首页|LOXL2、TGF-β、CTGF在结缔组织病合并间质性肺病患者使用环磷酰胺治疗前后的变化及临床意义

LOXL2、TGF-β、CTGF在结缔组织病合并间质性肺病患者使用环磷酰胺治疗前后的变化及临床意义

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目的:观察血清赖氨酰氧化酶样蛋白2(lysyl oxidase-like protein 2,LOXL2)、转化生长因子β(transforming growth factor-β,TGF-β)、结缔组织生长因子(connective tissue growth factor,CTGF)在结缔组织病合并间质性肺病(connective tissue disease and interstitial lung disease,CTD-ILD)患者使用环磷酰胺治疗前后的变化及临床意义.方法:选择 2021 年 3 月-2022 年5 月在内蒙古科技大学包头医学院第一附属医院风湿免疫科收治的CTD-ILD并使用环磷酰胺针静脉滴注治疗的患者30 例,观察患者治疗前基线期及使用环磷酰胺治疗 12 周后及24 周后的临床资料、影像学资料及实验室资料,分析血清LOXL2、TGF-β、CTGF在CTD-ILD患者使用环磷酰胺治疗前后的变化及临床意义.结果:CTD-ILD患者使用环磷酰胺治疗24 周后血清ESR、IgM、IgA、IgG水平明显降低,肺功能指标TLC、FVC、FEV1/FVC、DLCO%明显改善(P<0.05);治疗 12 周后及24 周后血清LOXL2、TGF-β、CTGF 的水平明显降低,6-MWT明显改善.HRCT评分与CRP评分明显降低(P<0.05);治疗 12 周后及 24 周后C-反应蛋白及血气分析指标PaO2 与PaCO2 变化差异不大(P>0.05).CTD-ILD患者血清中LOXL2 水平与ESR、IgA、IgG呈正相关(P<0.05);LOXL2 与TGF-β、CTGF呈正相关(P =0.001、0.003);TGF-β与CTGF呈正相关(P=0.025).结论:环磷酰胺治疗可能通过抑制血清LOXL2 的表达进一步抑制TGF-β信号通路进而影响CTGF的表达而有效地控制CTD-ILD患者的肺纤维化.
The changes and clinical significance of LOXL2,TGF-β and CTGF in patients with connective tissue disease associated with interstitial lung disease before and after treatment with cyclophosphamide
Objective:To observe the changes and clinical significance of serum lysyl oxidase-like protein 2(LOXL2),transforming growth factor-β(TGF-β)and connective tissue growth factor(CTGF)in pa-tients with connective tissue disease and interstitial lung disease(CTD-ILD)before and after treatment with cyclophosphamide.Methods:From March 2021 to May 2022,30 patients with CTD-ILD who were admitted to the Department of Rheumatology and Immunology,the First Affiliated Hospital of Baotou Medical College,In-ner Mongolia University of Science and Technology and treated with intravenous infusion of cyclophosphamide were selected.The clinical data,imaging data and laboratory data of patients at baseline before treatment and 12 weeks and 24 weeks after treatment with cyclophosphamide were observed.The changes and clinical signifi-cance of serum LOXL2,TGF-β and CTGF in patients with CTD-ILD before and after treatment with cyclo-phosphamide were analyzed.Results:After 24 weeks of treatment with cyclophosphamide,the levels of serum ESR,IgM,IgA and IgG in patients with CTD-ILD were significantly decreased,and the lung function inde-xes TLC,FVC,FEV1/FVC and DLCO%were significantly improved(P<0.05).After 12 weeks and 24 weeks of treatment,the levels of serum LOXL2,TGF-β and CTGF were significantly decreased,and 6-MWT was significantly improved.HRCT score and CRP score were significantly lower(P<0.05).There was no significant difference in C-reactive protein and blood gas analysis indexes PaO2 and PaCO2 after 12 weeks and 24 weeks of treatment(P>0.05).The level of serum LOXL2 in CTD-ILD patients was positively corre-lated with ESR,IgA and IgG(P<0.05).LOXL2 was positively correlated with TGF-β and CTGF(P=0.001,0.003),TGF-β was positively correlated with CTGF(P=0.025).Conclusion:Cyclophospha-mide may inhibit TGF-β signaling pathway by inhibiting the expression of serum LOXL2,and then affect the expression of CTGF to effectively control pulmonary fibrosis in patients with CTD-ILD.

Connective tissue diseaseInterstitial lung diseaseCyclophosphamideLysyl oxidase-like protein 2Transforming growth factor βConnective tissue growth factor

韩枫、王永福、鲁芙爱

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内蒙古科技大学包头医学院,内蒙古 包头 014040

内蒙古科技大学包头医学院第一附属医院风湿免疫科

结缔组织病 间质性肺病 环磷酰胺 赖氨酰氧化酶样蛋白2 转化生长因子β 结缔组织生长因子

2024

包头医学院学报
内蒙古科技大学包头医学院

包头医学院学报

影响因子:0.543
ISSN:1006-740X
年,卷(期):2024.40(5)
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