Improved monitoring of clinical response in Systemic Lupus Erythematosus by longitudinal trend in soluble vascular cell adhesion molecule-1.
Improved monitoring of clinical response in Systemic Lupus Erythematosus by longitudinal trend in soluble vascular cell adhesion molecule-1.
复制标题
通过可溶性血管细胞粘附分子 1 的纵向趋势改善系统性红斑狼疮临床反应的监测。
DOI：
10.1186/s13075-015-0896-7
复制
发表时间：
2016-01-08
影响因子：
4.9
通讯作者：
D'Cruz DP
中科院分区：
文献类型：
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作者：
Lewis MJ;Vyse S;Shields AM;Zou L;Khamashta M;Gordon PA;Pitzalis C;Vyse TJ;D'Cruz DP
目的：确定最佳使用血清可溶性细胞黏附分子(CAM)水平的连续测量是否可以改善SLE疾病活动性的监测。对21例系统性红斑狼疮患者(n = -80)血清中可溶性细胞黏附分子和常规标志物的水平进行了检测，并与疾病活动性进行了纵向相关分析。对34名SLE患者的第二个队列的血液样本进行了流式细胞术检测，以确定血清生物标记物与B细胞亚群之间的关系。通过调整基线水平(在第一次就诊时)，三角洲可溶性血管细胞黏附分子-1(sVCAM-1)与ECLAM评分的变化显示出更强的相关性，与包括抗dsDNA抗体滴度和补体C3在内的传统SLE生物标志物相比，在识别SLE应答者和无应答者方面的敏感性和特异性更高。多元回归分析表明，sVCAM-1增量是反映SLE临床疗效的最佳指标。SLE患者sVCAM-1水平与CD95+CD27+激活的记忆B细胞、CD95+浆母细胞和循环浆细胞数显著相关。减去每个个体的sVCAM-1基线水平，大大提高了其作为生物标记物的实用性。Delta sVCAM-1在监测疾病活动性变化方面优于传统的SLE生物标志物。这表明，应考虑对SLE患者的血清sVCAM-1趋势进行连续监测，以记录治疗反应。我们推测，SLE患者活化的B细胞亚群和循环浆细胞数与血清中可溶性VCAM-1水平的相关性可能与VCAM-1在骨髓和次级淋巴组织中B淋巴细胞存活和成熟过程中的重要作用有关。本文的在线版本(doi：10.1186/s13075-0150896-7)包含补充材料，授权用户可以使用。
To determine whether optimal use of serial measurements of serum levels of soluble cell adhesion molecules (CAM) can improve monitoring of disease activity in SLE. Serum levels of soluble CAM and conventional SLE biomarkers were measured in serial samples (n = 80) from 21 SLE patients during and after flare and correlated in longitudinal analysis with disease activity determined by ECLAM score. Blood samples from a second cohort of 34 SLE patients were subject to flow cytometry to correlate serum biomarkers with B cell subsets. By adjusting for the baseline level (at the first visit), delta soluble vascular cell adhesion molecule-1 (sVCAM-1) showed stronger correlation with changes in ECLAM score and improved sensitivity and specificity for identifying SLE responders versus non-responders compared to conventional SLE biomarkers including anti-dsDNA antibody titre and complement C3. Multiple regression analysis identified delta sVCAM-1 as the best marker of SLE clinical response. sVCAM-1 levels were significantly correlated with CD95+CD27+ activated memory B cells, CD95+ plasmablasts and circulating plasma cell numbers in SLE patients. Subtracting a baseline level of sVCAM-1 for each individual substantially improved its utility as a biomarker. Delta sVCAM-1 was superior to conventional SLE biomarkers for monitoring changes in disease activity. This suggests that serial monitoring of serum sVCAM-1 trends should be considered in SLE patients to document responses to treatment. We hypothesise that the correlation between activated B cell subsets and circulating plasma cell numbers with soluble VCAM-1 serum levels in SLE may relate to the important role of VCAM-1 in B lymphocyte survival and maturation in bone marrow and secondary lymphoid tissues. The online version of this article (doi:10.1186/s13075-015-0896-7) contains supplementary material, which is available to authorized users.