目的探讨中性粒细胞胞外网状陷阱(NETs)与皮肌炎患者间质性肺病(ILD)发生的关联性。方法研究纳入36例皮肌炎患者,其中19例伴发ILD。同时选择47名健康成年人作为健康对照组。比较2组血浆诱发NETs形成和降解NETs的能力。结果皮肌炎患者的血浆较健康对照组的血浆能诱发更多的正常中性粒细胞形成NETs[(246+93)RFUs和(192±53)RFUs,P=-0.002]。皮肌炎患者的血浆对NETs的降解显著低于健康对照,而且与不伴ILD的皮肌炎患者相比,伴发ILD的皮肌炎患者降低更明显[(83±13)%和(59±21)%,P〈0.01]。进一步分析皮肌炎伴发ILD的亚组发现,4例伴发亚急性ILD的患者对NETs的降解显著低于慢性或无症状ILD的皮肌炎患者[(36±14)%和(65%±19)%,P=-0.0139]。结论皮肌炎患者的血浆诱发NETs形成显著增加,伴发ILD的皮肌炎患者不能完全降解形成的NETs;提示NETs的清除异常在皮肌炎及皮肌炎伴发的ILD中起一定作用。
Objective This study was focused on the association between neutrophil extracellular traps (NETs) and interstitial lung disease (ILD) in patients with dermatomyositis (DM). Methods Thirty six patients who satisfied the Bohan & Peter criteria for DM were recruited to this study, among whom 19 were complicated with ILD. Forty seven age and sex matched healthy Chinese volunteers were selected to be control subjects. The plasma samples of these patients were tested for the formation and degradation of NETs. Results DM plasma induced more NETs formation than control plasma did [ (246±93) RFUs vs (192±53) RFUs, P=0.002 ]. Compared to control, DM plasma exhibited a signficantry decreased ability to degrade NETs . Further mere, compared with DM patients without ILD (DMNL), DM patients with ILD (DML) could not degrade NETs completely [(83 ±13)% vs (59±21)% , P〈0.01]. All four DM patients with subacute ILD exhibited a significantly lower ability to degrade NETs than patients with chronic or asymptomatic ILD [(36±14)% vs (65±19)%, P=0.0139]. Conclusion These data show that more NETs formation is induced by plasma and DML fails to completely degrade NETs. These suggest that NETs may play a role in the pathogenesis of DM and DM-associated ILD.