25(OH)D And Autophagy In The Pathogenesis Of Systemic Lupus Erythematosus In Children

Objective:By analyzing the levels of serum 25(OH)D and autophagic proteins in peripheral blood lymphocytes of children with SLE,the role of 25(OH)D and autophagy in the pathogenesis of childhood SLE was explored to further guide the use of adjuvant drugs in children with lupus.Methods:A total of 73 children with SLE diagnosed at a pediatric outpatient and hospitalized hospital at the Second Hospital of Hebei Medical University from December 2015 to December 2017 were collected and divided into the initial SLE(non-vitamin D treatment)group and vitamin D treatment group,38 cases and 35 cases respectively.During the same period,30 children were referred to the control group as the control group.Serum 25(OH)D levels(ng/ml)were detected by enzyme-linked immunosorbent assay.LC3 and Beclin-1 protein expression levels were detected by Western blotting in peripheral blood lymphocytes,LC3-II expression sites were detected by immunofluorescence,and the relevant laboratory indicators were recorded.The level of 25(OH)D and expression of autophagy protein in children with SLE before and after vitamin D treatment were analyzed.The role and clinical significance of serum 25(OH)D in the pathogenesis of children with SLE were explored.Results:1.Serum 25(OH)D levels in children with SLE1)The level of 25(OH)D in the initially treated SLE group was significantly lower than that in the normal control group,which was statistically significant(P<0.05)[(6.241 ± 1.308)ng/ml vs(11.9 ± 4.80)ng/ml].2)25(OH)D levels increased in the vitamin D treatment group compared with the initial SLE group,with statistical significance(P<0.05)[(6.241 ±1.308)ng/ml vs(8.507±2.801)ng/ml].3)25(OH)D levels were still lower in the vitamin D treatment group compared with the normal controls,which was statistically significant(P<0.05)[(8.507±2.801)ng/ml vs(11.9±4.80)ng/ml].2.The expression of autophagy in peripheral blood lymphocytes of children with SLE1)The expression of LC3-II protein in peripheral blood lymphocytes was significantly increased in the initially treated SLE group compared with normal controls(Z=-3.033,P<0.05).2)The expression of LC3-II protein in peripheral blood lymphocytes was increased in the vitamin D treatment group compared with the normal control group(Z=-2.343,P<0.05).3)There was no significant difference in LC3-II protein expression between the initially treated SLE group and the vitamin D treatment group,which was not statistically significant(Z=-0.781,P>0.05).4)Immunofluorescence staining showed that the expression of LC3-II in lymphocyte cytoplasm was stronger than that of normal control group,which was consistent with Western blotting results.5)The Beclin-1 protein expression in peripheral blood lymphocytes was significantly increased in the initially treated SLE group compared with normal controls(Z=-3.406,P<0.05).6)There was no significant difference in peripheral blood lymphocyte Beclin-1 protein expression between the vitamin D treatment group and the normal control group(Z=-0.808,P>0.05).7)The expression of Beclin-1 protein in peripheral blood lymphocytes was statistically significant in the initially treated SLE group compared with the vitamin D treatment group(Z=-3.551,P<0.05).3.Serum 25(OH)D in Children with SLE Correlates with Related Laboratory Indices Related to Autophagy Proteins1)The 25(OH)D levels in the untreated SLE group were negatively correlated with the SLEDAI,IgG,and ANA,which was statistically significant(Pearson correlation coefficients were-0.482,-0.49,and-0.465,respectively,P<0.05.There was no significant correlation with ds-DNA,C3,hs-CRP,C4,ESR,PCT.2)There was a positive correlation between the scatter plots of LC3-II and Beclin-1 integral optical density of peripheral blood lymphocytes in children with SLE,and it was statistically significant(Pearson correlation coefficient 0.552,P<0.05).Conclusions:1.The serum 25(OH)D level in children with SLE is significantly lower than those in normal children.2.Serum 25(OH)D levels in children with SLE were significantly negatively correlated with SLEDAI,IgG,and ANA.Vitamin D supplementation could increase 25(OH)D levels in vivo,which may be involved in the regulation of autoimmunity.3.The autophagy of children with SLE was significantly higher than that of normal children.Autophagy was involved in the pathogenesis of SLE.4.25(OH)D may be involved in the regulation of autophagy in SLE.