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重症肌无力患者接受糖皮质激素治疗后 BAFF 水平降低。

Lower BAFF Levels in Myasthenic Patients Treated with Glucocorticoids.

机构信息

Department of Neurology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.

Department of Immunology, Biochemistry and Nutrition, Medical University of Warsaw, Warsaw, Poland.

出版信息

Arch Immunol Ther Exp (Warsz). 2021 Aug 2;69(1):22. doi: 10.1007/s00005-021-00626-5.

Abstract

B-cell activating factor (BAFF), a member of tumor necrosis factor family, activates B cells, promotes their survival and proliferation. BAFF is considered to have an influence on development of autoimmune diseases including myasthenia gravis (MG). We aimed to evaluate BAFF serum levels in MG patients, their potential connection with therapy and course of MG. Cross-sectional study. Two hundred eighteen adult patients with MG (67% women, age: 18-89 years, 82.6% AChR antibody seropositive (AChRAb(+)). Serum BAFF levels, their relationship with severity of clinical symptoms, therapy conducted, clinical and demographic features and other factors were analyzed. Patients with AChRAb(+) MG demonstrated significantly higher BAFF levels than MuSK-MG patients (831.2 ± 285.4 pg/ml vs. 745.6 ± 633.4 pg/ml, respectively; p = 0.030). Serum BAFF levels in women were significantly higher than in men (855.9 ± 302.5 vs. 756.6 ± 289.4, respectively; p = 0.017). Mean serum BAFF level was significantly decreased in patients who were ever treated with corticosteroids (CS) (770.4 ± 327.8 pg/ml vs. 891.3 ± 246.1 pg/ml, respectively; p = 0.001). Thymoma-MG patients demonstrated significantly lower BAFF levels (671.2 ± 244.9 vs. 833.5 ± 302.4, respectively; p = 0.044). Thymectomized patients did not differ in BAFF levels from the MG patients who had not undergone thymectomy. In multiple linear regression model, recent CS therapy and male sex were found to be independent predictors of lower BAFF levels. Serum BAFF level is decreased in patients treated with CS, which may suggest inhibiting influence of CS on BAFF-a potential mechanism contributing to the effectiveness of such therapy.

摘要

B 细胞激活因子(BAFF)是肿瘤坏死因子家族的一员,可激活 B 细胞,促进其存活和增殖。BAFF 被认为对包括重症肌无力(MG)在内的自身免疫性疾病的发展有影响。我们旨在评估 MG 患者的 BAFF 血清水平,及其与治疗和 MG 病程的潜在关系。这是一项横断面研究。纳入 218 例成年 MG 患者(67%为女性,年龄 18-89 岁,82.6%乙酰胆碱受体抗体阳性(AChRAb(+))。分析了 BAFF 血清水平及其与临床症状严重程度、所进行的治疗、临床和人口统计学特征及其他因素的关系。AChRAb(+)MG 患者的 BAFF 水平显著高于 MuSK-MG 患者(分别为 831.2±285.4pg/ml 和 745.6±633.4pg/ml,p=0.030)。女性的血清 BAFF 水平显著高于男性(分别为 855.9±302.5pg/ml 和 756.6±289.4pg/ml,p=0.017)。曾接受皮质类固醇(CS)治疗的患者的平均血清 BAFF 水平显著降低(770.4±327.8pg/ml 比 891.3±246.1pg/ml,p=0.001)。胸腺瘤-MG 患者的 BAFF 水平显著降低(671.2±244.9pg/ml 比 833.5±302.4pg/ml,p=0.044)。胸腺切除的患者与未行胸腺切除术的 MG 患者的 BAFF 水平无差异。在多元线性回归模型中,近期 CS 治疗和男性是 BAFF 水平降低的独立预测因素。CS 治疗可降低血清 BAFF 水平,这可能表明 CS 对 BAFF 有抑制作用,这是 CS 治疗有效的潜在机制之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7426/8328853/532d7ead8922/5_2021_626_Fig1_HTML.jpg

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