Central Laboratory, The First Hospital of Jilin University, Changchun, China.
Department of Pediatric Rheumatology and Allergy, The First Hospital of Jilin University, Changchun, China.
BMC Immunol. 2020 Feb 17;21(1):6. doi: 10.1186/s12865-020-0335-7.
There is a growing body of evidences indicating iNOS has involved in the pathogenesis of SLE. However, the role of iNOS in SLE is inconsistency. This systematic review was designed to evaluate the association between iNOS and SLE.
Six studies were included, reporting on a total of 277 patients with SLE. The meta-analysis showed that SLE patients had higher expression of iNOS at mRNA level than control subjects (SMD = 2.671, 95%CI = 0.446-4.897, z = 2.35, p = 0.019), and a similar trend was noted at the protein level (SMD = 3.602, 95%CI = 1.144-6.059, z = 2.87, p = 0.004) and positive rate of iNOS (OR = 9.515, 95%CI = 1.915-47.281, z = 2.76, p = 0.006) were significantly higher in SLE group compared with control group. No significant difference was observed on serum nitrite level between SLE patients and control subjects (SMD = 2.203, 95%CI = -0.386-4.793, z = 1.64, p = 0.095). The results did not modify from different sensitivity analysis, representing the robustness of this study. No significant publication bias was detected from Egger's test.
There was a positive correlation between increasing iNOS and SLE. However, the source of iNOS is unknown. Besides NO pathway, other pathways also should be considered. More prospective random studies are needed in order to certify our results.
越来越多的证据表明诱导型一氧化氮合酶（iNOS）参与了系统性红斑狼疮（SLE）的发病机制。然而，iNOS 在 SLE 中的作用并不一致。本系统评价旨在评估 iNOS 与 SLE 之间的关系。
纳入了 6 项研究，共报道了 277 例 SLE 患者。Meta 分析显示，SLE 患者 iNOS 的 mRNA 水平表达高于对照组（SMD=2.671，95%CI=0.446-4.897，z=2.35，p=0.019），蛋白水平也有类似的趋势（SMD=3.602，95%CI=1.144-6.059，z=2.87，p=0.004），且 iNOS 阳性率（OR=9.515，95%CI=1.915-47.281，z=2.76，p=0.006）也显著高于对照组。SLE 患者与对照组血清硝酸盐水平无显著差异（SMD=2.203，95%CI=-0.386-4.793，z=1.64，p=0.095）。不同敏感性分析结果未改变，表明本研究结果稳健。Egger 检验未发现明显的发表偏倚。
iNOS 水平升高与 SLE 呈正相关。然而，iNOS 的来源尚不清楚。除了 NO 途径外，还应考虑其他途径。需要更多前瞻性随机研究来证实我们的结果。
