Clinical application of plasma GAS5 in the diagnosis and treatment of systemic lupus erythematosus

doi:10.3969/j.issn.1673-8640.2019.08.005

Abstract

Abstract:

Objective To investigate the role of plasma growth arrest-specific 5（GAS5） in the diagnosis and treatment of systemic lupus erythematosus（SLE）. Methods A total of 169 patients with SLE,50 patients with rheumatoid arthritis（RA） and 50 patients with primary Sjögren's syndrome（pSS） were enrolled,and 102 healthy subjects were enrolled as healthy control group. Plasma GAS5 level was determined by real-time quantitation reverse transcription polymerase chain reaction（qRT-PCR）. The correlations between GAS5 and anti-double-stranded DNA（dsDNA） and anti-Smith（Sm） antibodies were analyzed. Receiver operating characteristic（ROC） curves were used to identify the diagnostic efficiency of plasma GAS5 for SLE. In the 169 patients with SLE,39 cases were selected,and their plasma GAS5 levels were compared before and after treatment. Results Compared to RA,pSS and healthy control groups,the GAS5 level was higher in SLE group（P<0.001）. GAS5 had positive correlations with anti-dsDNA antibody（r=0.53,P<0.001） and anti-Sm antibody（r=0.45,P<0.001）. The area under curve（AUC） of plasma GAS5 was 0.84. At the optimal cut-off value of 0.56,the diagnostic sensitivity and specificity were 89% and 75%. The AUC of GAS5 for the diagnosis of RA and pSS were 0.61 and 0.53,respectively. The GAS5 level after treatment was decreased compared with that before treatment. Conclusions Plasma GAS5 can provide a reference for the diagnosis and treatment of SLE. It can be used as a new biomarker for the diagnosis of SLE.

Key words: Growth arrest-specific 5, Anti-double-stranded-DNA antibody, Anti-Smith antibody, Systemic lupus erythematosus

CLC Number:

R446.1

CHEN Yanhong, SUN Li, FU Yu, LIU Yan, NIU Guoping. Clinical application of plasma GAS5 in the diagnosis and treatment of systemic lupus erythematosus[J]. Laboratory Medicine, 2019, 34(8): 696-700.

Figures/Tables 5

References 19

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组别	年龄（岁）	抗dsDNA抗体（AU/mL）	抗Sm抗体（AU/mL）	ESR（mm/h）	RF（IU/mL）	IgG（g/L）
健康对照组	46.39±11.27	19.13（11.21~31.68）^*	18.17（8.49~31.57）^*	7.52（2.08~18.52）^*	21.40（11.37~34.18）	10.10（3.24~21.52）^*
SLE组	47.12±16.44	91.78（42.51~139.18）	35.60（23.43~49.31）	27.08（14.37~36.29）	33.60（17.15~45.66）	22.91（14.73~35.87）
RA组	47.85±13.53	33.08（23.16~44.57）	21.86（12.35~36.04）	22.25（10.14~45.28）	197.26（112.40~293.05）	19.14（7.23~31.09）
pSS组	44.35±13.53	27.54（16.03~41.25）	24.43（10.56~38.07）	21.62（9.25~43.06）	27.01（16.30~41.59）	14.67（5.84~26.37）
统计值	0.30	7.12	5.81	5.42	5.98	0.64
P值	0.88	<0.01	<0.01	<0.01	<0.01	0.51
组别	IgA（g/L）	IgE（IU/mL）	IgM（g/L）	CRP（mg/L）	C3（g/L）	C4（g/L）
健康对照组	3.11（1.53~4.89）	61.12（34.52~83.65）	1.31（0.53~2.17）^*	1.79（0.93~2.30）^*	0.80 （0.42~1.14）^*	0.18（0.09~0.53）^*
SLE组	2.17（1.05~3.98）	75.62（44.17~105.39）	2.37（1.60~3.25）	2.74（1.58~4.63）	2.15 （1.42~3.90）	0.42（0.29~1.16）
RA组	2.80（1.09~4.37）	73.21（33.62~120.50）	3.52 （1.88~4.26）	2.49（1.07~4.06）	2.08 （1.13~3.45）	0.35（0.16~0.84）
pSS组	3.02（1.51~4.47）	81.18（30.25~124.61）	1.97（0.85~2.68）	2.81（1.03~4.52）	0.95 （0.58~1.37）	0.34（0.11~0.68）
统计值	2.32	1.60	5.09	3.11	4.25	4.06
P值	0.11	0.17	<0.01	<0.05	<0.01	<0.01

组别	年龄（岁）	抗dsDNA抗体（AU/mL）	抗Sm抗体（AU/mL）	ESR（mm/h）	RF（IU/mL）	IgG（g/L）
健康对照组	46.39±11.27	19.13（11.21~31.68）^*	18.17（8.49~31.57）^*	7.52（2.08~18.52）^*	21.40（11.37~34.18）	10.10（3.24~21.52）^*
SLE组	47.12±16.44	91.78（42.51~139.18）	35.60（23.43~49.31）	27.08（14.37~36.29）	33.60（17.15~45.66）	22.91（14.73~35.87）
RA组	47.85±13.53	33.08（23.16~44.57）	21.86（12.35~36.04）	22.25（10.14~45.28）	197.26（112.40~293.05）	19.14（7.23~31.09）
pSS组	44.35±13.53	27.54（16.03~41.25）	24.43（10.56~38.07）	21.62（9.25~43.06）	27.01（16.30~41.59）	14.67（5.84~26.37）
统计值	0.30	7.12	5.81	5.42	5.98	0.64
P值	0.88	<0.01	<0.01	<0.01	<0.01	0.51
组别	IgA（g/L）	IgE（IU/mL）	IgM（g/L）	CRP（mg/L）	C3（g/L）	C4（g/L）
健康对照组	3.11（1.53~4.89）	61.12（34.52~83.65）	1.31（0.53~2.17）^*	1.79（0.93~2.30）^*	0.80 （0.42~1.14）^*	0.18（0.09~0.53）^*
SLE组	2.17（1.05~3.98）	75.62（44.17~105.39）	2.37（1.60~3.25）	2.74（1.58~4.63）	2.15 （1.42~3.90）	0.42（0.29~1.16）
RA组	2.80（1.09~4.37）	73.21（33.62~120.50）	3.52 （1.88~4.26）	2.49（1.07~4.06）	2.08 （1.13~3.45）	0.35（0.16~0.84）
pSS组	3.02（1.51~4.47）	81.18（30.25~124.61）	1.97（0.85~2.68）	2.81（1.03~4.52）	0.95 （0.58~1.37）	0.34（0.11~0.68）
统计值	2.32	1.60	5.09	3.11	4.25	4.06
P值	0.11	0.17	<0.01	<0.05	<0.01	<0.01

变量	AUC 95%可信区间	SE	P值	敏感性（%）	特异性（%）
SLE组GAS5	0.84（0.78~0.90）	0.03	<0.001	80	79
SLE组抗 dsDNA抗体	0.74（0.76~0.81）	0.03	<0.001	68	73
SLE组抗Sm 抗体	0.68（0.06~0.75）	0.04	<0.001	58	77
RA组GAS5	0.61（0.52~0.71）	0.05	0.02	52	70
pSS组GAS5	0.53（0.43~0.63）	0.05	0.53	60	56

变量	AUC 95%可信区间	SE	P值	敏感性（%）	特异性（%）
SLE组GAS5	0.84（0.78~0.90）	0.03	<0.001	80	79
SLE组抗 dsDNA抗体	0.74（0.76~0.81）	0.03	<0.001	68	73
SLE组抗Sm 抗体	0.68（0.06~0.75）	0.04	<0.001	58	77
RA组GAS5	0.61（0.52~0.71）	0.05	0.02	52	70
pSS组GAS5	0.53（0.43~0.63）	0.05	0.53	60	56