、IgM或C1q的膜联蛋白V结合MPs的数量。在SLE患者和对照的临床定义亚组中,通过质谱法测定MP蛋白水平。通过对SLE患者和健康对照的所有样本进行流式细胞术分析来确定MP IgG负载量。
SLE患者IgG阳性MPs的总数和相对数量显著增加(P = 0.0004),每个MP的平均IgG负载量比健康对照高得多(P < 0.0001)。纯化MPs的定量质谱法证实SLE患者的IgG、IgM和C1q水平显著升高。在RA和SSc患者中,每个MP的平均IgG负载量显著低于SLE患者(分别为P = 0.006和P = 0.05)。此外,SLE患者每个MP的IgM负载量和C1q负载量显著高于对照组(P < 0.05),RA组的IgM除外。IgG阳性MPs与抗双链DNA、抗可提取核抗原和抗组蛋白抗体的存在、总IgG以及白细胞计数减少显著相关。每个MP的平均IgG负载量与较低的MP浓度、抗C1q抗体的存在以及补体消耗相关。
我们的研究结果表明,SLE患者循环中细胞来源的MPs携带的IgG、IgM和C1q负载量增加,且IgG MPs与自身抗体和补体激活相关。这些发现将MPs上的免疫反应与SLE的病因联系起来。