Yuliasih Yuliasih, Rahmawati Lita Diah, Nisa' Nabilatun, Prastayudha Cahaya
Rheumatology Division of Internal Medicine Department, Faculty of Medicine, Airlangga University, Surabaya 60132, Indonesia.
Department of Biology, Faculty of Science and Technology, Airlangga University, Surabaya 60115, Indonesia.
Int J Inflam. 2022 Nov 8;2022:7168935. doi: 10.1155/2022/7168935. eCollection 2022.
Several key player factors, such as cytokine and complement, play an important role in the pathogenesis of systemic lupus erythematosus (SLE). The purpose of this study was to reveal the association between complement 3 (C3), complement 4 (C4), interleukin-6 (IL-6), and transforming growth factor- (TGF-) with SLE disease activity, renal damage, and hematological activity in patients with naïve SLE. The Laboratory of Clinical Pathology Dr. Soetomo General Hospital in Surabaya performed all laboratory examinations on thirty women with naïve SLE. The SLE diagnosis is based on ACR criteria (1998 revised criteria) from Dr. Soetomo General Hospital Surabaya, Indonesia, and the systemic lupus activity measurement (SLAM) score is used to assess the disease activity. The correlation was statistically tested using the Spearman and Pearson tests. The differences in cytokine and complement levels are between SLE severity groups using the two-way Anova and Kruskal-Wallis. The unpaired -test and Mann-Whitney test were used to determine the differences between the relatively normal and the more severe groups of organ damage and hematological activity. All tests were two-tailed, analyzed with GraphPad Prism 9 for windows, and a value of less than 0.05 was considered statistically significant. This study found a significant decrease in C3 (20.2, 16.4-24.2 mg/dL) and C4 (7, 6-14.3 mg/dL) and an increase in IL-6 (35.60 ± 7.43 mg/dL) and TGF- (311.1 ± 290.8 mg/dL) in the group of severe patients with SLAM scores >30. Although there is no significant relationship between SLAM and renal impairment or hematologic activity, patients with higher SLAM had a significant decrease in complement; this complement decrease was also significant in patients with higher leukocyte counts. An insignificant increase in cytokines was also observed in patients with higher SLAM. Patients with high serum creatinine levels had a significant increase in TGF-, whereas those with a faster ESR had a significant increase in IL-6. In conjunction with complements evaluation, assessment of the cytokine profile may become a promising marker for reliable diagnosis and treatment of SLE in the future.
几种关键的参与因素，如细胞因子和补体，在系统性红斑狼疮（SLE）的发病机制中起着重要作用。本研究的目的是揭示补体3（C3）、补体4（C4）、白细胞介素-6（IL-6）和转化生长因子-（TGF-）与初发SLE患者的SLE疾病活动度、肾损伤及血液学活动之间的关联。泗水苏托莫综合医院临床病理实验室对30例初发SLE女性患者进行了所有实验室检查。SLE诊断基于印度尼西亚泗水苏托莫综合医院的ACR标准（1998年修订标准），并使用系统性红斑狼疮活动度测量（SLAM）评分来评估疾病活动度。采用Spearman和Pearson检验进行相关性统计学检验。使用双向方差分析和Kruskal-Wallis检验比较SLE严重程度组之间细胞因子和补体水平的差异。采用不成对t检验和Mann-Whitney检验确定相对正常组与器官损伤和血液学活动更严重组之间的差异。所有检验均为双侧检验，使用GraphPad Prism 9 for windows进行分析，P值小于0.05被认为具有统计学意义。本研究发现，SLAM评分>30的重症患者组中，C3（20.2，16.4 - 24.2mg/dL）和C4（7，6 - 14.3mg/dL）显著降低，IL-6（35.60±7.43mg/dL）和TGF-（311.1±290.8mg/dL）升高。虽然SLAM与肾损害或血液学活动之间无显著相关性，但SLAM较高的患者补体显著降低；白细胞计数较高的患者补体降低也很显著。SLAM较高的患者中细胞因子也有不显著的升高。血清肌酐水平高的患者TGF-显著升高，而红细胞沉降率较快的患者IL-6显著升高。结合补体评估，细胞因子谱评估可能成为未来SLE可靠诊断和治疗的有前景的标志物。
