羟氯喹与系统性红斑狼疮患者血小板活性降低和血管健康改善有关。
Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus.
机构信息
Institute for Systems Genetics, NYU Langone Health, New York City, New York, USA.
Division of Translational Medicine, New York University School of Medicine, New York City, New York, USA.
出版信息
Lupus Sci Med. 2021 Mar;8(1). doi: 10.1136/lupus-2021-000475.
OBJECTIVE
Hydroxychloroquine (HCQ) is a mainstay of therapy in the treatment of SLE. The effect of HCQ on platelets and vascular health is uncertain. We investigated the relationship between HCQ use and dose with platelet activity, platelet transcriptomics and vascular health in patients with SLE.
METHODS
Platelet aggregation, platelet mRNA expression and vascular health (sublingual capillary perfused boundary region (PBR), red blood cell filling (RBCF) and brachial artery reactivity testing) were analysed by HCQ use and dose.
RESULTS
Among 132 subjects with SLE (age: 39.7±12.9 years, 97% female), 108 were on HCQ. SLE disease activity was similar between subjects on and off HCQ. Platelet aggregation in response to multiple agonists was significantly lower in patients on HCQ. There were inverse relationships between HCQ dose and gene expression pathways of platelet activity. Gene expression of P-selectin (SELP) was inversely correlated with HCQ dose (r=-0.41, p=0.003), which was validated at the protein level. Subjects on HCQ had improved vascular function correlating with HCQ dose as measured by lower PBR (r=-0.52, p=0.007), higher RBCF (r=0.55, p=0.004) and greater brachial artery reactivity (r=0.43, p=0.056).
CONCLUSION
HCQ use was associated with decreased platelet activation and activation-related transcripts and improved vascular health in SLE.
目的
羟氯喹 (HCQ) 是治疗系统性红斑狼疮 (SLE) 的主要药物。HCQ 对血小板和血管健康的影响尚不确定。我们研究了 HCQ 应用和剂量与血小板活性、血小板转录组学和 SLE 患者血管健康之间的关系。
方法
通过 HCQ 的应用和剂量分析血小板聚集、血小板 mRNA 表达和血管健康（舌下毛细血管灌注边界区 (PBR)、红细胞填充 (RBCF) 和肱动脉反应性测试）。
结果
在 132 名 SLE 患者（年龄：39.7±12.9 岁，97%为女性）中，有 108 名患者正在服用 HCQ。HCQ 应用和不应用的患者 SLE 疾病活动度相似。对多种激动剂的血小板聚集反应在服用 HCQ 的患者中明显降低。HCQ 剂量与血小板活性的基因表达途径呈负相关。血小板选择素 (SELP) 的基因表达与 HCQ 剂量呈负相关 (r=-0.41, p=0.003)，这在蛋白质水平上得到了验证。HCQ 应用与血管功能改善相关，这与 HCQ 剂量相关，表现为更低的 PBR(r=-0.52, p=0.007)、更高的 RBCF(r=0.55, p=0.004) 和更大的肱动脉反应性(r=0.43, p=0.056)。
结论
HCQ 的应用与 SLE 患者血小板活化和活化相关转录物减少以及血管健康改善相关。
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