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系统性红斑狼疮合并亚临床动脉粥样硬化和继发性抗磷脂综合征患者的调节性B细胞评估

Regulatory B Cells Evaluation in Systemic Lupus Erythematosus Patients with Subclinical Atherosclerosis and Secondary Antiphospholipid Syndrome.

作者信息

Abdelaziz Marwa Mahmoud, Fathi Nihal, Hetta Helal F, Abdel-Galeel Ahmed, Zidan Mohamed, Shawky Eman M, Gamal Rania M

机构信息

Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Mediterr J Rheumatol. 2023 Aug 3;34(4):486-494. doi: 10.31138/mjr.03823.rbc. eCollection 2023 Dec.

Abstract

OBJECTIVES

The current knowledge of human studies that address B cells in Systemic Lupus Erythematosus (SLE) patients with subclinical atherosclerosis remains insufficient. We aimed to evaluate the contribution of Breg cells in SLE and secondary antiphospholipid syndrome (APS) patients taking into consideration its relation to subclinical atherosclerosis and the disease activity.

METHODS

Thirty SLE patients and 23 controls were included. Systemic Lupus Erythematosus Disease Activity Index-2000 was estimated. Evaluation of Breg cells percentage using flow cytometry was done. All participants underwent carotid doppler ultrasound examination for measurements of the intima-media thickness of the common carotid artery (cIMT). The coronary artery calcium scoring was calculated using the Agatston method.

RESULTS

The mean± SD of age was 32.60±8.34 years, while of the age of onset was 28.27±7.60 years. Twenty-three patients (76.7%) had subclinical atherosclerosis. There was a highly significant difference in Breg cells between SLE and APS patients with subclinical atherosclerosis and controls (P= 0.001, 0.005). SLE and APS patients had significantly higher mean cIMT than control (P0.01, 0.050). Breg cells had 70% sensitivity and 87% specificity for diagnosing of SLE (P=0.01). Multivariate regression analysis indicated that low Breg cells were predictive for the disease activity (OR=1.76, 95% CI=1.21- 2.85; P= 0.01).

CONCLUSION

SLE patients had a high frequency of subclinical atherosclerosis, those and patients with secondary APS had a high risk of plaque formation. We found a contribution of Breg cells in SLE patients with subclinical atherosclerosis. Breg cells are considered a good predictor of diagnosis of SLE.

摘要

目的

目前关于系统性红斑狼疮(SLE)合并亚临床动脉粥样硬化患者B细胞的人体研究知识仍不足。我们旨在评估调节性B细胞(Breg细胞)在SLE和继发性抗磷脂综合征(APS)患者中的作用,并考虑其与亚临床动脉粥样硬化及疾病活动度的关系。

方法

纳入30例SLE患者和23例对照。评估系统性红斑狼疮疾病活动指数2000。采用流式细胞术评估Breg细胞百分比。所有参与者均接受颈动脉多普勒超声检查,以测量颈总动脉内膜中层厚度(cIMT)。采用阿加斯顿方法计算冠状动脉钙化评分。

结果

年龄的均值±标准差为32.60±8.34岁,发病年龄为28.27±7.60岁。23例患者(76.7%)有亚临床动脉粥样硬化。SLE和APS合并亚临床动脉粥样硬化患者与对照之间的Breg细胞存在高度显著差异(P = 0.001,0.005)。SLE和APS患者的平均cIMT显著高于对照(P < 0.01,0.050)。Breg细胞对SLE诊断的敏感性为70%,特异性为87%(P = 0.01)。多因素回归分析表明,低Breg细胞可预测疾病活动度(OR = 1.76,95%CI = 1.21 - 2.85;P = 0.01)。

结论

SLE患者亚临床动脉粥样硬化发生率高,SLE患者及继发性APS患者有较高的斑块形成风险。我们发现Breg细胞在SLE合并亚临床动脉粥样硬化患者中起作用。Breg细胞被认为是SLE诊断的良好预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543e/10815535/a327c9a58538/MJR-34-4-486-g001.jpg

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