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不完全性红斑狼疮的临床和免疫学特征及羟氯喹治疗后的改善情况

Clinical and Immunologic Profiles in Incomplete Lupus Erythematosus and Improvement with Hydroxychloroquine Treatment.

作者信息

Olsen Nancy J, McAloose Carl, Carter Jamie, Han Bobby Kwanghoon, Raman Indu, Li Quan-Zhen, Liao Duanping

机构信息

Division of Rheumatology, Department of Medicine, Penn State MS Hershey Medical Center, Hershey, PA, USA.

Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA.

出版信息

Autoimmune Dis. 2016;2016:8791629. doi: 10.1155/2016/8791629. Epub 2016 Dec 28.

Abstract

. The study goals were to evaluate performance of SLE classification criteria, to define patients with incomplete lupus erythematosus (ILE), and to probe for features in these patients that might be useful as indicators of disease status and hydroxychloroquine response. . Patients with ILE ( = 70) and SLE ( = 32) defined by the 1997 American College of Rheumatology criteria were reclassified using the 2012 Systemic Lupus International Collaborating Clinics criteria. Disease activity, patient reported outcomes, and levels of Type I interferon- (IFN-) inducible genes, autoantibodies, and cytokines were measured. Subgroups treated with hydroxychloroquine (HCQ) were compared to patients not on this drug. . The classification sets were correlated ( = 0.87). ILE patients were older ( = 0.0043) with lower disease activity scores ( < 0.001) and greater dissatisfaction with health status ( = 0.034) than SLE patients. ILE was associated with lower levels of macrophage-derived cytokines and levels of expressed Type I IFN-inducible genes. Treatment of ILE with HCQ was associated with better self-reported health status scores and lower expression levels of Type I IFN-inducible genes than ILE patients not on HCQ. . The 2012 SLICC SLE classification criteria will be useful to define ILE in trials. Patients with ILE have better health status and immune profiles when treated with HCQ.

摘要

本研究的目标是评估系统性红斑狼疮(SLE)分类标准的性能,定义不完全性红斑狼疮(ILE)患者,并探究这些患者中可能有助于作为疾病状态和羟氯喹反应指标的特征。采用1997年美国风湿病学会标准定义的ILE患者(n = 70)和SLE患者(n = 32),使用2012年系统性红斑狼疮国际协作临床组标准重新分类。测量疾病活动度、患者报告的结局以及I型干扰素(IFN-)诱导基因、自身抗体和细胞因子的水平。将接受羟氯喹(HCQ)治疗的亚组与未使用该药物的患者进行比较。分类集具有相关性(r = 0.87)。与SLE患者相比,ILE患者年龄更大(P = 0.0043),疾病活动评分更低(P < 0.001),对健康状况的不满程度更高(P = 0.034)。ILE与巨噬细胞衍生细胞因子水平较低以及I型IFN诱导基因表达水平较低相关。与未使用HCQ的ILE患者相比,使用HCQ治疗ILE与更好的自我报告健康状况评分以及更低的I型IFN诱导基因表达水平相关。2012年SLICC SLE分类标准在试验中有助于定义ILE。使用HCQ治疗时,ILE患者具有更好的健康状况和免疫特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209b/5225311/cbb7711642ba/AD2016-8791629.001.jpg

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