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可溶性血管细胞黏附分子-1 与成人发病型微小病变性肾病的疾病活动相关。

Soluble Vascular Cell Adhesion Molecule-1 Is Associated With Disease Activity in Adult-Onset Minimal Change Disease.

机构信息

Department of Nephrology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.

Department of Nephrology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.

出版信息

Am J Med Sci. 2019 Apr;357(4):311-315. doi: 10.1016/j.amjms.2019.01.017. Epub 2019 Feb 2.

DOI:10.1016/j.amjms.2019.01.017
PMID:30904046
Abstract

BACKGROUND

Cell adhesion molecules have been documented to be elevated in numerous immune inflammatory diseases. Minimal change disease (MCD) is an immune disorder. This study aimed to evaluate whether levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin) reflect disease activity in adult-onset MCD.

METHODS

A sandwich enzyme-linked immunosorbent assay was used to measure the soluble adhesion molecules in 40 patients with nephrotic-range proteinuria and biopsy-proven MCD, obtained at the time of diagnosis and during remission. Thirty-five age- and sex-matched healthy volunteers served as controls.

RESULTS

Patients with MCD during the active stage showed significantly higher levels of sVCAM-1 and sE-selectin when compared to controls. Moreover, sVCAM-1 had significantly positive correlations with both urine protein and serum cholesterol, and was negatively associated with serum albumin. Multiple analyses showed that serum albumin was an independent predictor of sVCAM-1. The correlations between sE-selectin and other clinical parameters were not statistically significant. At follow-up, these markers systematically decreased as the disease went into remission, but the increase in sVCAM-1 persisted even in patients obtaining complete remission for 6 months.

CONCLUSIONS

Patients with active MCD had increased levels of sVCAM-1 and sE-selectin. The correlation between sVCAM-1 and proteinuria, serum albumin and cholesterol and its decline during remission indicate that sVCAM-1 is associated with disease activity.

摘要

背景

细胞黏附分子在许多免疫炎症性疾病中被证实升高。微小病变性肾病(MCD)是一种免疫失调疾病。本研究旨在评估可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性 E-选择素(sE-选择素)的水平是否反映成人发病的 MCD 患者的疾病活动度。

方法

采用夹心酶联免疫吸附法检测 40 例肾病范围蛋白尿且经活检证实为 MCD 的患者(在诊断时和缓解期获得)和 35 名年龄和性别匹配的健康志愿者的可溶性黏附分子。

结果

与对照组相比,处于活动期的 MCD 患者的 sVCAM-1 和 sE-选择素水平显著升高。此外,sVCAM-1 与尿蛋白和血清胆固醇呈显著正相关,与血清白蛋白呈负相关。多元分析显示,血清白蛋白是 sVCAM-1 的独立预测因子。sE-选择素与其他临床参数之间的相关性无统计学意义。随访时,随着疾病缓解,这些标志物系统地降低,但即使在获得完全缓解 6 个月的患者中,sVCAM-1 的增加仍持续存在。

结论

处于活动期的 MCD 患者的 sVCAM-1 和 sE-选择素水平升高。sVCAM-1 与蛋白尿、血清白蛋白和胆固醇的相关性及其在缓解期的下降表明其与疾病活动度相关。

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