Dos Santos Álida Alves, de Castro Lucas Faria, de Lima Caroline Lourenço, da Motta Lucilia Domingues Casulari, da Motta Luiz Augusto Casulari Roxo, Amato Angélica Amorim
Rheumatology Division, University Hospital of Brasília, University of Brasília, Brasília, Brazil.
Endocrinology Division, University Hospital of Brasília, University of Brasília, Brasília, Brazil.
Sci Rep. 2024 Dec 3;14(1):30143. doi: 10.1038/s41598-024-74749-y.
This systematic review of clinical studies investigated whether circulating PRL levels differed between subjects with systemic lupus erythematosus (SLE) and healthy controls, the correlation between circulating PRL and SLE activity, and the effect of dopaminergic agonists as adjuvant therapy for SLE. We searched PubMed, Scopus, Web of Science, Cochrane, Embase, and Google Scholar for case-control and cross-sectional studies investigating circulating PRL levels in subjects with SLE and/or its correlation with disease activity, and clinical trials examining the effect of dopaminergic agonists on SLE activity assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Forty-five studies addressing circulating PRL levels in SLE met our inclusion criteria. SLE was associated with an increased odds of hyperprolactinemia (OR 11.69, 95%CI 5.64-24.22) and circulating PRL levels were significantly higher in subjects with SLE than in controls (standardized mean difference of 1.62, 95%CI 1.14-2.09). Circulating PRL was positively correlated with SLE activity assessed by the SLEDAI (correlation coefficient 0.38, 95% CI 0.26-0.48). Two randomized clinical trials with bromocriptine and three prospective open-label trials with quinagolide reported that treatment with dopaminergic agonists was associated with reduced frequency of disease flares and decreased SLEDAI score. Circulating PRL levels were higher in subjects with SLE than in healthy controls and were significantly associated with disease activity. In addition, treatment with the dopaminergic agonists bromocriptine and quinagolide reduced SLE disease activity in small studies and may be a beneficial adjuvant therapy for the disease if larger trials confirm these findings. This review was registered in PROSPERO (CRD42021237156).
这项临床研究的系统评价调查了系统性红斑狼疮（SLE）患者与健康对照者之间循环泌乳素（PRL）水平是否存在差异、循环PRL与SLE活动度之间的相关性，以及多巴胺能激动剂作为SLE辅助治疗的效果。我们在PubMed、Scopus、Web of Science、Cochrane、Embase和谷歌学术上搜索了病例对照研究和横断面研究，以调查SLE患者的循环PRL水平和/或其与疾病活动度的相关性，以及考察多巴胺能激动剂对通过系统性红斑狼疮疾病活动指数（SLEDAI）评分评估的SLE活动度影响的临床试验。45项关于SLE患者循环PRL水平的研究符合我们的纳入标准。SLE与高泌乳素血症几率增加相关（比值比11.69，95%置信区间5.64 - 24.22），且SLE患者的循环PRL水平显著高于对照组（标准化均值差为1.62，95%置信区间1.14 - 2.09）。通过SLEDAI评估，循环PRL与SLE活动度呈正相关（相关系数0.38，95%置信区间0.26 - 0.48）。两项使用溴隐亭的随机临床试验和三项使用喹高利特的前瞻性开放标签试验报告称，多巴胺能激动剂治疗与疾病发作频率降低及SLEDAI评分降低相关。SLE患者的循环PRL水平高于健康对照者，且与疾病活动度显著相关。此外，在小型研究中，使用多巴胺能激动剂溴隐亭和喹高利特治疗可降低SLE疾病活动度，如果更大规模试验证实这些发现，可能对该疾病是一种有益的辅助治疗。本综述已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号CRD42021237156）。
