系统性红斑狼疮患者高表达CD154促进自身抗体分泌.doc

系统性红斑狼疮患者高表达CD154促进自身抗体分泌 　 作者：李玉杰， 李幼姬， 张涤华， 许元文， 董秀清 【摘要】 【目的】 探讨系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）CD154表达水平、及CD40/CD154对SLE患者分泌自身抗体的影响和地塞米松（Dex）对此的作用。【方法】 选择SLE活动期患者（10例）和正常对照者（11例），分离PBMC，检测其CD154的表达水平；培养PBMC，应用CD40 mAb和Dex进行干预，使用ELISA法检测培养液上清抗dsDNA水平。【结果】①活动期组PBMC CD154表达水平明显高于对照组6.4%±2.1% vs 1.5%±1.2%，(Plt; 0.05）；②活动期组培养液上清抗dsDNA抗体水平明显高于对照组[（11.8±6.8）U/mL vs （5.6±2.3）U/mL（RPMI 1640），（11.4±7.0）U/mL vs （6.3±2.1）U/mL（IgG），P均lt; 0.05]；③CD40 mAb使两组培养液上清抗dsDNA抗体水平明显增高[活动期组：（18.6±7.7）U/mL vs (11.8±6.9)U/mL，对照组：（8.3±4.4 ）U/mL sv（5.6±2.3) U/mL，P均lt; 0.05]。④在活动期组，Dex明显抑制CD40 mAb引起的PBMC培养液上清抗dsDNA抗体水平的增高[（8.8±5.2）U/mL vs（18.6±7.7）U/mL， Plt; 0.05]，使其低于非特异性处理时水平[（8.8±5.2）U/mL vs （11.8±6.8 ）U/mL， Plt; 0.05]；Dex不影响对照组。【结论】 活动期SLE患者PBMC表达的CD154水平升高，此能够促进抗dsDNA抗体的分泌，而Dex能够抑制其作用。 【关键词】 红斑狼疮，系统性； 自身抗体； CD154； 地塞米松 Abstract: 【Objective】 To investigate the expression of CD154 on peripheral blood mononuclear cell (PBMC) and the effects to secretion of autoantibodies by CD154 and dexamethasone in the patients with systemic lupus erythematosus (SLE). 【Methods】 The PBMC from active SLE patients and healthy control were isolated and sent to measure expression of CD154 by flow cytometry, the left PBMC were cultured and treated with CD40 mAb or Dex. The supernatant concentration of anti-dsDNA antibody was measured by ELISA. 【Results】 (1) The expression of CD 154 on PBMC ( % ) in active SLE were higher than that in healthy control (6.4±2.1 vs 1.5±1.2, Plt; 0.05). (2) The supernatant concentration of anti-dsDNA antibody in active SLE were higher than that in healthy control [11.8±6.8 vs 5.6±2.3 (RPMI 1640), 11.4±7.0 vs 6.3±2.1 (IgG) U/mL, all Plt; 0.05]. (3) CD40 mAb could significantly increase the supernatant concentration of anti-dsDNA antibody in the two groups [18.6±7.7 vs 11.8±6.9 (active SLE), 8.3±4.4 vs 5.6±2.3 (control) U/mL all Plt; 0.05). (4) Dexamethasone could decrease the elevated supernatant concentration of anti-dsDNA caused by CD40 mAb in active SLE ( 8.8±5.2 vs 11.8±6.8 U/mL