Lupus：免疫抑制剂使用不会进一步损害儿童期发病的SLE患者中性粒细胞吞噬功能

激素和免疫抑制剂的使用不影响SLE患者PMNs对沙门氏菌的吞噬功能

系统性红斑狼疮（SLE）患者中性粒细胞（PMNs）功能受损，易导致严重的革兰氏阳性菌和革兰阴性细菌感染，成为疾病发作和死亡的主要原因。针对PMNs功能受损和SLE患者易感染状态的研究甚少。针对这一情况，来自台湾桃园长庚医院儿科系过敏性哮喘和风湿部的S-A Wu等人进行了一项研究，该研究的目的是分析儿童期发病的SLE合并严重严重感染时PMNs的功能，包括产生过氧化物能力、趋化性和吞噬作用。研究结果在线发布在2013年3月的《狼疮》（Lupus）杂志上，作者发现，免疫抑制剂的使用不影响SLE患者对沙门氏菌的吞噬功能。儿童期发病的SLE患者对沙门氏菌的吞噬功能显著受损并导致沙门氏菌感染率高。SLE患者PMNs的过氧化物产生能力和趋化性无差异。
研究对象分为三组：儿童期发病的SLE合并严重感染史者、儿童期发病的SLE不合并严重感染史者和正常健康对照。研究者分离了上述三组受试者的外周血中的PMNs，并对其功能进行检测分析。PMNs功能分析项目主要包括分析其生成过氧化物能力、趋化性和吞噬功能。此外，研究者还对新发SLE患者的疾病活动度，严重性和用药情况进行了比较。
研究结果如下：该研究总共纳入34位SLE患者（12位合并严重感染，22位不合并感染）和25位健康对照。合并严重感染的SLE患者和未合并严重感染的SLE患者的PMNs功能无显著差异。无论感染状态，用药情况，疾病活动度如何，SLE患者对沙门氏菌脂多糖（LPS）的吞噬功能均差于健康对照（p < 0.01）。免疫抑制剂的使用不影响SLE患者PMNs对沙门氏菌-LPS的吞噬功能。
研究结果如下，免疫抑制剂的使用不影响SLE患者对沙门氏菌的吞噬功能。儿童期发病的SLE患者对沙门氏菌的吞噬功能显著受损，导致沙门氏菌感染率高。SLE患者PMNs的过氧化物产生能力和趋化性无差异。
与SLE相关的拓展阅读：

• Sleep：揭示调节食欲的激素的作用方式因性别而异
• Lupus：CD40 T多态性可能与SLE患者某些临床症状呈负相关
• AR：社会经济地位低的人群中SLE和LN患病率高
• ACR：小儿心智自动评估标准可用于评估儿童期发病的SLE患者的认知障碍
• Sleep：睡眠呼吸暂停症与儿童多动症之相关性研究
• PEDIATR NEPHROL：SLEDD-f可有效治疗危症急性肾损伤患儿
更多信息请点击：有关SLE更多资讯

Impaired phagocytosis and susceptibility to infection in pediatric-onset systemic lupus erythematosus.
OBJECTIVES
Impaired function of polymorphonuclear cells (PMNs) in systemic lupus erythematosus (SLE) leads to severe gram-positive and gram-negative bacterial infection, and to major morbidity and mortality. Few studies have focused on the association of impaired function of PMNs and SLE patients' susceptibility to infection. This study aimed to analyze function of PMNs in peroxidase production, chemotaxis, and phagocytosis in pediatric-onset SLE with severe infection.
METHODS
This study compared function of PMNs among pediatric-onset SLE patients with and without histories of severe infection and in normal control subjects. Human peripheral blood PMNs were isolated from patients and controls. Function of PMNs was measured by analyzing peroxidase, chemotaxis, and phagocytic activities. Different disease activity and severity, and drug use in newly diagnosed SLE patients were also compared.
RESULTS
In total, 34 SLE patients (12 patients with severe infection, 22 patients without infection) and 25 healthy controls were analyzed. There were no differences in function of PMNs between SLE patients with or without severe infection. Regardless of infection status, medication, and disease activity, SLE patients had impaired phagocytic ability against Salmonella-specific lipopolysaccharides (LPS) compared with normal controls (p < 0.01). The use of immunosuppressants did not influence phagocytic ability against Salmonella-derived LPS.
CONCLUSIONS
Immunosuppressant agents do not influence phagocytic ability against Salmonella in SLE subjects. Impaired phagocytosis against Salmonella is prominent in pediatric-onset SLE subjects, which may result in the high prevalence of Salmonella infection. There is no deficiency of peroxidase production and chemotaxis activity among SLE subjects.