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目的 从狼疮抗凝物 (LA)抑制蛋白C(PC)途径研究系统性红斑狼疮 (SLE)患者发生血栓的机制。方法 依赖磷脂酰乙醇胺 (PE)活化的蛋白C(APC)活性抑制试验 (改良的dRVVT方法 ) ,将正常人与SLE患者IgG预先与PE孵育后再加入纯化的试验体系中 ,观察是否抑制APC活性。结果 试验体系中APC的抗凝活性由于加入PE而增强。LA可抑制依赖PE的APC抗凝活性 ;且与其浓度成正比。SLE伴LA阳性的血栓患者的LA IgG对APC抑制程度比LA阴性及无血栓的SLE患者更明显 ;而正常人IgG对APC无抑制作用。结论 LA通过干扰PE抑制PC途径可能是SLE患者发生血栓的重要原因。
Objective To investigate the mechanism of thrombosis in patients with systemic lupus erythematosus (SLE) from the lupus anticoagulant (LA) inhibitor protein C (PC) pathway. The method relies on phosphatidylethanolamine (PE) -activated protein C (APC) activity inhibition assay (modified dRVVT method). The IgG in normal and SLE patients is pre-incubated with PE and then added to the purified test system to observe whether it inhibits APC activity . Results The anticoagulant activity of APC in the experimental system was enhanced by the addition of PE. LA inhibits anticoagulant activity of PE-dependent APCs; and is proportional to its concentration. LA IgG in patients with SLE with LA-positive thrombus suppressed APC more significantly than patients with SLE-negative and thromboembolic SLE, whereas normal human IgG did not inhibit APC. Conclusions LA may be one of the important causes of thrombosis in patients with SLE by inhibiting the PC pathway by interfering with PE.