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目的 :探讨狼疮性肾炎 (LN)患者外周循环IL - 12 ,IFN -γ分泌水平的变化 ,以及肾上腺皮质激素对其分泌的影响。方法 :选取 16例活动性LN患者和 10例正常人 ,采集静脉血标本分空白组 ,LPS/PHA刺激组及LPS/PHA +DXM组作体外全血细胞培养 ,然后应用酶联免疫吸附法 (ELISA)检测培养上清IL - 12 ,IFN -γ分泌水平 ,经扣除血浆基础细胞因子水平后作为该例标本的IL - 12或IFN -γ分泌量。结果 :LN患者的全血培养细胞IL - 12及IFN -γ的分泌量明显高于正常人 (IL - 12 :P <0 .0 0 5 ,IFN -γ :P <0 .0 0 1) ;而且两者均与系统性红斑狼疮疾病活动指数 (SLEDIA)呈不同程度的正相关关系 ;DXM对IL - 12及IFN -γ分泌均有显著的抑制作用 (均P <0 .0 1) ,而且在LN患者抑制作用更明显。结论 :IL - 12及IFN -γ分泌上调在LN的发病中起重要作用 ,抑制IL - 12及IFN -γ的产生可能是它治疗LN中的机制之一。
Objective: To investigate the changes of peripheral blood levels of IL - 12 and IFN - γ in patients with lupus nephritis (LN) and the effects of adrenocorticotropic hormone on their secretion. Methods: Sixteen patients with active LN and 10 normal controls were enrolled in this study. Venous blood samples were collected for in vitro whole blood cell culture in vitro, LPS / PHA stimulation group and LPS / PHA + DXM group. ELISA was performed by enzyme-linked immunosorbent assay ) Was used to detect the secretion of IL - 12 and IFN - γ in the culture supernatant and the secretion of IL - 12 or IFN - γ in the sample after subtracting the plasma basic cytokine level. Results: The secretion of IL - 12 and IFN - γ in whole blood cultured cells of patients with LN was significantly higher than that of normal subjects (IL - 12: P <0.05, IFN - γ: P <0.01). Moreover, both of them showed positive correlation with SLEDIA. DXM had a significant inhibitory effect on the secretion of IL - 12 and IFN - γ (all P <0.01), and Inhibition in patients with LN more obvious. Conclusion: The up - regulation of IL - 12 and IFN - γ plays an important role in the pathogenesis of LN. Suppression of the production of IL - 12 and IFN - γ may be one of its mechanisms in the treatment of LN.