检测γ干扰素释放作为儿童系统性红斑狼疮的新型标志物。

Assay for interferon gamma release as a novel marker in pediatric patients with systemic lupus erythematosus.

机构信息

Department of Allergy, Immunology and Rheumatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University，Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China.

Department of Rheumatology and Immunology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510623, China.

出版信息

Pediatr Rheumatol Online J. 2024 Aug 1;22(1):70. doi: 10.1186/s12969-024-01008-9.

DOI:10.1186/s12969-024-01008-9

PMID:39090639

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11292859/

Abstract

BACKGROUND

The interferon-gamma (IFN-γ) release assay (IGRA) is an important laboratory diagnosis for latent Mycobacterium tuberculosis (TB) infection. The TB-IGRA measures the release of IFN-γ from peripheral blood cells, who are exposed to TB antigen (Ag), mitogen (MT), or negative/nil control (NL) in vitro. While, an exceptional higher TB Ag-NL level will reflect an elevation of peripheral lymphocytes released IFN-γ in a same condition. Therefore, we found that the elevated levels of TB Ag-NL could become a new biomarker for the diagnosis and treatment of pediatric systemic lupus erythematosus (SLE) patients.

METHODS

We have analyzed the clinical data of 776 children who are underwent TB-IGRA testing in the Department of Allergy and Rheumatology of Guangzhou Women and Children's Medical Center from 2018 to 2020. To investigate the association between TB Ag-NL and SLE, we have analyzed the clinical data of 47 SLE patients and TB Ag-NL testing results, and then evaluated the association between TB Ag-NL and SLE disease activity.

RESULTS

The TB Ag-NL levels were significantly higher in patients with active SLE than those in inactive SLE (p = 0.0002). The TB Ag-NL levels were positively correlated with the SLE disease activity index (SLEDAI) and laboratory diagnosis parameters. The mean value of TB Ag-NL in SLE patients (0.04191 ± 0.07955, IU/mL) were significantly higher than those in patients with juvenile dermatomyositis (JDM) (0.0158 ± 0.0337, IU/mL, p = 0.036), juvenile idiopathic arthritis (JIA) (0.0162 ± 0.0388, IU/mL, p = 0.001), and healthy controls (HC) (0.0001 ± 0.0027, IU/mL, p = 0.0003). Therefore, the elevated TB Ag-NL levels could serve as a potential diagnostic biomarker of SLE, especially for the active SLE.

CONCLUSION

The detection of IFN-γ release levels by the TB-IGRA may be useful to assess SLE disease activity in pediatric patients with active SLE.

摘要

背景

干扰素-γ（IFN-γ）释放试验（IGRA）是潜伏性结核分枝杆菌（TB）感染的重要实验室诊断方法。TB-IGRA 测量的是在体外接触 TB 抗原（Ag）、丝裂原（MT）或阴性/无对照（NL）的外周血单个核细胞（PBMC）释放 IFN-γ的情况。然而，异常高的 TB Ag-NL 水平反映了在相同条件下外周淋巴细胞释放 IFN-γ的增加。因此，我们发现升高的 TB Ag-NL 水平可能成为诊断和治疗儿科系统性红斑狼疮（SLE）患者的新生物标志物。

方法

我们分析了 2018 年至 2020 年在广州妇女儿童医疗中心过敏免疫风湿病科进行 TB-IGRA 检测的 776 例儿童的临床资料。为了探讨 TB Ag-NL 与 SLE 的关系，我们分析了 47 例 SLE 患者的临床资料和 TB Ag-NL 检测结果，并评估了 TB Ag-NL 与 SLE 疾病活动度的关系。

结果

活动期 SLE 患者的 TB Ag-NL 水平显著高于非活动期 SLE 患者（p=0.0002）。TB Ag-NL 水平与 SLE 疾病活动指数（SLEDAI）和实验室诊断参数呈正相关。SLE 患者的 TB Ag-NL 平均值（0.04191±0.07955，IU/mL）明显高于幼年皮肌炎（JDM）患者（0.0158±0.0337，IU/mL，p=0.036）、幼年特发性关节炎（JIA）患者（0.0162±0.0388，IU/mL，p=0.001）和健康对照者（HC）（0.0001±0.0027，IU/mL，p=0.0003）。因此，升高的 TB Ag-NL 水平可作为 SLE 的潜在诊断生物标志物，尤其是对活动期 SLE。