系统性红斑狼疮血脑屏障损伤的动态增强磁共振检测及分子免疫机制的研究

项目名称： 系统性红斑狼疮血脑屏障损伤的动态增强磁共振检测及分子免疫机制的研究

项目编号： No.81460256

项目类型： 地区科学基金项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 徐健

作者单位： 昆明医科大学

项目金额： 48万元

中文摘要： 系统性红斑狼疮（SLE）是一种病因不明的自身免疫病，中枢神经系统受累的神经精神狼疮（NPSLE）严重影响疾病疗效和预后。血脑屏障（BBB）的损伤在NPSLE中有重要作用，可能是SLE早期脑损伤的核心，而有效的治疗常伴随BBB的修复。现有BBB损伤的判断方法较少且不敏感，给NPSLE早期识别与疗效判断带来困难。新近开发的动态增强磁共振（DCE-MRI）技术具有无创、快捷、敏感性高等优势，已用于检查脑肿瘤及脑出血患者的BBB损伤，但尚未建立应用于SLE中BBB损伤的方法。本研究拟建立用DCE-MRI技术评价SLE中BBB损伤的方法；结合生物学标记和免疫因子检测，探讨BBB损伤的分子免疫机制；对有BBB损伤的患者进行治疗前后比较，了解该方法用于评价SLE中BBB损伤及修复程度的价值。研究结果将提供临床一种新的无创性评价SLE中BBB损伤的方法，对NPSLE的早期治疗及预后判断有极大应用价值。

中文关键词： 系统性红斑狼疮；血脑屏障；动态增强磁共振；自身抗体；细胞因子

英文摘要： Systemic Lupus Erythematosus (SLE) is a serious autoimmune disease that affects almost all of the organs and systems in the body. The etiologies of SLE remain unclear. The CNS involvement and neuropsychiatric symptoms (NPSLE) are usual in SLE, resulting in the poor treatment effect and prognosis. Until now, understanding of NPSLE is a big challenge for the clinical practice, due to the unknown pathologies, difficulty of early diagnosis, and absence of objective indictors. Recent studies prove the association between the damage of blood-brain barrier (BBB) and the NPSLE. The dysfunction of BBB may happen very early in the course of SLE and become the core deficit of the brain in NPSLE. Effective treatment may accompany with the recovery of BBB. However, the methods used to evaluate the damage of BBB are rare and insensitive, leading to the difficulty of early recognize and treatment decision. A newly developed technique, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with the advantage of invasive, convenient and sensitive, has been used to the evaluation of deficit of BBB in patients with brain tumor or hemorrhage successfully. Yet there is no established methods used in SLE. Present study aims to establish a systemic technique for evaluating the deficit of BBB in SLE. Combined with other biological makers, the measurement of BBB dysfunction may help to the understanding of the molecular mechanism of BBB deficit in SLE. We also want to compare the measurement of BBB dysfunction before and after the corticosteroid treatment to understand the value of DCE-MRI in the evaluation of BBB dysfunction and recovery. Providing a new method for the clinical evaluation of BBB dysfunction and recovery in SLE, this study will have a great value in the early diagnosis and treatment decision for the brain damage of SLE.

英文关键词： systemic lupus erythematosus;blood–brain barrier;dynamic contrast-enhanced MRI;autoantibodies;cytokines