[A pilot study on the significance of leucocyte CD146 expression in vasculitis].
[A pilot study on the significance of leucocyte CD146 expression in vasculitis].
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发表时间：
2006-09
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通讯作者：
Ling Li;Bai-ru Zhang;Xiao-feng Zeng;Xuan Wang
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作者：
Ling Li;Bai-ru Zhang;Xiao-feng Zeng;Xuan Wang
目的探讨外周血白细胞CD（146）表达与血管炎患者临床活动的关系。方法应用流式细胞术检测39例活动性系统性血管炎患者（显微镜下多血管炎（MPA）13例，韦格纳肉芽肿（WG）9例，钟-斯特劳斯综合征（CSS）2例，大动脉炎（TA）9例，结节性多动脉炎（PAN）2例，白塞病（BD）4例）和系统性红斑狼疮（SLE）24例外周血白细胞CD（146）的表达。18例患者（MPA 5例，WG 4例，CSS 2例，SLE 4例，PAN 2例，TA 1例）在活动期和改善期进行了评估。结果活动性血管炎患者外周血中性粒细胞（PMN）、淋巴细胞（LYM）和单核细胞CD（146）表达明显升高，以PMN表达最强。MPA组PMN-CD（146）阳性率为（20.5 +/- 25.0）%、WG（16.5 +/- 20.4）%、CSS（33.5 +/- 41.8）%、SLE（16.2 +/- 23.9）%、PAN（42.7 +/- 15.3）%和TA（6.5 +/- 4.3）%，均具有显著性差异（P0.05）。MPA组LYM-CD（146）阳性率为（7.3 ± 8.4）%、WG（9.6 ± 9.1）%、CSS（16.1 ± 20.1）%、SLE（12.2 ± 13.5）%和TA（5.1 ± 4.4）%，均具有显著性差异（P 0.05）。CD（146）在三组细胞上的表达具有相关性（r分别为0.66和0.853，P = 0.000），但与病程、年龄、ESR、C反应蛋白（CRP）、抗神经细胞胞浆抗体（ANCA）、SLE疾病活动指数（SLEDAI）与双下肢血管炎活动评分（BVAS）比较，差异无统计学意义（P > 0.5）。18例患者经糖皮质激素和免疫抑制剂治疗后随访。活动期和改善期PMN-CD（146）阳性率分别为（40.3 ± 27.0）%和（9.9 ± 18.8）%（P = 0.001），LYM-CD（146）阳性率分别为（15.7 ± 13.6）%和（6.7 ± 5.3）%（P = 0.021）。几乎在所有这些中，该比率从活跃期到改善期都有所下降。这些都是在世界文学中首次报道的。结论首次报道了活动性血管炎患者外周血白细胞尤其是中性粒细胞CD（146）的高表达，经激素和免疫抑制剂治疗后CD（146）转为阴性。这表明CD（146）可能是一种新的疾病激活标志物，并可能在血管炎的发病机制中发挥重要作用。在这方面需要进一步研究。
OBJECTIVE To investigate the correlation between CD(146) expression on peripheral leucocytes with clinical activation in patients and vasculitis. METHODS Flow cytometry was used to detect CD(146) expression on peripheral leucocytes of 39 patients with active systemic vasculitis [13 with microscopic polyangiitis (MPA), 9 with Wegener's granulomatosis (WG), 2 with chung-strauss syndrome (CSS), 9 with takayasu arteritis (TA), 2 with polyarteritis nodosa (PAN), 4 with Behcet's disease (BD)] and 24 with SLE. 18 patients (5 MPA, 4 WG, 2 CSS, 4 SLE, 2 PAN, 1 TA) were evaluated during active and improved phase. RESULTS Expression of CD(146) on polymorphonuclears (PMN), lymphocytes (LYM) and monocytes was elevated predominantly in active vasculitis patients, especially on PMN. PMN-CD(146) positive ratio in MPA group was (20.5 +/- 25.0)%, WG (16.5 +/- 20.4)%, CSS (33.5 +/- 41.8)%, SLE (16.2 +/- 23.9)%, PAN (42.7 +/- 15.3)% and TA (6.5 +/- 4.3)%, all with significant difference (P 0.05). LYM-CD(146) positive ratio in MPA group was (7.3 +/- 8.4)%, WG (9.6 +/- 9.1)%, CSS (16.1 +/- 20.1)%, SLE (12.2 +/- 13.5)% and TA (5.1 +/- 4.4)%, all with significant difference (P 0.05). The expression of CD(146) on the three groups of cells correlated with each other (r was 0.66 and 0.853 respectively, P = 0.000), but they did not correlate with the course of the disease, age, ESR, C reactive protein (CRP), antineutrophil cytoplasmic antibody (ANCA), birmingham vasculitis activity score (BVAS) and SLE disease activity index (SLEDAI) (P > 0.5). 18 patients were followed up after therapy with corticosteroids and immunosuppressive drugs. PMN-CD(146) positive ratio during active phase and improved phase was (40.3 +/- 27.0)% and (9.9 +/- 18.8)% (P = 0.001) and LYM-CD(146) positive ratio was (15.7 +/- 13.6)% and (6.7 +/- 5.3)% (P = 0.021) respectively. Almost in all of them the ratio decreased from active phase to improved phase. These were first reported in the world literature. CONCLUSION A high expression of CD(146) on peripheral leucocytes especially PMN in patients with active vasculitis is reported here for the first time and it turns to be negative with the therapy of corticosteroid and immunosuppressive drugs. This indicates that CD(146) may be a new marker for disease activation and may be important in the pathogenesis of vasculitis. Further study in this respect in needed.