| Objective: Systemic lupus erythematosus (SLE) is achronic autoimmune disorder. With the development ofimmunology, it is clear that the immune complex depositionproducting immune-mediated inflammation reaction andresulting in the injury of the target organs is one of the mainpathgenesis of SLE.Antiendothelial cell antibodies (AECA)were first noted more than 20 years ago, AECA is a group ofheterogeneous antibodies against antigenic dererminants ofvessel endothelial cell memberance and characterized byresulting in immune-mediated vascular damage. AECA consistof IgG-AECA and IgA-AECA. IgG-AECA has been relatedwith the activity of SLE and organ involvement.Yet, the exactmechanism of AECA resulting endothelial cell damage remainsunclear till now, the probability of AECA may be: ⑴the directinjury reacting with endothelial cell, ⑵antibody-andcomplement-dependent cytotoxicity , and ⑶activateendothelial cell by upregulating the expression of intercellularadhesion molecule-1 (ICAM-1) and the secretion of somecytokines. This enhanced ICAM-1 expression facilitates therecruitment and the ensuing attachment of monocytes as well aspolyphonuclear neutrophils to the inflamed vessel walls. Atpresent the study of role AECA and ICAM-1 in the onset anddevelopment of SLE as well as their relation to clinicalmanifestation has been paid attention to. Soluble intercellularadhesion molucule-1 (sICAM-1) which occur in serum could beprecisely detected. An enzyme linked inmunosorbent assay(ELISA) usually were used to the detection of AECA before, butit is difficult to manager a variety of technology, such as theincubation and culture and fixation of endothelial cell, to usethis assay as regular clinical detection . We try to detect thepositive rate and titer of IgG-AECA in patients with SLE and inhealthy controls by indirect immunofluorescence (IIF) in orderto observe the correlation between IgG-AECA and sICAM-1and the activity of SLE. The specificity of this assay is higherthan ELISA, but the sensitivity is lower than ELISA. IIF applyto clinic because of its simple operation.Methods: 1.eighty-nine subjects were divided into threegroups: ⑴Group A, the active patients with SLE ⑵Group B,the remissive patients with SLE ⑶Group C, healthy controls.All patients with SLE fulfill the diagnostic criteria of theAmerican Rheumatism Association (1997), disease activity inthese patients was assessed by the systemic lupus erythematosusdisease activity index (SLEDAI). 2. IgG-AECA was determinedby indirect immunofluorescence (IIF) technique, this test kit wasprovided by Germen Euroimmum com. sICAM-1 was detectedby an enzyme linked immunosorbent assay (ELISA) using acommercial anti-sICAM-1 assay provided by DRLab.California USA. 3. statistical analysis was performed using theSPSS12.0 statistical software: all the result of qualitative datawas expressed by probability and rank, the comparison of thedifference between qualitative data was done by chi-square test(x2 test)or rank sum test or Fisher exact probability. Thequantitative data was expressed by X±S, the comparison of thedifference between quantitative data was assessed by analysis ofvariance or t-test. The study of correlation among all the indexwere done by spearman's correlation analysis or linearcorrelation analysis.Results: 1. The positive rate of IgG-AECA is 53.8% ingroup A, 24% in group B, and 0 in group C(P<0.05), therewere significant difference between group A and B, B and C, Aand C. The titer of IgG-AECA in group A is higher than the titerin group B, there were significant difference in group A and B.2.The serum level of sICAM-1 in three group: group A was818.39±613.14ng/ml, group B was 329.44±146.22ng/ml,group C was 110.52 ±45.73ng/ml. We found there weresignificant difference in group A and B, B and C, A and C, (P<0.05). 3. In group A, the serum level of sICAM-1 in IgG-AECApositive patients and negtive patients respectively was 1004.41±650.57ng/ml and 581.21±514.52ng/ml, there was significantdifference between the positive and negtive patients. There werepositive correlation between the titer of IgG-AECA and theserum level of sICAM-1 r=0.623 P=0.00. 4.We found there waspositive correlation between the titer of IgG-AECA andSLEDAI r=0.44 P=0.005, between the serum level of sICAM-1and SLEDAI r=0.346 P=0.031. 5. In group A, there were nocorrelation between IgG-AECA and ds-DNA,APL,ESR,complement-C3 P﹥0.05. There were no correlation betweensICAM-1 and ds-DNA,APL,complement-C3, there waspositive correlation between the serum level of sICAM-1 andESR r=0.328 P=0.042. 6. In group A, among patients with lupusnephritis,neuropsychiatric lupus,arthritis,vasculitic lesions ofskin and other organ, the positive rate of IgG-AECArespectively was 69.6%,80%,76.5%,68%, there weresignificant difference between patients with lupus nephritis,neuropsychiatric lupus,arthritis,vasculitic lesions of skin andother organ and patients without lupus nephritis ,neuropsychiatric lupus,arthritis,vasculitic lesions of skin andother organ. We also found there were correlation betweenIgG-AECA and lupus nephritis ,neuropsychiatric lupus ,arthritis ,vasculitic lesions of skin and other organs, thecorrelative index respectively was 0.378,0.415,0.399,0.379.There were no correlation between serositis,the abnormality ofhematology and IgG-AECA. 7. In group A, among patients withlupus nephritis,neuropsychiatric lupus,arthritis,vasculiticlesions of skin and other organs, the serum level of sICAM-1respectively was 982.93 ±734.13ng/ml ,1119.79 ±848.29ng/ml,1168.71±788.38ng/ml,948.88±699.16ng/ml,there were significant difference between the level of sICAM-1in patients with or without lupus nephritis,neuropsychiatriclupus,arthritis,vasculitic lesions of skin and other organs. Therewere correlation between the serum level of sICAM-1 and lupusnephritis,neuropsychiatric lupus,arthritis,vasculitic lesions ofskin and other organs.We also found there were no correlationbetween the serum level of sICAM-1 and serositis ,theabnormality of hematology.Conclusions: 1. The positive rate of IgG-AECA and serumlevel of sICAM-1 in patients with active SLE were higher thanthese in patients with remissive SLE and healthy controls. Therewas relativity between the titer of IgG-AECA and the serumlevel of sICAM-1. IgG-AECA and sICAM-1 play importantroles in the pathogenesis of SLE. 2.After treatment, the titer ofIgG-AECA and the serum level of sICAM-1 in remissivepatients were lower than these in active patients. The titer ofIgG-AECA and the serum level of sICAM-1 could be used asstandard evaluating the treatment effect. 3. There werecorrelation between the titer of IgG-AECA and the serum levelof sICAM-1 and lupus nephritis,neuropsychiatric lupus,arthritis,vasculitic lesions of skin and other organs. Yet, therewere no correlation between the titer of IgG-AECA,the serumlevel of sICAM-1 and serositis,the abnormality of hematology.4. There were positive correlation between IgG-AECA ,sICAM-1 and SLEDAI. We may try to use IgG-AECA andsICAM-1 as an index observing the activity of SLE. 5. Therewere no correlation between IgG-AECA and ds-DNA,APL,...
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