摘要目的 建立丙种球蛋白(IgG)Fc段唾液酸化水平的检测方法,并探讨血清IgG-Fc段唾液酸化在系统性红斑狼疮(SEE)尤其是神经精神狼疮(NPSLE)中的临床意义.方法 采用基于亲和素的夹心法酶联免疫吸附试验(ELISA)检测75例SLE患者(进一步分为NPSLE和非NPSLE 2个亚组),30例类风湿关节炎(RA)患者,32例幼年特发性关节炎(JIA)患者和41名健康对照者血清唾液酸化IgG,同时记录SLE患者临床资料,计算SLE疾病活动指数(SLEDAI),分析唾液酸化IgG的临床意义.结果 唾液酸化的IgG在RA组为(0.82±1.81)mg/mg/ml,JIA组为(0.69±1.30)mg/ml,健康对照组为(0.64±1.09)mg/ml,组间差异无统计学意义(P=0.82),SLE组为(0.12±0.17)mg/ml,唾液酸化水平明显降低(P<0.01),其中NPSLE组为(0.03±0.03)mg/ml,较其他组显著下降(P<0.01);健康对照组IgG唾液酸化的程度为(4.64±5.90)%,显著高于非NPSLE组的(1.88±2.16)%和NPSLE组的(0.29±0.47)%(P<0.01).唾液酸化的IgG占总IgG的百分数与SLEDAI负相关(r=-0.43,P<0.01).结论 SLE患者的IgG-Fc段唾液酸化水平较健康人群显著降低,且与狼疮活动度负相关,尤其在神经精神累及患者的IgG-Fc段唾液酸化水平下降尤为突出,提示唾液酸化的IgG有可能成为一种新的生物治疗手段.

abstractsObjective To establish the method of testing immunoglobulin G (IgG) with Fc sialylation, and to investigate the clinical significance of IgG with Fc sialylation in systemic lupus erythematosus (SLE), especially in those with neuropsychiatric manifestations (NPSLE). Methods Seventy-five SLE including thirty patients with neuropsychiatric manifestations (NPSLE) and forty-five non-NPSLE patients, 30 rheuma-toid arthritis (RA) patients, 32 juvenile idiopathic arthritis (JIA) patients and 41 healthy controls were recruited in this study. Standard method of testing lgG with Fc sialylation was established by a lectin based sandwiched enzyme linked immunosorbent assay (ELISA). The levels of IgG with Fc sailylation were assayed, and its clinical significance was evaluated. Results There were no difference in the levels of serum IgG with Fc sailylation in RA group (0.82±1.81) mg/ml, JIA group (0.69±1.30) mg/ml, healthy control group (0.64± 1.09) mg/ml, and the levels of IgG with Fc sailylation in SLE group (0.12±0.17) mg/ml (P<0.01), especially in NPSLE group [(0.03±0.03) mg/ml, P<0.01] was significantly lower than that of control groups. The perc-entage of IgG with Fc sialylation in control group (4.64±5.90)% were significantly higher than that in non-NPSLE (1.88±2.16)% (P<0.01) and in NPSLE (0.29±0.47)% (P<0.01). The percentage of IgG with Fc sial-ylation was negatively associated with SLEDAI score (r=-0.43, P<0.01). Conclusion Significantly low level of serum IgG with Fc sialylation was associated with disease activity in SLE patients, especially in NPSLE patients, lgG with Fc sialylation may be a new target for therapeutic strategy.