免疫衰老过早与系统性红斑狼疮患者贫血的存在和严重程度相关。
Association of the premature immunosenescence with the presence and severity of anemia among patients with systemic lupus erythematosus.
机构信息
Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia.
Rheumatology and Immunology Division, Department of Internal Medicine, Facuty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia.
出版信息
Lupus. 2021 Oct;30(12):1906-1914. doi: 10.1177/09612033211038057. Epub 2021 Oct 30.
INTRODUCTION
One of the possible mechanisms that contribute to the development of anemia in systemic lupus erythematosus (SLE) is the presence of premature immunosenescence in SLE. This study aimed to observe the correlation between immunosenescence with anemia in SLE.
METHODS
This research was a cross-sectional study with the subject was 60 women with SLE aged 16-45 years old. Subjects were recorded for the demographic and clinical data, complete blood counts, iron status (iron serum, total iron-binding capacity, and transferrin saturation), ferritin, inflammatory markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]), and anti-dsDNA levels. Immunosenescence was observed by measuring the senescent T cells from peripheral blood mononuclear cells (PBMC) by flow cytometry, counted as CD4CD57 and CD8CD57 T cells. Serum IL-2 and IFNγ as the cytokines associated with immunosenescence were also measured from all subjects. Subjects were divided into anemic and non-anemic groups according to the classification of anemia from WHO (Hb < 12 gr/dl).
RESULTS
Anemic SLE patients had higher CD4CD57, CD8CD57, and IFNγ, while IL-2 was lower in SLE patients with anemia. Multivariate linear regression revealed that the decreasing levels of Hb were associated with the increase of CD8CD57 percentages and IFNγ levels. Anti-dsDNA, ESR, CRP, ferritin, iron serum, and transferrin saturation were correlated with CD8CD57. IFNγ level also correlated with the anti-dsDNA, iron serum, and ferritin levels. No correlation was found between the iron status and inflammatory markers with CD4CD57 percentages and IL-2 levels. Multivariate regression analysis showed that IFNγ was positively associated with anti-dsDNA and negatively associated with iron serum and transferrin saturation, while CD8CD57 percentages were positively associated with the ferritin levels.
CONCLUSION
Immunosenescence is associated with anemia by modulating the inflammatory response and causing iron dysregulation in SLE.
简介
导致系统性红斑狼疮 (SLE) 发生贫血的可能机制之一是 SLE 中存在免疫衰老。本研究旨在观察免疫衰老与 SLE 贫血之间的相关性。
方法
这是一项横断面研究，研究对象为 60 名年龄在 16-45 岁之间的女性 SLE 患者。记录受试者的人口统计学和临床数据、全血细胞计数、铁状态（血清铁、总铁结合能力和转铁蛋白饱和度）、铁蛋白、炎症标志物（红细胞沉降率 [ESR] 和 C 反应蛋白 [CRP]）和抗 dsDNA 水平。通过流式细胞术测量外周血单个核细胞（PBMC）中的衰老 T 细胞来观察免疫衰老，计数 CD4CD57 和 CD8CD57 T 细胞。还从所有受试者中测量与免疫衰老相关的血清 IL-2 和 IFNγ。根据世界卫生组织 (Hb < 12 gr/dl) 的贫血分类，将受试者分为贫血和非贫血组。
结果
贫血性 SLE 患者的 CD4CD57、CD8CD57 和 IFNγ 更高，而贫血性 SLE 患者的 IL-2 水平较低。多元线性回归显示，Hb 下降与 CD8CD57 百分比和 IFNγ 水平增加相关。抗 dsDNA、ESR、CRP、铁蛋白、血清铁和转铁蛋白饱和度与 CD8CD57 相关。IFNγ 水平与抗 dsDNA、血清铁和铁蛋白水平也相关。铁状态和炎症标志物与 CD4CD57 百分比和 IL-2 水平之间无相关性。多元回归分析显示，IFNγ 与抗 dsDNA 呈正相关，与血清铁和转铁蛋白饱和度呈负相关，而 CD8CD57 百分比与铁蛋白水平呈正相关。
结论
免疫衰老通过调节炎症反应和导致 SLE 中的铁失调与贫血相关。
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