| Background:SLE, an autoimmune disease, is caused by many factors, and predominantly affects women of reproductive age. Estrogen exertes its effect by activating estrogen receptors (ERs). It is widely recognized that estrogen and ERs is implicated in SLE. However, the mechanisms of inflammatory lesion remain unknown.Objective:To examine the levels of mRNA and protein expression of ER subtypes in peripheral blood mononuclear cells from female patients with SLE and analyze the relevance to SLE. To detecte the levels of E2 and inflammatory cytokines in plasma, and analyze the correlation between ER subtypes and SLE. Furthermore, to observe the effect on cytokines generation by E2 in PBMCs. Eventually reveal the role and mechanisms of ERs in the process of inflammatory pathology in SLE.Methods:1. Isolated fresh plasma and PBMCs from 68 female patients with SLE and 47 healthy women, and the clinical data of SLE patients were collected.2. The mRNA expression of ERs in PBMCs were measured by reverse transcription polymerase chain reaction, the protein expression of ERs were measured by immunofluorescence. And the relationship between ERs and SLE was analysed.3. PBMCs from 8 female SLE were cultured for 48h with or without E2 (1×10-6mol/L) in the sterile incubator under the condition of 37℃and 5% CO2, then the supernatants were isolated. Both the plasma and supernatants were frozen at -80℃until they were tested.4. Plasma E2 were measured by chemiluminescence immunoassay, the levels of IL-10, IL-17, TNF-αwere tested by enzyme-linked immunosorbent assay with commercial kits, and the relationship between ERs and disease activity index (SLEDAI or ESR or C3) were analysed.Results:1. In the PBMCs of female patients with SLE, the co-expression of ERαmRNA and ERβmRNA were 25.0% (17/68), the alone positive expression of ERαmRNA were 4.0% (3/68), the alone positive expression of ERβmRNA were 56.0% (38/68), neither ERαmRNA nor ERβmRNA expressed were 15.0% (10/68); the situation of healthy control correspondingly were 19.1% (9/47), 4.3% (2/47), 53.2% (25/47), 23.4% (11/47). Furthermore, the expression of ERs protein in the PBMCs of SLE were respectively: the co-expression of ERαand ERβwere 25.5% (12/47), ERαexpressed alone were 4.3% (2/47), only ERβexpressed were 44.7% (21/47), neither ERαnor ERβexpressed were 25.5% (12/47); the situation of healthy control correspondingly were 20.6% (7/34), 3.0% (1/34), 38.2% (13/34), 38.2% (13/34). There were no significant difference of expression proportions of ERs between female patients with SLE and healthy control (P>0.05). Whether the patients with SLE or healthy control, the mRNA expression and the protein expression of ERs were coincident (P>0.05). 2. In the plasma of patients with SLE, the median concentration of E2, IL-10, IL-17, TNF-αwere 74.00pg/ml (38.50pg/ml-180.25pg/ml), 5.97pg/ml (4.31pg/ml-9.49pg/ml), 10.14 pg/ml (7.47pg/ml - 11.82pg/ml) and 17.05 pg/ml (7.95pg/ml-21.02pg/ml), resepectively; while the concentration in healthy control were 27.50 pg/ml (10.00pg/ml - 87.75pg/ml), 3.95 pg/ml (2.82pg/ml-5.38pg/ml), 5.92 pg/ml (4.89pg/ml - 9.79pg/ml), 7.95 pg/ml (3.86pg/ml-11.59pg/ml), resepectively. The levels of above factors in SLE patients were significant higher than that in healthy control (P<0.05).3. The levels of IL-17 were higher in plasma of SLE patient whose ERαmRNA and ERβmRNA were co-expressed (12.58 pg/ml±6.02 pg/ml) than that ERβmRNA were expressed alone (9.02 pg/ml±2.84 pg/ml) (P<0.05). There were no significant difference compared with healthy control (P>0.05). While the levels of IL-10 and TNF-αdid not indicated the same tendency.4. There were no significant correlation among the levels of IL-10, IL-17, TNF-αin plasma and SLEDAI, ESR, C3 of patients with SLE (P>0.05).And there were no significant correlation between the levels of E2 and IL-10, IL-17, TNF-αof patients with SLE too.5. The level of TNF-αin supernatant from PBMCs treated with E2 (1×10-6mol/L) was decreased compared without E2. Simultaniously, the level of IL-10 and IL-17 was increased, but there were no significant difference (P>0.05).Conclution:1. In the PBMCs of female patients with SLE, the expression of ERs in mRNA level and protein level shew that alone ERβexpression was the mainly type.2. The proportions of ERs expression was not significant different between female patients with SLE and healthy control.3. E2 and IL-10, IL-17, TNF-αmay involved in the pathologic course of SLE.4. The evidences were not enough to use the levels of IL-10, IL-17, TNF-αto evaluate the activity of female patients with SLE.5. Some concentration of E2 may participated in the pathologic course of SLE by repressing the production of TNF-αand promoting the production of IL-10, IL-17.
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