系统性红斑狼疮患者外周血单个核细胞Toll样受体9和核因子-κB水平的测定及其临床意义

TLR9 and NF-κB levels in peripheral blood mononuclear cells of patients with systemic lupus erythematosus and their clinical significance

摘要:

目的  测定系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMCs）Toll样受体9（TLR9）和核因子-κB（NF-κB）水平并分析其临床意义。方法  选取2013年4月-2014年12月该院风湿免疫科收治的60例SLE患者作为研究对象，其中35例SLE患者处于活动期作为活动组，25例SLE患者处于缓解期作为缓解组。同时选取该院健康体检者30例作为对照组。对比3组PBMCs中TLR9和NF-κB水平，观察SLE患者PBMCs中TLR9、NF-κB水平与脏器受累和免疫抑制剂种类的相关性。结果  活动组PBMCs中TLR9水平低于缓解组和对照组，差异有统计学意义（P <0.05）；缓解组PBMCs中TLR9水平低于对照组，差异有统计学意义（P <
0.05）。活动组PBMCs中NF-κB水平低于缓解组和对照组，差异有统计学意义（P <0.05）；缓解组PBMCs中NF-κB水平低于对照组，差异有统计学意义（P <0.05）。皮疹、白细胞降低表现阳性患者与阴性患者PBMCs中TLR9水平比较，差异无统计学意义（P >0.05）。发热、浆膜炎、血尿表现阳性患者与阴性患者PBMCs中TLR9水平比较，差异有统计学意义（P <0.05）。浆膜炎、血尿表现阳性患者与阴性患者PBMCs中NF-κB水平比较，差异无统计学意义（P >0.05）。发热、皮疹、白细胞降低表现阳性患者与阴性患者PBMCs中NF-κB水平比较，差异有统计学意义（P <0.05）。结论  SLE患者TLR9水平较正常人群明显降低，NF-κB水平较正常人群明显升高，同时TLR9水平的降低与发热、浆膜炎、血尿的临床表现相关。NF-κB水平升高与发热、皮疹、白细胞降低的临床表现相关，严密监测SLE患者PBMCs中TLR9和NF-κB水平变化对患者的临床诊治有重要价值。

Abstract:

Objective To explore and analyze the levels of toll-like receptor 9 (TLR9) and nuclear factor-κB (NF-κB) in peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods Sixty SLE patients in the Department of Rheumatology and Immunology of our hospital from April 2013 to December 2014 were selected as the research objects, including 35 SLE patients in active stage as active group and 25 cases of SLE patients in remission stage as remission group. At the same time, 30 healthy cases in our hospital were selected as control group. TLR9 and NF-κB levels in PBMCs were compared between the three groups. The correlations of TLR9 and NF-κB levels in PBMCs with organ involvement and types of immunosuppressants were observed. Results The level of TLR9 in PBMCs of the active group was significantly lower than that of the remission group and the control group (P < 0.05). The level of TLR9 in PBMCs of the remission group was significantly lower than that of the control group (P < 0.05). The level of NF-κB in PBMCs in the active group was significantly lower than that of the remission group and the control group (P < 0.05). The level of NF-κB in PBMCs of the remission group was significantly lower than that of the control group (P < 0.05). The TLR9 in PBMCs in the patients with skin rash and decreased white blood cells was not significantly different from that in the patients without skin rash or decreased white blood cells (P > 0.05). The TLR9 level in PBMCs of the patients with fever, serositis or hematuria was significantly different from that of the patients without fever, serositis or hematuria (P < 0.05). There was no significant difference in the NF-κB level between the patients with and the patients without serositis or hematuria (P > 0.05). The level of NF-κB in PBMCs of the patients with serositis or hematuria was not significantly different from that of the patients without serositis or hematuria. The level of NF-κB in PBMCs of the patients with fever, rash or decreased white blood cells was statistically different from that in PBMCs of the patients with negative findings (P < 0.05). Conclusions TLR9 level significantly decreases while NF-κB level significantly increases in patients with systemic lupus erythematosus compared to that in normal population. Decreased TLR9 level is correlated with fever, serositis and hematuria. Increased NF-κB level is correlated with fever, rash and reduced white cell count. Close monitoring of TLR9 and NF-κB level changes in PBMCs of system lupus erythematosus patients has important value in clinical diagnosis and treatment of the disease.