周围血程序性死亡分子-配体2 (sPD-L2)在系统性红斑狼疮中的水平变化及临床意义

Changes in the Levels of Soluble Programmed Death Molecule-Ligand 2 (sPD-L2) in the Peripheral Blood of Systemic Lupus Erythematosus and Their Clinical Significance

摘要: 系统性红斑狼疮(systemic lupus erythematosus, SLE)是一种自身免疫性疾病，发病机制仍不明确。初步探讨sPD-L2在SLE患者外周血清中的表达水平变化及临床意义。选择SLE患者101例，类风湿性关节炎(rheumatoid arthritis, RA)患者26例和健康体检者(healthy control, HC) 32例，收集患者的临床资料，抽取周围静脉血，应用ELISA方法检测外周血清中sPD-L2表达水平，根据数据特点和研究目的，采用Mann-Whitney U检验、χ²检验或Spearman相关分析法，比较分析其与SLE常见临床表现及实验室指标的关系。结果：1) 与健康对照组比较，SLE患者周围血中sPD-L2表达显著升高(28.04 ± 3.68 pg/mL vs 7.59 ± 2.07 pg/mL, P < 0.0001)。2) 与RA患者组相比，SLE患者血清中sPD-L2表达显著升高(28.04 ± 3.68 pg/mL vs 23.07 ± 3.39 pg/mL, P < 0.0001)。3) SLE患者中，sPD-L2与年龄(r = 0.296, P = 0.003)，病程(r = −0.245, P = 0.014)，浆膜炎(r = 0.208, P = 0.038)、SLEDAI-2K (r = 0.223, P = 0.026)、抗dsDNA增高(r = 0.205, P = 0.040)、低补体血症(r = 0.196, P = 0.068)、胸膜炎(r = 0.253, P = 0.011)、脓尿(r = 0.271, P = 0.006)、CRP (r = 0.211, P = 0.036)呈正相关关系，而与eGFR呈现出负相关关系(r = −0.360, P = 0.002)。结论：1) 与健康和RA患者人群比较，SLE患者周围血中sPD-L2的表达水平，不仅显著高于健康人群，且显著高于RA患者。2) SLE患者周围血中sPD-L2表达水平与SLE疾病活动度成正相关，可能成为临床判断SLE病情活动程度的潜在生物标志物。

Abstract: Systemic lupus erythematosus (SLE) is an autoimmune disease whose pathogenesis remains unclear. To preliminarily investigate the changes in the expression level of sPD-L2 in the peripheral serum of SLE patients and its clinical significance, a total of 101 patients with SLE, 26 patients with rheumatoid arthritis (RA) and 32 healthy control (HC) patients were selected, the clinical data of the patients were collected, peripheral venous blood was drawn, and the expression levels of sPD-L2 in peripheral serum were detected by ELISA. According to the characteristics of the data and the purpose of the study, it is adopted that Mann-Whitney U test, chi-square test or Spearman correlation analysis were used to compare and analyze their relationship with common clinical manifestations and laboratory indicators of SLE. Results: 1) Compared with the healthy control group, the expression of sPD-L2 in the peripheral blood of SLE patients was significantly increased (28.04 ± 3.68 pg/mL vs 7.59 ± 2.07 pg/mL, P < 0.0001). 2) Compared with RA patients, the expression of sPD-L2 in serum was significantly increased in SLE patients (28.04 ± 3.68 pg/mL vs 23.07 ± 3.39 pg/mL, P < 0.0001). 3) In SLE patients, sPD-L2 was significantly associated with age (r = 0.296, P = 0.003), course of disease (r = −0.245, P = 0.014), serositis (r = 0.208, P = 0.038), SLEDAI-2K (r = 0.223, P = 0.026), increased anti-dsDNA (r = 0.205, P = 0.040), hypocomplementemia (r = 0.196, P = 0.068), and pleurisy (r = 0.253, P = 0.011), pyuter (r = 0.271, P = 0.006), and CRP (r = 0.211, P = 0.036) were positively correlated, while eGFR was negatively correlated (r = −0.360, P = 0.002). Conclusions: 1) Compared with healthy and RA patients, the expression level of sPD-L2 in the peripheral blood of SLE patients was not only significantly higher than that of healthy people, but also significantly higher than that of RA patients. 2) The expression level of sPD-L2 in the peripheral blood of SLE patients is positively correlated with SLE disease activity, which may become a potential biomarker for clinical judgment of SLE disease activity.