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 可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。 與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。 因此由本研究發現，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). Compared 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). In 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. Therefore, 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.