研究比較活動性類風濕關節炎及全身性紅斑狼瘡患者血清中溶性共同刺激因子及粘著因子的濃度

Abstract

T細胞共同刺激分子群 (Co-stimulatory molecules)及細胞粘著分子(Cell adhesion molecules)在由T細胞及白血球所引起的發炎反應上扮演重要角色。本實驗針對16位活動性類風濕關節炎(rheumatoid arthritis，RA)、20位全身性紅斑狼瘡(Systemic Lupus Erythematosus，SLE)患者及8位正常人，利用酵素連結免疫吸附分析法(ELISA)分析比較其血清中可溶性T細胞共同刺激分子群(sCTLA-4, sCD28, sCD80, sCD86)及細胞粘著分子(sE-selectin, sICAM-1, sVCAM-1)的變化。正常人的血清樣本做對照比較，發現在活動性類風濕關節炎患者，統計上其血清中sCTLA-4的濃度明顯下降(p<0.05)，且sCD80、sE-selectin、sICAM-1及sVCAM-1的濃度明顯上升(p<0.05)。也發現在全身性紅斑狼瘡患者，統計上其血清中sCTLA-4及sE-selectin的濃度明顯下降(p<0.05)，sCD86的濃度明顯上升(p<0.05)。比較活動性類風濕關節炎及全身性紅斑狼瘡患者，顯示出活動性類風濕關節炎患者獨特的分子標記(Bio-Marker)變化，即血清中sCTLA-4的濃度下降，sCD80和三種adhesion molecules (sE-selectin、sICAM-1及sVCAM-1)的濃度上升。同時也顯示出全身性紅斑性狼瘡患者獨特的分子標記(Bio-Marker)變化，即血清中的sCTLA-4和sE-selectin的濃度下降，sCD86的濃度上升。此由本研究發現，可溶性T細胞共同刺激分子群及細胞粘著分子不正常的產生進而活化T細胞及白血球，可能是引起活動性類風濕關節炎及全身性紅斑狼瘡發生的重要途徑，且在活動性類風濕關節炎及全身性紅斑狼瘡上具有特異性。

Co-stimulatory molecules connecting with leukocyte adhesion molecules play an important role in responses to T lymphocyte and leukocyte-mediated inflammatory. The aim of the study was to analyze serum concentrations of soluble co-stimulatory molecules (sCTLA-4, sCD28, sCD80, sCD86) and soluble cell adhesion molecules (sE-selectin, sICAM-1, sVCAM-1) among 16 active rheumatoid arthritis (RA) patients, 20 Systemic Lupus Erythematosus (SLE) patients and 8 healthy controls. The analysis method was based on a quantitative sandwich enzyme-linked immunosorbent assay (ELISA).ompared with healthy control subjects (all p<0.05), serum levels of sCTLA-4 was significantly lower in active RA patients, whereas sCD80, sE-selectin, sICAM-1 and sVCAM-1 were significantly higher. In SLE patients, serum levels of sCTLA-4 and sE-selectin were significantly lower whereas sCD86 was significantly higher when comparing with healthy control subjects (all p<0.05).n addition, the comparison of the serum levels of soluble co-stimulatory and cell adhesion molecules between active RA and SLE patients indicates the characteristics of active RA patients, that is the decreasing levels of sCTLA-4 and elevated levels of sCD80, sE-selectin, sICAM-1 and sVCAM-1. The comparison also indicates the characteristics of active SLE patients , that are the decreasing levels of sCTLA-4 and sE-selectin and elevated levels of sCD86.herefore, the study indicates that the aberrant expression of soluble co-stimulatory and cell adhesion molecules activates T cells and leukocytes. And this may be the cause for the inflammation and has the distinctness in active RA and SLE patients.