Department of Rheumatology and BK21 Division of Cell Transformation and Restoration, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, South Korea, 443-721.
J Clin Immunol. 2013 Jan;33(1):143-50. doi: 10.1007/s10875-012-9765-1. Epub 2012 Aug 23.
Growth arrest-specific protein 6 (Gas6) has been suggested to be a biomarker of disease activity in patients with systemic lupus erthematosus (SLE). We investigated the clinical significance of this protein in Korean SLE.
Blood samples were collected from 150 SLE patients and 50 normal controls (NC). In addition, follow-up samples were collected from 50 SLE patients.
Serum Gas6 levels of SLE patients (43.01 ± 28.02 ng/mL) were higher than those of NC (20.15 ± 9.23 ng/mL, p<0.001). When evaluated sensitivity and specificity of the Gas6 for diagnosing SLE using ROC curves, the sensitivity and specificity were 72.7 % and 84 % with a cut-off value of 25.3 ng/mL. In the ROC analysis of Gas6, anti-dsDNA antibody, ESR, complement 3 and complement 4 to identify patients with active lupus, area under the curve (AUC) of Gas6 was highest with 0.763. Serum Gas6 levels were significantly higher in the patients with serositis (70.04 ± 30.85 ng/mL) and renal disorder (65.66 ± 32.28 ng/mL) compared to those without (41.88 ± 27.44 ng/mL, p=0.033, 40.3 ± 26.33 ng/mL, p=0.001, respectively). Gas6 levels were correlated positively with anti-dsDNA antibody (r=0.199, p=0.015), ESR (r=0.204, p=0.013) and SLEDAI (r=0.512, p<0.001). In addition, serum Gas6 levels were correlated negatively with hemoglobin (r= -0.165, p=0.043), lymphocyte count (r= -0.165, p=0.043), complement 3 (r= -0.343, p<0.001) and complement 4 (r= -0.316, p<0.001). Furthermore, change in serum Gas6 levels was correlated with change in SLEDAI levels in the SLE patients that were followed up (r=0.524, p<0.001).
These results suggest that serum Gas6 can be a reliable clinical marker for monitoring disease activity and treatment response in SLE.
生长停滞特异性蛋白 6（Gas6）已被认为是全身性红斑狼疮（SLE）患者疾病活动的生物标志物。我们研究了这种蛋白在韩国 SLE 患者中的临床意义。
采集 150 例 SLE 患者和 50 例正常对照（NC）的血样。此外，还采集了 50 例 SLE 患者的随访样本。
SLE 患者血清 Gas6 水平（43.01±28.02ng/ml）高于 NC（20.15±9.23ng/ml，p<0.001）。使用 ROC 曲线评估 Gas6 诊断 SLE 的灵敏度和特异性时，截断值为 25.3ng/ml 时，灵敏度和特异性分别为 72.7%和 84%。在 Gas6、抗 dsDNA 抗体、ESR、补体 3 和补体 4 对识别活动期狼疮患者的 ROC 分析中，Gas6 的 AUC 最高为 0.763。有浆膜炎（70.04±30.85ng/ml）和肾脏疾病（65.66±32.28ng/ml）的患者血清 Gas6 水平明显高于无浆膜炎（41.88±27.44ng/ml，p=0.033）和无肾脏疾病（40.3±26.33ng/ml，p=0.001）的患者。Gas6 水平与抗 dsDNA 抗体（r=0.199，p=0.015）、ESR（r=0.204，p=0.013）和 SLEDAI（r=0.512，p<0.001）呈正相关。此外，血清 Gas6 水平与血红蛋白（r= -0.165，p=0.043）、淋巴细胞计数（r= -0.165，p=0.043）、补体 3（r= -0.343，p<0.001）和补体 4（r= -0.316，p<0.001）呈负相关。此外，随访的 SLE 患者血清 Gas6 水平的变化与 SLEDAI 水平的变化相关（r=0.524，p<0.001）。
这些结果表明，血清 Gas6 可作为监测 SLE 疾病活动和治疗反应的可靠临床标志物。
