Цитокиновый профиль у больных системной красной волчанкой

Цель – исследовать уровни цитокинов у больных системной красной волчанкой (СКВ), определить корреляцию с активностью СКВ и поражением органов, а также динамику на фоне терапии ритуксимабом (РТМ).

Материал и методы. В исследование включено 26 больных СКВ (5 мужчин и 21 женщина) медиана (Ме) возраста больных 27 [23; 40] лет, длительность СКВ от 9 до 300 мес (Ме 72 [36; 108] мес), и 30 здоровых доноров, сопоставимых по полу и возрасту с обследованными больными. Активность заболевания оценивали по индексу SLEDAI2K. В сыворотке определяли уровни 27 цитокинов с использованием технологий Х-МАР на приборе BioPlex200 (Bio-Rad, США). Больные были разделены на две группы по 13 человек: с волчаночным нефритом (ВН) и без поражения почек. Все больные, включенные в исследование, получили терапию РТМ.

Результаты. Выявлено статистически достоверное повышение концентраций интерлейкина 13 (ИЛ13) и G-CSF у больных СКВ по сравнению со здоровой контрольной группой (р=0,03 и р=0,003 соответственно). В группе больных с ВН выявлено статистически значимое повышение концентраций ИЛ4, ИЛ6, ИЛ7, ИЛ13 и G-CSF по сравнению с больными без ВН (р=0,039; р=0,03; р=0,037; р=0,03 и р=0,028 соответственно). Проведенный ROC-анализ установил чувствительность и специфичность этих показателей в группе больных ВН. Площадь под ROC-кривой для всех показателей была одинаковой. Наиболее высокая специфичность в группе больных с ВН отмечена у ИЛ13 (85%). Чувствительность у данных цитокинов была одинаковой (70%), кроме ИЛ13 (62%).

Заключение. У больных с ВН статистически значимо повышены концентрации ИЛ4, ИЛ6, ИЛ7, ИЛ13 и G-CSF. Полученные результаты свидетельствуют об ассоциации данных цитокинов с ВН.

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