本文選題：可誘導(dǎo)共刺激分子 + v-set域含有T細(xì)胞激活抑制劑1��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景系統(tǒng)性紅斑狼瘡(systemic lupus erythematosus,SLE),是細(xì)胞和體液免疫功能紊亂引起的自身免疫性疾病,狼瘡性腎炎(lupus nephritis,LN)是其嚴(yán)重的并發(fā)癥之一。ICOSL(Inducible costimulatory molecule ligand)和VTCN1(V-set domain containing T cell activation inhibitor 1,VTCN1,即B7-H4)是B7/CD28家族成員,是兩個(gè)重要的協(xié)同共刺激分子,在自身免疫性疾病中起到舉足輕重的作用。目的檢測(cè)SLE患者血清中B7/CD28家族可溶性分子ICOSL(soluble ICOSL,s ICOSL)和VTCN1(soluble VTCN1,s VTCN1)濃度,分析其水平改變與SLE疾病活動(dòng)度、臨床表型、實(shí)驗(yàn)室檢查指標(biāo)之間的關(guān)系,并探索其在SLE發(fā)病機(jī)制中的作用,為SLE診斷、治療提供指導(dǎo)意義。方法納入49例2015年3月至2015年8月在安徽醫(yī)科大學(xué)第一附屬醫(yī)院和第二附屬醫(yī)院明確診斷為SLE的患者,并選擇年齡、性別匹配的健康對(duì)照者33例。收集患者和健康對(duì)照者人口學(xué)資料、臨床表現(xiàn)和實(shí)驗(yàn)室檢查指標(biāo)。與此同時(shí)使用ELISA方法檢測(cè)SLE患者和健康對(duì)照組血清s ICOSL、s VTCN1水平。分析s ICOSL、s VTCN1血清水平與SLE活動(dòng)度、臨床分型和實(shí)驗(yàn)室檢查指標(biāo)之間的相關(guān)性。結(jié)果(1)與健康對(duì)照組相比,血清中s ICOSL濃度在SLE組顯著降低,并且在LN、活動(dòng)組中也顯著降低(SLE:1.63±0.67ng/ml,P=0.004;LN:1.66±0.67ng/ml,P=0.008;活動(dòng)組:1.63±0.67ng/ml,P=0.003;對(duì)照組:2.17±0.75ng/ml),差異有統(tǒng)計(jì)學(xué)意義;而血清中s VTCN1濃度在SLE及LN組較健康對(duì)照組明顯升高(0.63±0.26 vs 0.52±0.11ng/ml,P=0.006;0.66±0.27 vs 0.52±0.11ng/ml,P=0.008),差異有統(tǒng)計(jì)學(xué)意義。(2)與非活動(dòng)組相比,活動(dòng)組血清s ICOSL水平無明顯差異,而活動(dòng)組s VTCN1水平顯著降低(0.54±0.19 vs 0.74±0.29 ng/ml,P=0.002),差異有統(tǒng)計(jì)學(xué)意義。狼瘡性腎炎組與非狼瘡性腎炎組s ICOSL、s VTCN1濃度均并未發(fā)現(xiàn)統(tǒng)計(jì)學(xué)差異。(3)SLE患者血清s ICOSL水平與SLEDAI無明顯相關(guān)性,而血清s VTCN1水平與SLEDAI成負(fù)相關(guān)(r=-0.3055,P=0.022)。SLE患者血清s ICOSL、s VTCN1的濃度與抗雙鏈DNA滴度、血沉ESR、補(bǔ)體(C3、C4)、總蛋白、血肌酐、血尿素氮均未發(fā)現(xiàn)相關(guān)性。(4)SLE和LN患者大多數(shù)使用了免疫抑制劑和激素,但是其并未對(duì)血清s ICOSL、s VTCN1濃度產(chǎn)生明顯影響(P=0.495,P=0.371)。結(jié)論SLE患者血清中s ICOSL水平降低、s VTCN1水平升高、并且s VTCN1水平與疾病活動(dòng)度呈負(fù)相關(guān),均提示ICOSL、VTCN1可能參與了SLE的發(fā)生發(fā)展,但是其具體作用機(jī)制尚需進(jìn)一步研究。
[Abstract]:Background systemic lupus erythematosus (lupus) is an autoimmune disease caused by cellular and humoral immune dysfunction. Lupus nephritis (LN) is one of its severe complications. ICOSL Inducible costimulatory molecule ligand) and VTCN1(V-set domain containing T cell activation inhibitor 1 / VTCN1 (B7-H4) are members of the B7/CD28 family. It is an important costimulatory molecule and plays an important role in autoimmune diseases. Objective to detect the serum concentrations of soluble ICOSL(soluble ICOSLS (ICOSL(soluble ICOSL) and VTCN1(soluble VTCN1s (VTCN1) in the serum of patients with SLE, and to analyze the relationship between the changes of their levels and the disease activity, clinical phenotype and laboratory parameters of SLE, and to explore their role in the pathogenesis of SLE. To provide guidance for the diagnosis and treatment of SLE. Methods 49 patients with SLE were selected from the first affiliated Hospital and the second affiliated Hospital of Anhui Medical University from March 2015 to August 2015, and 33 healthy controls with age and sex matching were selected. Demographic data, clinical manifestations and laboratory findings of patients and healthy controls were collected. At the same time, ELISA method was used to detect the serum levels of sICOSL VTCN1 in patients with SLE and healthy controls. To analyze the correlation between serum level of sICOSLS VTCN1 and SLE activity, clinical classification and laboratory examination. Results (1) compared with the healthy control group, the serum s ICOSL concentration in the SLE group was significantly lower than that in the control group, and in the active group it was also significantly lower than that in the active group (1.63 鹵0.67 ng / ml 路ml ~ (-1) LN: 1.66 鹵0.67 ng 路ml ~ (-1) P ~ (0.008); in the active group, it was 1.63 鹵0.67 ng / ml ~ (-1) P ~ (0.003); in the control group, 2.17 鹵0.75 ng 路ml ~ (-1) 路L ~ (-1); there was a significant difference in the control group (n = 2.17 鹵0.75 ng / ml). The serum s VTCN1 concentration in the SLE and LN groups was significantly higher than that in the healthy control group (0.63 鹵0.26 vs 0.52 鹵0.11ng / ml 路ml ~ (-1) 0.66 鹵0.27 vs 0.52 鹵0.11ng / ml 路ml ~ (2) P ~ (). There was no significant difference in serum s ICOSL levels between the active group and the inactive group. The level of s VTCN1 in active group was significantly lower than that in active group (0.54 鹵0.19 vs 0.74 鹵0.29 ng / ml). In lupus nephritis group and non-lupus nephritis group, there was no significant correlation between the serum s ICOSL level and SLEDAI in patients with lupus nephritis and non-lupus nephritis. The serum s VTCN1 level was negatively correlated with SLEDAI. The serum sICOSLs VTCN1 level and anti-double-stranded DNA titer, erythrocyte sedimentation rate (ESR), complement C _ (3) C _ (4), total protein, serum creatinine, blood urea nitrogen were not found to be related to the level of serum sICOS VTCN1 and immunosuppressive agents and hormones were found in most of the patients with SLE and LN. However, it had no significant effect on the concentration of serum sICOSLS VTCN1. Conclusion the level of s ICOSL in serum of SLE patients decreased and the level of s VTCN1 increased, and the level of s VTCN1 was negatively correlated with the disease activity, which suggested that the level of VTCN1 VTCN1 might be involved in the occurrence and development of SLE, but the mechanism of its action should be further studied.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R593.241

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 李若潔;葉冬青;;系統(tǒng)性紅斑狼瘡的全基因組關(guān)聯(lián)研究進(jìn)展[J];中華疾病控制雜志;2011年07期

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本文編號(hào)：1952131