MPO-ANCA相關(guān)性血管炎中性粒細(xì)胞CD35、CD55、MPO表達(dá)以及外周血、尿Ba水平的變化及意義
[Abstract]:Background MPO-ANCA-associated vascular inflammation (MPO-AAV) is one of the most common types of vasculitis in our country. It can be seen as a microscopic polyangitis (MPA), a granulomatous polyangitis (GPA) and an eosinophilic granuloma with polyangitis. EGPA). Because the disease of this kind of disease is more insidious, the clinical manifestations are various, the progress is fast, the patient often causes the disease to delay or even death due to the failure of timely diagnosis and treatment. In recent years, by animal experiments, in vitro experiments and clinical studies, the activation of the complement bypass pathway may play an important role in the pathogenesis of MPO-AAV and the progression of the disease. Activation of the complement system is regulated by a variety of factors, such as CD35, CD55. It is reported that CD35 and CD55 play an important role in the regulation of complement system in autoimmune diseases such as rheumatoid arthritis (RA), and the relationship between the complement activation in MPO-AAV has not been reported. Objective To study the changes of neutrophil activity, complement bypass activation and regulator level in patients with MPO-AAV and their relationship with clinical damage. Methods The whole blood, serum and urine of 40 patients with active MPO-AAV were collected and the clinical damage and the activity score of Birmingham Vasculitis Activity Score-version3, BVAS-V3 were recorded. The whole blood, serum and urine of 30 healthy people were collected as the normal control group. The expression of CD35, CD55 and MPO in peripheral blood of patients with MPO-ANCA positive and the expression of CD35, CD55 and MPO were analyzed by flow cytometry (FCM), and the levels of Ba in serum and urine of patients and healthy people were detected by enzyme-linked immunosorbent assay (ELISA), and CD35 was also discussed. The relationship between the level of CD55, MPO and Ba and the clinical damage of the patient. Results The expression of CD35 and CD55 in the patients with MPO-AAV was higher than that in the normal control group (t = 3.339, p = 0.001; t = 2.180, p = 0.033). The expression of MPO in the MPO-AAV group was lower than that in the control group (t =-3.161, p = 0.003); the serum Ba concentration in the MPO-AAV group was higher than that in the control group (Z =-4.641, p0.001); 2. The average fluorescence intensity of the neutrophils CD35 in the MPO-AAV group was positively correlated with the serum Ba and the urine Ba (r = 0.336, p = 0.034; r = 0.324, The mean fluorescence intensity of the C-reactive protein (r = 0. 516, p = 0. 001), the C-reactive protein (r = 0. 516, p = 0. 001), the complement C3 (r = 0.494, p = 0. 020), the peripheral blood neutrophil count (r = 0.415, p = 0. 008) was positively correlated with the patient's age (r = 0.415, p = 0. 008), and the mean fluorescence intensity of the CD55 was related to the patient's age (r = 0.514, p = 0.001), and the total BVAS (r = 0.441, p = 0. 004), CRP (r = 0.377, p = 0. 020), complement C4 (r = 0.445, p = 0.038), peripheral blood neutrophil count (r = 0.485, p = 0.001), chest damage BVAS (r = 0.358, p = 0.023), and positive correlation between the average fluorescence intensity and complement C4 in MPO cells (r = 0.572, p = 0.021); the serum Ba concentration was negatively correlated with the course of the patient (r =-0.323, In urine, Ba was positively correlated with ESR (r = 0.373, p = 0.025), CRP (r = 0.399, p = 0.013), breast BVAS (r = 0.318, p = 0.046), and the mean fluorescence intensity of CD35 and MPO in patients with lung damage in patients with lung impairment was higher in patients with lung impairment (t =-2.373, p = 0.023; t =-2.121, p = 0.043); The MFI of CD55 in patients with renal impairment was higher in patients with no renal impairment (t =-2.412, p = 0.021). Conclusion 1. The expression of the complement activation inhibitor CD35, CD55 in the MPO-AAV patient is significantly enhanced, and it is possible to reduce the complement system that is activated by the neutrophils and to aggravate the inflammatory response of the neutrophils. Neutrophil CD35 high-expressed MPO-AAV patient lung may be more susceptible to involvement; the CD55 high-expression kidney may be more susceptible to involvement. 3. The level of expression of MPO in the neutrophils of the MPO-AAV patient is significantly reduced, It was suggested that MPO might play a more important role in the pathogenesis and development of MPO-AAV. It may be used to assist in the determination of MPO-AAV disease activity.
【學(xué)位授予單位】:安徽醫(yī)科大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2015
【分類號】:R543
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