Ferreira Karine Silvestre, Cicarini Walter Batista, Alves Luan Carlos Vieira, Loures Cristina de Mello Gomide, Campos Fernanda Magalhães Freire, Santos Luara Isabela Dos, da Silva Marcos Vinícius Ferreira, Guimarães Tânia Mara Dabés, Toledo Vicente de Paulo Coelho Peixoto de, Reis Edna Afonso, Neiva Claudia Lopes Santoro, Consoli Renato Vargas, de Pádua Paulo Madureira, Carvalho Maria das Graças
Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Department of Statistics, Institute of Exact Sciences, Federal University of Minas Gerais, Brazil.
Clin Chim Acta. 2019 Mar;490:107-112. doi: 10.1016/j.cca.2018.12.008. Epub 2018 Dec 10.
This study has investigated whether high levels of Reticulocytes-C4d (R-C4d) and Platelets-C4d (P-C4d) reflecting recent activity in SLE patients are correlated with changes in natural anticoagulation components, coagulation activation and endothelial injury markers.
This study included three groups: 1) healthy women (control, n = 30); 2) women with low activity of the disease (SLEDAI 2 K ≤ 4, n = 30); 3) women with active disease (moderate or high activity) (SLEDAI 2 K > 4, n = 30). Median fluorescence intensity (MFI) of R-C4d and P-C4d were determined by flow cytometry using double labeling with specific monoclonal antibodies. Endothelial injury and hypercoagulability were evaluated by measuring Thrombomodulin and D-dimer levels.
Higher MFI index of R-C4d were related to the recent activity of SLE, and higher expression of P-C4d indicated an elevated risk of thrombotic complications. Increased levels of soluble thrombomodulin and D-dimer were observed in patients with active SLE.
R-C4d is helpful to monitor early disease activity and PC4-d may be an important tool to detect a prothrombotic phenotype in SLE. Elevated levels of D-dimer and thrombomodulin add value to P-C4d data and corroborate a hypercoagulable profile in women with SLE, contributing to an increased prothrombotic risk associated with inflammation.
本研究调查了反映系统性红斑狼疮（SLE）患者近期疾病活动的高水平网织红细胞-C4d（R-C4d）和血小板-C4d（P-C4d）是否与天然抗凝成分、凝血激活及内皮损伤标志物的变化相关。
本研究纳入三组：1）健康女性（对照组，n = 30）；2）疾病活动度低的女性（SLEDAI 2K≤4，n = 30）；3）疾病活动的女性（中度或高度活动）（SLEDAI 2K>4，n = 30）。使用特异性单克隆抗体进行双重标记，通过流式细胞术测定R-C4d和P-C4d的中位荧光强度（MFI）。通过测量血栓调节蛋白和D-二聚体水平评估内皮损伤和高凝状态。
R-C4d的较高MFI指数与SLE的近期活动相关，P-C4d的较高表达表明血栓形成并发症风险升高。在活动期SLE患者中观察到可溶性血栓调节蛋白和D-二聚体水平升高。
R-C4d有助于监测疾病早期活动，PC4-d可能是检测SLE患者血栓前表型的重要工具。D-二聚体和血栓调节蛋白水平升高为P-C4d数据增添价值，并证实SLE女性存在高凝状态，导致与炎症相关的血栓形成风险增加。
