Investigation Between Plasma SCD146 And Endothelial Injury In Systemic Lupus Erythematosus And The Role In Renal Damnification

Objective:To investigate the role of soluble CD146(sCD146) in the disease activity and clinical significance of monitoring renal involved in systemic lupus erythematosus(SLE),the blood plasma level of sCD146 in SLE patients were evaluated,and the relationship between sCD146 and other clinical and laboratory findings were analyzed simultaneously.Method:The serum of 57 SLE patients and 25 healthy controls were collected. The concentrations of blood plasma sCD146 in SLE and healthy controls were measured by enzyme-linked immunosorbent assay(ELISA).The clinical manifestation, routine and immumological laboratory investigations,urine analysis,quantity of 24 hour urine protein and ultrasonic cardiogram(UCG) result were recorded..Statistic analysis was made to explore the relationship between them using SPSS11.5.statistic software.Result:1.The level of blood plasma sCD146 in SLE patients is higher than that in heathy controls.(P=0.000＜0.05)2.The level of blood plasma sCD146 in SLE patients with first onset is higher than that in SLE patients without first onset.(P=0.006＜0.05)3.The level of blood plasma sCD146 in the active SLE patients is higher than that in the inactive SLE patients.(P=0.183＜0.05)4.The level of blood plasma sCD146 in SLE patients with renal involved is higher than that in those without renal involved.(P=0.000＜0.05)5.The level of blood plasma sCD146 in active SLE patients with renal involved is higher than that in the inactive SLE patients with renal involved. (P=0.001＜0.05)6.The levels of blood plasma sCD146 in SLE with quantity of 24 hour urine protein greater than or equal to 0.5g/24h is higher than that in those less than 0.5g/24h.(P=0.000＜0.05)7.The levels of blood plasma sCD146 in SLE with skin rash and hydrymenitis are higher than that in those without rash and hydrymenitis respectively (P=0.012＜0.05,P=0.003＜0.05),while there are no statistical significance in those with clinical symptom as arthritis,dental ulcer,hand vasculitis, pulmonary hypertension and digestive system impairment.8.The levels of blood plasma sCD146 in SLE with positive anti-ds-DNA antibody,anti-U1RNP antibody and anti- histone antibody are higher than that in those with negative antibodies above-mentioned respectively (P=0.009＜0.05,P=0.004＜0.05,P=0.039＜0.05),while there are no statistical significance in those with anti-Sm antibody,anti-SSA antibody,anti-SSB antibody,ACL,ANCA.9.The levels of blood plasma sCD146 in SLE show inverse correlation with complement 3 and complement 4(r=-0.446,P=0.001＜0.05;r=-0.307, P=0.020＜0.05),show positive correlation with quantity of 24 hour urine protein,erythrosedimentation rate(ESR),D-Dimer,and SLEDAI score (r=0.576,P=0.000＜0.05;r=0.291,P=0.028＜0.05;r=0.707,P=0.000＜0.05; r=0.744,P=0.000＜0.05);while no relationships are found with IgG,C-Reactive Protein(CRP) and circulating immune complex(CIC).10.No relationships are found between the level of blood plasma sCD146 and age,course of disease.Conclusion:1.The level of blood plasma sCD146 in SLE patients is higher than that in heathy controls,which suggests sCD146 may take part in the progress of SLE.2.The level of blood plasma sCD146 in the active SLE patients is higher than that in those inactive ones,SLE with first onset is higher than that in those without first onset,and it shows positive correlation with the active index such as ESR and SLEDAI score,inverse correlation with C3 and C4,which suggested that sCD146 is associated with the active phase of the disease,and be an inflammation index of judging the activity of the disease.3.The level of blood plasma sCD146 in SLE patients with renal involved is higher than that in those without renal involved especially those in active SLE patients.and with quantity of urine protein greater than or equal to 0.5g/24h,and it shows positive correlation with quantity of 24 hour urine protein,which suggested that sCD146 can be an index of reflecting the degree of renal damnification.4.The levels of blood plasma sCD146 in SLE with skin rash and hydrymenitis are higher than that in those free from the previous signs respectively,SLE with positive anti-ds-DNA antibody,anti-U1RNP antibody and anti- histone antibody are higher than that in those with negative antibodies above-mentioned respectively,and it shows positive correlation with D-Dimer,which suggested that sCD146 may represent a maker of widespread endothelial injury mediated by immunoreaction and inflammation,following by hypercoagulabale state.