Association of plasma B lymphocyte stimulator levels and disease activity in systemic lupus erythematosus
Association of plasma B lymphocyte stimulator levels and disease activity in systemic lupus erythematosus
复制标题
DOI：
10.1002/art.23678
复制
发表时间：
2008-08-01
影响因子：
--
通讯作者：
Freimuth, William
中科院分区：
文献类型：
--
作者：
Petri, Michelle;Stohl, William;Freimuth, William
Objective.探讨系统性红斑狼疮（SLE）患者血浆B淋巴细胞刺激因子（BLyS）水平、免疫抑制治疗及其他临床参数与疾病活动性的关系。在4个中心对245例SLE患者进行了为期2年的前瞻性评价。每3-6个月进行一次评估。采用单变量分析确定雌激素在红斑狼疮中的安全性：系统性红斑狼疮疾病活动指数（SLEDAI）评分的国家评估（SELENA）版本、血清抗双链DNA（抗dsDNA）和血浆BLyS水平之间的相关性。采用多变量重复测量模型结合免疫抑制治疗。92%的患者是女性。67%是白色，31%是非洲裔美国人，2%是亚洲人（所有这些群体都可能包括西班牙裔）。基线时的平均值如下：年龄41.5岁，疾病持续时间8.1年，SELENA-SLEDAI 3.3（中位数2，范围0-18），BLyS 5.57 ng/ml，IgG 1，439 mg/dl，C3 104.4 mg/dl和C4 21.3 mg/dl;在抗dsDNA阳性患者中，中位滴度为1：40（范围1：10-1：1，280）。单变量分析显示，血浆BLyS水平与抗dsDNA滴度（P = 0.0465）和SELENA-SLEDAI评分（P = 0.0002）相关。在多变量分析中，自上一次访视以来，SELENA-SLEDAI评分的较大增加与上一次访视时较高的BLyS水平相关（P = 0.0042），并且与自上一次访视以来BLyS水平的较大增加相关（P = 0.0007）。BLyS水平较前一次访视增加幅度较大与后续访视时SELENA-SLEDAI评分增加幅度较大之间的相关性，以及前一次访视时BLyS水平升高与后续访视时SELENA-SLEDAI评分升高之间的相关性，证明了循环BLyS水平与SLE疾病活动性之间的关系。这些结果支持BLyS是SLE治疗靶向的候选者的观点。
Objective. To determine the association of plasma B lymphocyte stimulator (BLyS) levels, immunosuppressive therapy, and other clinical parameters with disease activity in systemic lupus erythematosus (SLE).Methods. Two hundred forty-five SLE patients were evaluated prospectively over a 2-year period at 4 centers. Assessments were performed every 3-6 months. Univariate analysis was used to determine the association among the Safety of Estrogens in Lupus Erythematostis: National Assessment (SELENA) version of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, serum anti-double-stranded DNA (anti-dsDNA), and plasma BLyS levels. A multivariate repeated-measures model incorporating immunosuppressive therapy was utilized.Results. Ninety-two percent of the patients were female. Sixty-seven percent were white, 31% African American, and 2% Asian (all of these groups may include Hispanic). Mean values at baseline were as follows: age 41.5 years, disease duration 8.1 years, SELENA-SLEDAI 3.3 (median 2, range 0-18), BLyS 5.57 ng/ml, IgG 1,439 mg/dl, C3 104.4 mg/dl, and C4 21.3 mg/dl; among those positive for anti-dsDNA, the median titer was 1:40 (range 1:10-1:1,280). Univariate analysis showed that plasma BLyS levels were associated with anti-dsDNA titers (P = 0.0465) and SELENA-SLEDAI scores (P = 0.0002). In multivariate analyses, a greater increase in the SELENA-SLEDAI score from the previous visit was associated with higher BLyS levels at the previous visit (P = 0.0042) and with a greater increase in the BLyS level from the previous visit (P = 0.0007).Conclusion. The findings of association between a greater increase in the BLyS level from the previous visit and a greater increase in the SELENA-SLEDAI score at the subsequent visit, and between an elevated BLyS level at the previous visit and a greater SELENA-SLEDAI score at the subsequent visit, demonstrate a relationship between circulating BLyS levels and SLE disease activity. These results lend support to the notion that BLyS is a candidate for therapeutic targeting in SLE.