To Investigate The Relationship Between Plasma Complement Activation Products And Inflammatory Cytokines And The Clinical Research In Patients With Antiphospholipid Antibody Syndrome (APS)

Objective To investigate the relationship between plasma complement activation products C4d、C5b-9 and inflammatory cytokines TNF-a,IFN-r,IL-1β,IL-6,VEGF and the clinical research in patients with Antiphospholipid antibody syndrome(APS).Methods The expression levels of plasma C4 d,C5b-9,TNF-a,IFN-r,IL-1β,IL-6、VEGF in60 APS patients and 30 healthy controls were analyzed by ELISA; The relationship was analyzed in APS patients between the C4 d,C5b-9,TNF-a,IFN-r,IL-1β,IL-6,VEGF and the clinical research. Comparison between the two groups in accordance with normal distribution were analyzed by independent sample T test, while if not accord with normal distribution were analyzed by Mann-Whitney U-test. Pearson correlation analysis or Spearman correlation analysis were used for variables related analysis.Results ① There was significant difference were found in the plasma levels of C5b-9,C4 d,TNF-a,IFN-r,IL-1β,IL-6,VEGF between APS patients and healthy controls,C5b-9 、C4d were significantly higher in APS patients than that in the controls【2766.59(480.41,12993.05)and 712.24(340.96,2770.26)ug/ml,z=-6.347,p<0.001;5.51(0.12,20.78)and 1.83(0.44,8.40)ug/ml,z=-4.58,p<0.001】. TNF-a、IFN-r、IL-1βwere significantly higher in APS patients than that in the controls as well.【 【27,86(1.54,488.53)and 24.15(1.51,54.38) pg/ml,z=1.542,p=0.017】;【4.36(1.12,41.98)and 1.53(0.94,2.89) pg/ml,z=1.505,p=0.02】;【5.42(1.08,19.06)and 2.16(0.26,5.26)pg/ml,z=1.793,p=0.03】】.The levels of IL-6and VEGF were significantly lower inpatients than that in the controls【 【1.93(1.39,5.42)and2.97(1.41,7.26)pg/ml】,z=2.177,p=0.00;【66.58(5.13,177.38)and 108.34(50.95,290.55)pg/ml,z=1.406,p=0.038】】.And the levels of the complement,the complement activation products and inflammatory cytokines in healthy adults and normal pregnant women,the primary APS and secondary APS are no statistical differences between patients(P>0.05).②Significant positive correlation was observed between C5b-9 and ESR,anticardiolipin antibody immunoglobulin G,anti-β2-glycoprotein I antibodies( r=0.602,p=0.000;r= 0.287,p= 0.039;r= 0.386,p= 0.002). No correlation was found between C5b-9 and C3,C4,ACAIg M,ACAIg A,CRP. Significant negative correlation was observed between C4 d and C3,C4(r=-0.951,p<0.001;r=-0.803,p<0.001).No correlation was found between C4 d and ACA Ig G 、ACAIg M,ACAIg A,ESR,anti-β2-glycoprotein I antibodies,CRP. The levels of the complement activation products C4 d,C5b-9 and the blood clotting index(D-dimer,CA700 prothrombin time,activated partial thrombin time CA700 live enzymes,fibrinogen degradation products CA700,fibrinogen CA700) in the APS patients are no statistical differences between patients(P>0.05). And t he levels of the complement activation products C4 d,C5b-9 in healthy adults and normal pregnant women,the primary APS and secondary APS are no statistical differences between patients(r=0.00,P>0.05;r=0.236,P>0.05;r=-0.211,P>0.05;r=0.244,P>0.05).Conclusions The complement system is activated in APS, the plasma levels of complement activation products C5b-9,C4 d and inflammatory cytokines TNF-a,IFN-r,IL-1β were significantly increased; the plasma levels of IL-6,VEGF were significantly decreasd. These results demonstrated that the complement activation and inflammatory cytokines may play an important role in the pathogenesis of APS.