Department of Rheumatology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia.
Int J Mol Sci. 2021 Apr 15;22(8):4095. doi: 10.3390/ijms22084095.
Deregulation of adiponectin is found in systemic autoimmune rheumatic diseases (SARDs). Its expression is downregulated by various inflammatory mediators, but paradoxically, elevated serum levels are present in SARDs with high inflammatory components, such as rheumatoid arthritis and systemic lupus erythematosus. Circulating adiponectin is positively associated with radiographic progression in rheumatoid arthritis as well as with cardiovascular risks and lupus nephritis in systemic lupus erythematosus. However, in SARDs with less prominent inflammation, such as systemic sclerosis, adiponectin levels are low and correlate negatively with disease activity. Regulators of adiponectin gene expression (PPAR-γ, Id3, ATF3, and SIRT1) and inflammatory cytokines (interleukin 6 and tumor necrosis factor α) are differentially expressed in SARDs and could therefore influence total adiponectin levels. In addition, anti-inflammatory therapy could also have an impact, as tocilizumab treatment is associated with increased serum adiponectin. However, anti-tumor necrosis factor α treatment does not seem to affect its levels. Our review provides an overview of studies on adiponectin levels in the bloodstream and other biological samples from SARD patients and presents some possible explanations why adiponectin is deregulated in the context of therapy and gene regulation.
脂联素在系统性自身免疫性风湿病 (SARD) 中失调。其表达受多种炎症介质下调，但矛盾的是，在炎症成分高的 SARD 中，如类风湿关节炎和系统性红斑狼疮，血清水平升高。循环脂联素与类风湿关节炎的放射学进展以及系统性红斑狼疮的心血管风险和狼疮肾炎呈正相关。然而，在炎症不那么明显的 SARD 中，如系统性硬化症，脂联素水平较低，与疾病活动呈负相关。脂联素基因表达的调节剂 (过氧化物酶体增殖物激活受体-γ、Id3、ATF3 和 SIRT1) 和炎症细胞因子 (白细胞介素 6 和肿瘤坏死因子-α) 在 SARD 中表达不同，因此可能影响总脂联素水平。此外，抗炎治疗也可能有影响，因为托珠单抗治疗与血清脂联素水平升高有关。然而，抗肿瘤坏死因子-α治疗似乎并不影响其水平。我们的综述概述了 SARD 患者血液和其他生物样本中脂联素水平的研究，并提出了一些可能的解释，说明为什么脂联素在治疗和基因调节的背景下失调。
