Rashad Nearmeen M, El-Shabrawy Reham M, Said Dina, El-Shabrawy Shereen M, Emad George
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Egypt J Immunol. 2019 Jan;26(1):31-42.
About 40-50% of all patients with systemic lupus erythematosus (SLE) patients are associated with significant morbidity and a poor prognosis. The transforming growth factor β-1(TGF-β1) is a member of cytokines families which has emerged as an important player in the pathogenesis of autoimmune diseases, including SLE. In this study we aimed to evaluate TGF-β1 as a noninvasive diagnostic test for early diagnosis of LN and to assess the correlations between TGFβ-1 and clinic-pathologic characteristics as well as disease activity of SLE. This case-control study included 188 patients with SLE, stratified into two subgroups LN group and Non-LN group. We assessed diseases activity by SLE disease activity index and measured TGEβ-1 by using ELISA. Our results showed that LN patients had significant lower values of serum TGF-β1 compared with non-LN patients (P < 0.001). Moreover, there were significant differences between LN histopathological classes. The lowest levels values of serum TGFβ1 was in Class V. There were significant negative correlations between levels of TGF-β1 and SLEDAI, fever, arthritis, proteinuria, hematuria, serum creatinine, thrombocytopenia, lymphopenia, ESR, ANA, pus cell and cellular cast's, all (P < 0.01). In lupus nephritis patients, TGF-β1 levels were positively correlated with eGFR, C3 and C4 (P < 0.001). Linear regression analysis revealed that, eGFR, CRP, thrombocytopenia, and serum creatinine were independently correlated with TGF-β1 among lupus nephritis patients (P < 0.001). According to Receiver Operating Characteristic analysis, the sensitivity and specificity of TGF-β1 were 91% and 65.5%, respectively in the diagnosis of LN among SLE patients. As LN group had significantly lower values of serum TGFβ1 and the values further decreased with more damage of kidney tissues and progression of SLE activity. We conclude that serum TGF- β1 could be a valuable non-invasive marker for assessment of LN activity and organ damage.
约40%-50%的系统性红斑狼疮（SLE）患者伴有严重发病情况且预后不良。转化生长因子β-1（TGF-β1）是细胞因子家族的一员，已成为包括SLE在内的自身免疫性疾病发病机制中的重要因素。在本研究中，我们旨在评估TGF-β1作为LN早期诊断的非侵入性诊断试验，并评估TGFβ-1与临床病理特征以及SLE疾病活动度之间的相关性。这项病例对照研究纳入了188例SLE患者，分为两个亚组，即LN组和非LN组。我们通过SLE疾病活动指数评估疾病活动度，并使用酶联免疫吸附测定法（ELISA）测量TGEβ-1。我们的结果显示，与非LN患者相比，LN患者的血清TGF-β1值显著更低（P < 0.001）。此外，LN组织病理学类别之间存在显著差异。血清TGFβ1的最低水平值出现在V类。TGF-β1水平与SLE疾病活动指数（SLEDAI）、发热、关节炎、蛋白尿、血尿、血清肌酐、血小板减少、淋巴细胞减少、红细胞沉降率（ESR）、抗核抗体（ANA）、脓细胞和细胞管型均呈显著负相关（P < 0.01）。在狼疮性肾炎患者中，TGF-β1水平与估算肾小球滤过率（eGFR）、补体C3和C4呈正相关（P < 0.001）。线性回归分析显示，在狼疮性肾炎患者中，eGFR、C反应蛋白（CRP）、血小板减少和血清肌酐与TGF-β1独立相关（P < 0.001）。根据受试者工作特征分析，TGF-β1在SLE患者LN诊断中的敏感性和特异性分别为91%和65.5%。由于LN组的血清TGFβ1值显著更低，且随着肾组织损伤加重和SLE活动进展，该值进一步降低。我们得出结论，血清TGF-β1可能是评估LN活动度和器官损伤的有价值的非侵入性标志物。
