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血清可溶性 CXCL16 在青少年系统性红斑狼疮中的作用:疾病严重程度和狼疮肾炎的有前景的预测指标。

Serum-soluble CXCL16 in juvenile systemic lupus erythematosus: a promising predictor of disease severity and lupus nephritis.

机构信息

Dermatology and Venereology Department, Faculty of Medicine, Tanta University, El Geish Street, Tanta, 31111, Egypt.

Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

Clin Rheumatol. 2018 Nov;37(11):3025-3032. doi: 10.1007/s10067-018-4203-2. Epub 2018 Jul 13.

Abstract

Juvenile systemic lupus erythematosus (jSLE) is a multisystem autoimmune disease of unpredicted course and prognosis. Rates of organ involvement in SLE are higher in children, and overt lupus nephropathy is more often a presenting manifestation of SLE in children than adults. Inflammatory soluble chemokine CXC motif-ligand 16 (sCXCL16) is an important pathogenic mediator in inflammatory diseases as SLE. Herein, we aimed to evaluate serum level of sCXCL16 in jSLE patients in comparison to healthy controls and to correlate it with disease activity and extent of cutaneous and renal affection, to detect its possible role in disease pathogenesis. Serum level of sCXCL16 was determined by ELISA in 27 patients with jSLE (mean age 12.35 years ± 2.26 SD) in addition to 30 age- and sex-matched healthy controls and correlated with clinical and laboratory parameters in lupus group. Serum sCXCL16 was significantly higher in jSLE patients than controls (P ≤ 0.001), and it correlated positively with SLE disease activity, severity of lupus nephritis, 24-h urinary protein, anti-dsDNA titre, blood pressure, and ESR, while it correlated negatively with serum C3 levels. Serum sCXCL16 was higher in jSLE patients with alopecia and malar erythema. Serum sCXCL16 might play a role in inflammatory pathogenesis of jSLE particularly in periods of disease activity. It might serve as a future useful laboratory test for detection of jSLE activity, renal insult, and its severity which might limit the need for invasive renal biopsies in such a delicate patient population.

摘要

儿童系统性红斑狼疮 (jSLE) 是一种不可预测病程和预后的多系统自身免疫性疾病。SLE 患者的器官受累率在儿童中更高,且显性狼疮肾炎在儿童中比成人更常作为 SLE 的首发表现。炎症性趋化因子 CXC 基序配体 16(sCXCL16)是 SLE 等炎症性疾病的重要致病介质。在此,我们旨在评估 jSLE 患者与健康对照组之间血清 sCXCL16 水平,并将其与疾病活动度和皮肤及肾脏受累程度相关联,以检测其在疾病发病机制中的可能作用。通过 ELISA 法检测了 27 例 jSLE 患者(平均年龄 12.35 ± 2.26 岁)和 30 名年龄和性别匹配的健康对照者的血清 sCXCL16 水平,并与狼疮组的临床和实验室参数相关联。与对照组相比,jSLE 患者的血清 sCXCL16 显著升高(P ≤ 0.001),且与 SLE 疾病活动度、狼疮肾炎严重程度、24 小时尿蛋白、抗 dsDNA 滴度、血压、ESR 呈正相关,而与血清 C3 水平呈负相关。jSLE 患者有脱发和蝶形红斑时血清 sCXCL16 水平更高。血清 sCXCL16 可能在 jSLE 的炎症发病机制中发挥作用,尤其是在疾病活动期。它可能成为未来检测 jSLE 活动度、肾损伤及其严重程度的有用实验室检测手段,从而可能减少在这种娇嫩患者群体中进行有创性肾活检的需求。

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