将γ干扰素释放测定作为系统性红斑狼疮儿科患者的新型标记物

IF 2.8 3区医学 Q1 PEDIATRICS

Pediatric Rheumatology Pub Date : 2024-08-01 DOI:10.1186/s12969-024-01008-9

Song Zhang, Xue Li, Huishan Chen, Xianfei Gao, Zhe Cai, Huasong Zeng

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引用次数: 0

摘要

γ干扰素（IFN-γ）释放测定（IGRA）是潜伏结核分枝杆菌（TB）感染的重要实验室诊断方法。TB-IGRA 检测的是体外暴露于结核抗原（Ag）、有丝分裂原（MT）或阴性/无对照（NL）的外周血细胞中 IFN-γ 的释放情况。而结核抗原-NL水平的异常升高将反映出在相同条件下外周淋巴细胞释放的 IFN-γ 的升高。因此，我们发现 TB Ag-NL 水平的升高可以成为诊断和治疗小儿系统性红斑狼疮（SLE）患者的新生物标志物。我们分析了2018年至2020年在广州市妇女儿童医疗中心过敏风湿科接受TB-IGRA检测的776名儿童的临床数据。为探讨TB Ag-NL与系统性红斑狼疮的相关性，我们分析了47例系统性红斑狼疮患者的临床资料和TB Ag-NL检测结果，进而评估TB Ag-NL与系统性红斑狼疮疾病活动性的相关性。活动性系统性红斑狼疮患者的结核菌素Ag-NL水平明显高于非活动性系统性红斑狼疮患者（P = 0.0002）。TB Ag-NL 水平与系统性红斑狼疮疾病活动指数（SLEDAI）和实验室诊断参数呈正相关。系统性红斑狼疮患者的 TB Ag-NL 平均值（0.04191 ± 0.07955，IU/mL）明显高于幼年皮肌炎（JDM）患者（0.0158 ± 0.0337，IU/mL，p = 0.036）、幼年特发性关节炎（JIA）（0.0162 ± 0.0388，IU/mL，p = 0.001）和健康对照组（HC）（0.0001 ± 0.0027，IU/mL，p = 0.0003）患者明显更高。因此，TB Ag-NL 水平升高可作为系统性红斑狼疮的潜在诊断生物标志物，尤其是对于活动性系统性红斑狼疮。通过 TB-IGRA 检测 IFN-γ 释放水平可能有助于评估活动性系统性红斑狼疮儿童患者的系统性红斑狼疮疾病活动性。自发性 IFN-γ 释放与儿童系统性红斑狼疮有关。通过结核分枝杆菌 IFN-c 释放试验测定的 IFN-γ 释放潜能与儿童系统性红斑狼疮的活动有关。IFN-γ 释放测定可为评估儿童系统性红斑狼疮疾病活动性提供一种新颖的、基于血液的方法。

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Assay for interferon gamma release as a novel marker in pediatric patients with systemic lupus erythematosus

The interferon-gamma (IFN-γ) release assay (IGRA) is an important laboratory diagnosis for latent Mycobacterium tuberculosis (TB) infection. The TB-IGRA measures the release of IFN-γ from peripheral blood cells, who are exposed to TB antigen (Ag), mitogen (MT), or negative/nil control (NL) in vitro. While, an exceptional higher TB Ag-NL level will reflect an elevation of peripheral lymphocytes released IFN-γ in a same condition. Therefore, we found that the elevated levels of TB Ag-NL could become a new biomarker for the diagnosis and treatment of pediatric systemic lupus erythematosus (SLE) patients. We have analyzed the clinical data of 776 children who are underwent TB-IGRA testing in the Department of Allergy and Rheumatology of Guangzhou Women and Children’s Medical Center from 2018 to 2020. To investigate the association between TB Ag-NL and SLE, we have analyzed the clinical data of 47 SLE patients and TB Ag-NL testing results, and then evaluated the association between TB Ag-NL and SLE disease activity. The TB Ag-NL levels were significantly higher in patients with active SLE than those in inactive SLE (p = 0.0002). The TB Ag-NL levels were positively correlated with the SLE disease activity index (SLEDAI) and laboratory diagnosis parameters. The mean value of TB Ag-NL in SLE patients (0.04191 ± 0.07955, IU/mL) were significantly higher than those in patients with juvenile dermatomyositis (JDM) (0.0158 ± 0.0337, IU/mL, p = 0.036), juvenile idiopathic arthritis (JIA) (0.0162 ± 0.0388, IU/mL, p = 0.001), and healthy controls (HC) (0.0001 ± 0.0027, IU/mL, p = 0.0003). Therefore, the elevated TB Ag-NL levels could serve as a potential diagnostic biomarker of SLE, especially for the active SLE. The detection of IFN-γ release levels by the TB-IGRA may be useful to assess SLE disease activity in pediatric patients with active SLE. Spontaneous IFN-γ release is associated with Systemic lupus erythematosus in children. IFN-γ-releasing potential, as measured by the mycobacterium tuberculosis IFN-c release assay, associates with Systemic lupus erythematosus activity in children . IFN-γ release assays may offer a novel, blood-based approach to assessing SLE disease activity in children.

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来源期刊

Pediatric Rheumatology PEDIATRICS-RHEUMATOLOGY

CiteScore

4.10

自引率

8.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Rheumatology is an open access, peer-reviewed, online journal encompassing all aspects of clinical and basic research related to pediatric rheumatology and allied subjects. The journal’s scope of diseases and syndromes include musculoskeletal pain syndromes, rheumatic fever and post-streptococcal syndromes, juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, local and systemic scleroderma, Kawasaki disease, Henoch-Schonlein purpura and other vasculitides, sarcoidosis, inherited musculoskeletal syndromes, autoinflammatory syndromes, and others.