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活化诱导胞嘧啶核苷脱氨酶在系统性红斑狼疮患者肾组织中的表达及临床意义
李杨1,黄邓高2,曹卉2,郑琳麟2,高元慧2,范忠诚1*
0
(1. 中南大学湘雅医学院附属海口医院肾病风湿科, 海口 570203;
2. 中南大学湘雅医学院附属海口医院中心实验室, 海口 570203
*通信作者)
摘要:
目的 探讨活化诱导的胞嘧啶核苷脱氨酶(AICDA)在系统性红斑狼疮(SLE)患者肾组织中的表达及临床意义。方法 收集2013年3月至2017年6月于中南大学湘雅医学院附属海口医院就诊的73例SLE患者和36例原发性膜性肾病(Ⅱ期)患者(对照组)肾穿刺活组织检查的肾组织,利用免疫组织化学染色方法检测肾组织中AICDA的表达水平。分析AICDA的表达与SLE患者临床病理参数(病理分型、系统受累情况、疾病活动度评分、治疗转归)的关系。结果 SLE患者肾组织中AICDA的表达水平高于原发性膜性肾病患者,差异有统计学意义(6.12±2.47 vs 3.33±1.91,P<0.05)。Ⅲ型(5.25±4.06)、Ⅳ型(6.88±2.20)、Ⅴ型(6.10±1.66)、Ⅲ+Ⅴ型(5.75±2.34)、Ⅳ+Ⅴ型(5.72±2.37)狼疮性肾炎患者间AICDA的表达水平差异无统计学意义(P均>0.05)。有口腔溃疡、间质性肺炎、神经系统损害、关节炎、血液系统损害和浆膜炎SLE患者肾组织中AICDA的表达水平分别高于无上述系统损害者(7.02±2.14 vs 4.17±1.97,7.86±2.39 vs 4.98±1.76,9.83±1.34 vs 5.39±1.92,6.88±2.04 vs 2.93±1.21,7.51±1.81 vs 3.70±1.23,7.29±2.33 vs 5.34±2.29;P均<0.01)。SLE疾病活动度评分越高,AICDA的表达越强,组间差异有统计学意义(P<0.01)。SLE完全缓解患者肾组织中AICDA表达低于未完全缓解患者,但差异无统计学意义(5.84±2.39 vs 6.80±2.56,P>0.05)。结论 AICDA与SLE的发生和发展有关,有望为SLE的治疗带来新的靶点。
关键词:  系统性红斑狼疮  活化诱导胞苷脱氨酶    治疗结果
DOI:10.16781/j.0258-879x.2018.07.0803
投稿时间:2018-05-09修订日期:2018-07-06
基金项目:海口市科技计划项目(2014-074).
Expression of activation-induced cytidine deaminase in renal tissues of patients with systemic lupus erythematosus and its clinical significance
LI Yang1,HUANG Deng-gao2,CAO Hui2,ZHENG Lin-lin2,GAO Yuan-hui2,FAN Zhong-cheng1*
(1. Department of Nephropathy and Rheumatology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570203, Hainan, China;
2. Central Laboratory, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570203, Hainan, China
*Corresponding author)
Abstract:
Objective To explore the expression of activation-induced cytidine deaminase (AICDA) in renal tissues of patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods The renal biospy tissues from 73 patients with SLE and 36 patients with primary membranous nephropathy, who underwent biopsy between Mar. 2013 to Jun. 2017 in Central South University Xiangya School of Medicine Affiliated Haikou Hospital, were collected. Immunohistochemical method was used to detect the expression of AICDA in renal tissues. The correlations between the expression level of AICDA and the clinicopathological parameters, including pathological classification, system damage, SLE disease activity index (DAI) score and treatment outcome of SLE patients were analyzed. Results The expression level of AICDA in renal tissues of SLE patients was significantly higher than that of primary membrane nephropathy patients (6.12±2.47 vs 3.33±1.91, P<0.05). There was no significant difference in the expression level of AICDA between the type Ⅲ (5.25±4.06), type Ⅳ (6.88±2.20), type Ⅴ (6.10±1.66), type Ⅲ+Ⅴ (5.75±2.34), and type Ⅳ+Ⅴ(5.72±2.37) lupus nephritis patients (all P>0.05). The expression levels of AICDA were significantly higher in renal tissues of SLE patients with oral ulcer, interstitial pneumonia, nervous system damage, arthritis, blood system damage or serositis than those in the patients without above symptoms (7.02±2.14 vs 4.17±1.97, 7.86±2.39 vs 4.98±1.76, 9.83±1.34 vs 5.39±1.92, 6.88±2.04 vs 2.93±1.21, 7.51±1.81 vs 3.70±1.23, and 7.29±2.33 vs 5.34±2.29; all P<0.01). The SLE disease activity index (SLEDAI) score was positively correlated with the expression level of AICDA (P<0.01). The expression level of AICDA in renal tissues of SLE patients with complete remission was lower than that of the patients without complete remission, but the difference was not statistically significant (5.84±2.39 vs 6.80±2.56, P>0.05). Conclusion AICDA is related to the occurrence and development of SLE, and it is expected to bring new targets for the treatment of SLE.
Key words:  systemic lupus erythematosus  activation-induced cytidine deaminase  kidney  treatment outcome