The Clinical Significance Of Glycosylation End Products And Its Receptor In Patients With Systemic Lupus Erythematosus

Objective To investigate the experssion level and clinical significance ofglycosylation end products (AGEs)，soluble RAGE and peripheral blood mononuclearcells (PBMC) glycosylation end products receptor (RAGE) in patients with systemiclupus erythematosus.Methods Forty-two consecutive patients fulfilling the American College ofRheumatology (ACR)1997criteria for SLE, who attended the in-patients clinic of ourHospital.(female，age，18-49yrs，31.79±6.58yrs，mean±S.D.).Sixteen age andsex matched healthy subjects were recruited as controls (female，age，22-44yrs，32.87±5.32yrs，mean±S.D.). Disease activity was assessed by SLEDAI>4. The serumlevels of AGEs and sRAGE were measured by ELISA in42SLE patients and16controls respectively. The expression level of PBMC RAGE mRNA were measuredby RT-PCR in16SLE and16controls. The serum levels of MDA、SOD and T-AOCwere measured by spectrophotometry. IMT were measured by ultrasound.Results The serum levels of AGEs in SLE patients were significantly higher thanthose of the healthy controls (P＜0.05).The levels of AGEs had positively correlationwith disease duration, diease activity and MDA(P＜0.0l～0.05). The levels of AGEshad inversely correlation with sRAGE、RAGE mRNA、SOD and T-AOC（P＜0.01）.The levels of PBMC RAGE mRNA in SLE patients were remarkably higher thanhealthy controls (P＜0.05). The levels of RAGE mRNA had positively correlationwith diease activity and MDA(P＜0.0l～0.05). The levels of RAGE mRNA hadinversely correlation with AGEs、sRAGE、SOD and T-AOC(P＜0.0l～0.05). Therewas no statistical relationship between RAGE mRNA and diease duration（P>0.05）.The serum levels of sRAGE in SLE patients were significantly lower than controlgroups (P＜0.05). The levels of sRAGE had positively correlation with SOD andT-AOC(P＜0.0l～0.05). The levels of sRAGE had inversely correlation with AGEs、RAGE mRNA and MDA(P＜0.0l). There was no correlation among sRAGEand disease duration, diease activity（P>0.05）. The IMT in SLE patients wassignificantely higher than control group (P＜0.05). The IMT had positively correlationwith AGEs，disease duration，diease activity and MDA(P＜0.0l～0.05). The IMThad inversely correlation with SOD and T-AOC(P＜0.0l). There was no correlationbetween IMT and sRAGE，RAGE mRNA（P>0.05）.Conclusion The serum levels of AGEs are remarkably increased in SLE comparedwith controls； PBMC RAGE mRNA levels are remarkably increased in SLEcompared with controls；The low expression level of sRAGE in patients with systemiclupus erythematosusmay owe to enhanced scavenging activity after the increasingcombination of high serum AGE and srAGE；AGEs-RAGE/sRAGE shaft imbalancemay be associated with SLE disease.