新发系统性红斑狼疮中的抗中性粒细胞胞浆抗体
Anti-neutrophil cytoplasmic antibodies in new-onset systemic lupus erythematosus.
作者信息
Su Fang, Xiao Weiguo, Yang Pingting, Chen Qingyan, Sun Xiaojie, Li Tienan
机构信息
Department of Dermatology, the Seventh People's Hospital of Shenyang - Shenyang, China.
Department of Rheumatology and Immunology, the First Affiliated Hospital of China Medical University - Shenyang, China.
出版信息
An Bras Dermatol. 2017 Jul-Aug;92(4):466-469. doi: 10.1590/abd1806-4841.20175476.
BACKGROUND
: The clinical significance of anti-neutrophil cytoplasmic antibodies in patients with new-onset systemic lupus erythematosus, especially in systemic disease accompanied by interstitial lung disease remains to be elucidated.
OBJECTIVES
: This study was designed to investigate the role of anti-neutrophil cytoplasmic antibodies in new-onset systemic lupus erythematosus patients.
METHODS
: A hundred and seven patients with new-onset SLE were enrolled. Presence of anti-neutrophil cytoplasmic antibodies in the sera was assessed by indirect immunofluorescence as well as enzyme linked immunosorbent assay against proteinase-3 and myeloperoxidase. Clinical features and laboratory parameters of patients were also recorded. All patients were subjected to chest X-ray, chest high-resolution computed tomography and pulmonary function test.
RESULTS
: Forty-five systemic lupus erythematosus patients (45/107, 42%) were seropositive for anti-neutrophil cytoplasmic antibodies. Compared with anti-neutrophil cytoplasmic antibodies-negative patients, the anti-neutrophil cytoplasmic antibodies-positive patients had significantly higher incidence of renal involvement, anemia, and Raynaud's phenomenon as well as decreased serum level of complement 3/complement 4 and elevated erythrocyte sedimentation rate. In addition, there was a positive correlation between serum anti-neutrophil cytoplasmic antibodies level and disease activity of systemic lupus erythematosus. Furthermore, prevalence of interstitial lung disease in the anti-neutrophil cytoplasmic antibodies -positive patients (25/45, 55.6%) was obviously higher than that in the anti-neutrophil cytoplasmic antibodies-negative patients (15/62, 24.2%).
STUDY LIMITATIONS
: The sample size was limited and the criteria for screening new-onset systemic lupus erythematosus patients might produce bias.
CONCLUSIONS
: The level of anti-neutrophil cytoplasmic antibodies in new-onset systemic lupus erythematosus patients correlates positively with the disease activity and the prevalence of interstitial lung disease.
背景
新发系统性红斑狼疮患者中抗中性粒细胞胞浆抗体的临床意义，尤其是在伴有间质性肺病的系统性疾病中的意义仍有待阐明。
目的
本研究旨在探讨抗中性粒细胞胞浆抗体在新发系统性红斑狼疮患者中的作用。
方法
纳入107例新发系统性红斑狼疮患者。通过间接免疫荧光以及针对蛋白酶3和髓过氧化物酶的酶联免疫吸附试验评估血清中抗中性粒细胞胞浆抗体的存在情况。记录患者的临床特征和实验室参数。所有患者均接受胸部X线、胸部高分辨率计算机断层扫描和肺功能测试。
结果
45例系统性红斑狼疮患者（45/107，42%）抗中性粒细胞胞浆抗体血清学阳性。与抗中性粒细胞胞浆抗体阴性患者相比，抗中性粒细胞胞浆抗体阳性患者的肾脏受累、贫血和雷诺现象发生率显著更高，血清补体3/补体4水平降低，红细胞沉降率升高。此外，血清抗中性粒细胞胞浆抗体水平与系统性红斑狼疮的疾病活动度呈正相关。此外，抗中性粒细胞胞浆抗体阳性患者的间质性肺病患病率（25/45，55.6%）明显高于抗中性粒细胞胞浆抗体阴性患者（15/62，24.2%）。
研究局限性
样本量有限，筛选新发系统性红斑狼疮患者的标准可能产生偏差。
结论
新发系统性红斑狼疮患者的抗中性粒细胞胞浆抗体水平与疾病活动度和间质性肺病患病率呈正相关。
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