研究背景

        目前正在嚐試揭開關於抗雙鏈脫氧核糖核酸(anti-dsDNA)的未解決疑問，抗dsDNA的確致病作用以及阻斷它們的程度將是一個潛在的治療目標。

        研究目的

        本研究的目的是確定係統性紅斑狼瘡(SLE)患者的抗dsDNA抗體滴度，並研究其與疾病特征，活性，損傷和抗磷脂自身抗體(aPL)的關係。

        研究方法

        納入70例女性SLE患者和35例年齡和性別匹配的對照者。測量抗dsDNA水平和aPL。評估係統性紅斑狼瘡疾病活動指數(SLEDAI)和係統性狼瘡國際協作組/美國風濕病學會損傷指數(SLICC / ACR-DI)。

        研究結果

        患者平均年齡27.5±5.1歲，病程7.7±5.4年，SLEDAI和SLICC / ACR-DI評分分別為6.8±8.04和1.2±1.3。在61.4%的患者中抗dsDNA陽性，滴度(133.2±100.5IU / ml)顯著高於對照(22.03±17.2IU / ml)(p \u003c0.0001)。在具有肌肉骨骼表現(p = 0.007)和陽性抗β2糖蛋白(抗-β2GP)(p = 0.037)的患者中抗dsDNA水平顯著增加並且在患有神經精神表現的患者(p = 0.004)和接受環磷酰胺(CYC)(p = 0.013)。病情活動患者的抗dsDNA水平往往較高。抗dsDNA滴度與紅細胞沉降率(p = 0.001)，抗心磷脂IgG和IgA抗體(p = 0.008)和抗β2GPIgG(p = 0.03)和IgA(p = 0.002)顯著相關，與總的白細胞計數(p \u003c0.0001)和SLICC / ACR-DI(p = 0.001)。

        研究結論

        SLE患者特別是有肌肉骨骼表現和aPL患者的抗dsDNA水平明顯升高。神經精神表現和那些接受CYC的患者似乎可能具有保護作用，並可能形成對疾病組織損傷的屏障。

        參考文獻：anti-dsDNA titre in female systemic lupus erythematosus patients:relation to disease manifestations,damage and antiphospholipd antibodies

        AbstractBackground Attempts are ongoing to unveil unresolved queries about anti-double-stranded deoxyribonucleic acid (anti-dsDNA), their precise pathogenic effects and to what extent blocking them would be a useful therapeutic goal. Objectives The aim of the present study was to determine the anti-dsDNA antibodies titre in systemic lupus erythematosus (SLE) patients and investigate their relation to the disease characteristics, activity, damage and antiphospholipid autoantibodies (aPL). Methods Seventy female SLE patients and 35 age- and sex-matched controls were included. The anti-dsDNA level and aPL were measured. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) were assessed. Results The mean age of the patients was 27.5 ± 5.1 years, disease duration 7.7 ± 5.4 years, and SLEDAI and SLICC/ACR-DI scores were 6.8 ± 8.04 and 1.2 ± 1.3, respectively. Anti-dsDNA was positive in 61.4% of the patients and the titre (133.2 ± 100.5 IU/ml) was significantly higher compared to controls (22.03 ± 17.2 IU/ml) ( p < 0.0001). The anti-dsDNA level was significantly increased in those with musculoskeletal manifestations ( p = 0.007) and positive anti-β2 glycoprotein (anti-β2GP) ( p = 0.037) and decreased in those with neuropsychiatric manifestations ( p = 0.004) and those receiving cyclophosphamide (CYC) ( p = 0.013). The anti-dsDNA level tended to be higher in active patients. The anti-dsDNA titre significantly correlated with the erythrocyte sedimentation rate ( p = 0.001), anticardiolipin IgG and IgA antibodies ( p = 0.008) and anti-β2GP IgG ( p = 0.03) and IgA ( p = 0.002) and inversely with the total leucocytic count ( p < 0.0001) and SLICC/ACR-DI ( p = 0.001). Conclusion Anti-dsDNA is remarkably increased in SLE patients especially those with musculoskeletal manifestations and aPL. A protective role seems likely in those with neuropsychiatric manifestations and those receiving CYC and may form a shield against disease tissue damage.