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目的研究25-羟基维生素D_3[25-(OH)D_3]水平对儿童系统性红斑狼疮(SLE)患者外周血CD19~+ B7-1(CD19+CD80)和B7-2(CD19+CD86)及高敏抗双链DNA-Nc X(dsDNA-NcX)抗体表达的影响。方法根据SLEDAI评分将58例SLE患儿分为活动期组和稳定期组,采用电化学发光法测定血清25-(OH)D_3水平,将血清25-(OH)D_3低于20 ng/ml定义为D_3缺乏组,介于20 ng/ml~30 ng/ml为D_3不足组;另设50例健康体检儿童为对照组。以流式细胞术检测外周血CD19+B7-1、B7-2分子表达。ELISA法测定血清dsDNA-NcX抗体水平,并分析各项检测指标之间的相关性。结果 SLE活动期组血清25-(OH)D_3水平显著低于稳定期组和对照组,而CD19+B7-1、B7-2分子及dsDNA-NcX抗体则明显高于稳定期组和对照组;D_3缺乏组CD19+B7-1和B7-2分子与dsDNA-NcX抗体水平也显著高于D_3不足组,组间比较差异均有统计学意义(P<0.01)。SLE患儿血清25-(OH)D_3水平与CD19+B7-1和B7-2分子、dsDNA-NcX抗体及SLEDAI评分呈负相关(P<0.01),而CD19+B7-2分子与dsDNA-NcX抗体及SLEDAI评分呈正相关(P<0.01)。结论 SLE患儿血清25-(OH)D_3水平降低,外周血CD19+B7分子表达增强,导致B淋巴细胞过度合成dsDNA-NcX抗体,可能参与了儿童SLE的发生与进展。
Objective To investigate the effects of 25-hydroxyvitamin D3 (25- (OH) D_3] on peripheral blood CD19 ~ + B7-1 (CD19 + CD80) and B7-2 (CD19 + CD86) in children with systemic lupus erythematosus Anti-double stranded DNA-Nc X (dsDNA-NcX) antibody expression. Methods According to the SLEDAI score, 58 children with SLE were divided into active group and stable group. The level of 25- (OH) D 3 in serum was determined by electrochemiluminescence and the serum 25- (OH) D 3 was lower than 20 ng / ml D_3 deficiency group, ranging from 20 ng / ml to 30 ng / ml for the D_3 deficiency group; another 50 healthy children as the control group. Flow cytometry was used to detect the expression of CD19 + B7-1 and B7-2 in peripheral blood. ELISA method for the determination of serum dsDNA-NcX antibody levels, and analyze the correlation between the detection of indicators. Results Serum 25- (OH) D 3 level in active SLE group was significantly lower than that in stable group and control group, while CD19 + B7-1, B7-2 and dsDNA-NcX antibodies were significantly higher than those in stable group and control group. The levels of CD19 + B7-1 and B7-2 molecules and dsDNA-NcX antibody in D_3-deficient group were also significantly higher than those in D_3-deficient group, with significant difference between the two groups (P <0.01). Serum levels of 25- (OH) D_3 in children with SLE were negatively correlated with CD19 + B7-1 and B7-2, dsDNA-NcX antibody and SLEDAI scores (P <0.01), whereas CD19 + B7-2 and dsDNA-NcX Antibody and SLEDAI score was positively correlated (P <0.01). Conclusions Serum 25- (OH) D_3 levels are decreased in children with SLE and the expression of CD19 + B7 in peripheral blood is enhanced, leading to over-synthesis of dsDNA-NcX antibodies by B lymphocytes, which may be involved in the pathogenesis and progression of SLE.