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目的:探讨PD-L1在系统性红斑狼疮(SLE)患者外周血单核细胞(Mo)上的表达及临床意义。方法:应用流式细胞仪检测51例SLE患者和38例健康对照者外周血CD14+Mo表面PD-L1表达水平,比较SLE不活动组、活动组和健康对照组以及狼疮肾炎组和无狼疮肾炎组之间CD14+Mo表面PD-L1表达的百分比,并分析其与临床表现及实验室检查数据的相关性。结果:SLE活动组和稳定组CD14+PD-L1+Mo百分率均高于健康对照组,差异均有统计学意义(P<0.05)。狼疮肾炎患者CD14+PD-L1+Mo百分率高于无狼疮肾炎患者(P<0.05)。SLE患者CD14+PD-L1+Mo百分率与SLEDAI评分、尿蛋白定量呈正相关。SLE患者中抗dsDNA抗体、抗Sm抗体、抗U1snRNP抗体、抗核小体抗体阳性组外周血CD14+PD-L1+单核细胞百分率均高于对应阴性组,且均有统计学意义(均P<0.05)。结论:SLE患者外周血CD14+Mo细胞表达PD-L1异常,与病情活动性和抗体产生有关。
Objective: To investigate the expression and clinical significance of PD-L1 on peripheral blood mononuclear cells (Mo) in patients with systemic lupus erythematosus (SLE). Methods: Flow cytometry was used to detect PD-L1 expression on CD14 + Mo surface in peripheral blood of 51 SLE patients and 38 healthy controls. SLE inactive group, active group and healthy control group were compared with those without lupus nephritis The percentage of PD-L1 expression on the CD14 + Mo surface between groups was analyzed and its correlation with clinical manifestations and laboratory data was analyzed. Results: The percentage of CD14 + PD-L1 + Mo in SLE group and stable group were significantly higher than those in healthy control group (P <0.05). The percentage of CD14 + PD-L1 + Mo in patients with lupus nephritis was higher than that in patients without lupus nephritis (P <0.05). The percentage of CD14 + PD-L1 + Mo in patients with SLE was positively correlated with SLEDAI score and urine protein. The percentage of CD14 + PD-L1 + monocytes in peripheral blood of anti-dsDNA antibody, anti-Sm antibody, anti-U1snRNP antibody and anti-nucleosome antibody positive group were higher than those of corresponding negative group in SLE patients (all P < 0.05). Conclusion: PD-L1 is abnormal in CD14 + Mo cells in peripheral blood of SLE patients, which is related to disease activity and antibody production.