Department for Diagnosis, John Paul II Hospital, Prądnicka str. 80, 31-202, Krakow, Poland.
Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland.
Clin Rheumatol. 2018 Aug;37(8):2087-2093. doi: 10.1007/s10067-018-4104-4. Epub 2018 Apr 20.
The aim of this study is to assess the relationship between autoimmunity and endothelial activation/damage (ICAM-1 and vWF serum levels) and the degree of prothrombotic activity (thrombin-antithrombin complexes-TAT serum levels) in SLE. In 60 clinically stable SLE patients, levels of the following parameters were estimated in their serum: lupus anticoagulant (LA), anticardiolipin antibodies in both IgG and IgM classes (aCL-IgG and aCL-IgM, respectively), antiβ2GPI antibodies in both IgG and IgM classes (antiβ2GPI-IgG and antiβ2GPI-IgM, respectively), ICAM, von Willebrand factor (vWF), TAT, CRP, C3c, C4, and IL-6. ICAM-1 values exceeded the upper reference limit in 9 (15%) patients. vWF levels were increased in 21 (35%) patients. In all patients with elevated ICAM-1 values, vWF were also increased. TAT concentrations were elevated in 12 (20%) people. ICAM-1 were significantly higher in patients with elevated aCL-IgM (> 30 MPL vs ≤ 30 MPL; p < 0.05). Similarly, ICAM-1 were significantly higher in patients with elevated antiβ2-GPI-IgM (> 20 SMU vs ≤ 20 SMU; p < 0.05). There was no significant difference in ICAM-1 levels in relation to LA-positivity. vWF were not significantly different in relation to antiphospholipid antibodies nor the inflammation marker levels. TAT were significantly higher in patients with elevated aCL-IgM (> 30 MPL vs ≤ 30 MPL; p < 0.05). In one third of young patients with stable SLE, signs of endothelial activation/damage were found, as shown by elevated plasma ICAM-1 or vWF. Increased prothrombotic tendency manifested by elevated TAT was found in one fifth of the patients. Elevated anticardiolipin (IgM) and anti-β2-glycoprotein I (IgM) antibodies influence endothelial dysfunction and enhance prothrombotic state.
本研究旨在评估自身免疫与内皮细胞激活/损伤（ICAM-1 和 vWF 血清水平）以及促血栓形成活性程度（TAT 血清水平）之间的关系在 SLE 中。在 60 例临床稳定的 SLE 患者中，估计其血清中的以下参数水平：狼疮抗凝剂 (LA)、IgG 和 IgM 类抗心磷脂抗体（分别为 aCL-IgG 和 aCL-IgM）、IgG 和 IgM 类抗β2 糖蛋白 I 抗体（分别为抗β2GPI-IgG 和抗β2GPI-IgM）、ICAM、血管性血友病因子 (vWF)、TAT、CRP、C3c、C4 和 IL-6。9 名（15%）患者的 ICAM-1 值超过了上限参考值。21 名（35%）患者的 vWF 升高。在所有 ICAM-1 值升高的患者中，vWF 也升高。12 名（20%）人 TAT 浓度升高。ICAM-1 在 aCL-IgM 升高的患者中显著升高（>30 MPL 与 ≤30 MPL；p<0.05）。同样，ICAM-1 在抗β2-GPI-IgM 升高的患者中显著升高（>20 SMU 与 ≤20 SMU；p<0.05）。LA 阳性患者的 ICAM-1 水平无显著差异。ICAM-1 水平与抗磷脂抗体或炎症标志物水平无关。TAT 在 aCL-IgM 升高的患者中显著升高（>30 MPL 与 ≤30 MPL；p<0.05）。在三分之一的稳定 SLE 年轻患者中，发现了内皮细胞激活/损伤的迹象，表现为血浆 ICAM-1 或 vWF 升高。五分之一的患者出现了 TAT 升高提示的促血栓形成倾向增加。升高的抗心磷脂（IgM）和抗-β2-糖蛋白 I（IgM）抗体影响内皮功能障碍并增强促血栓形成状态。
