Abstract:

Objective To discuss the changes in the levels of chemokine ligand 19 （CCL19） and soluble CD163 （sCD163） in serum of the patients with systemic lupus erythematosus （SLE） during pregnancy， and to clarify their effects on the maternal and infant outcomes. Methods A total of 180 pregnant SLE patients were selected as SLE group and then divided into successful pregnancy group （n=132） and pregnancy failure group （n=48） based on the maternal and infant outcomes. A total of 180 healthy pregnant women underwent prenatal checks during the same period were randomly selected as control group. The general data of the patients in two groups were collected， and the serum levels of CCL19 and sCD163， along with related serum factors， were detected by kits. Multivariate Logistic regression analysis was used to detect the risk factors for pregnancy failure in the SLE patients， and receiver operating characteristic （ROC） curve was used to evaluate the effectiveness of serum CCL19 and sCD163 levels in predicting the pregnancy outcomes of the patients in SLE group. Results Compared with control group， the levels of complements C3 and C4 in the serum of the patients in SLE group were significantly decreased （P<0.05）， and the levels of erythrocyte sedimentation rate （ESR）， creatinine （CR）， anti-cardiolipin antibody （ACA）-IgG， anti-β2 glycoprotein Ⅰ （anti-β2GPⅠ）， CCL19， and sCD163 of the patients were significantly increased （P<0.01）. Compared with successful pregnancy group， the levels of complement C3 and C4 pregnancy of the patients in failure group were significantly decreased （P<0.01）， and the levels of ESR， CR， ACA-IgG， anti-β2GPⅠ， CCL19， and sCD163 were significantly increased （P<0.01）. The serum levels of CCL19， sCD163， ESR， CR， ACA-IgG， and anti-β2GPⅠ were the risk factors for pregnancy failure of the SLE patients （P<0.05 or P<0.01）， while the levels of complement C3 and C4 were the protective factors （P<0.01）. The area under the ROC curve （AUC） of the serum CCL19 level for predicting the pregnancy failure of the SLE patients was 0.726， and the AUC of serum SCD163 level for predicting the pregnancy failure of the SLE patients was 0.789； the AUC of combination of both markers for predicting the pregnancy failure of the SLE patients was 0.835. The predictive performance of CCL19 and sCD163 for pregnancy outcomes of the SLE patients was superior to either marker alone （Z_{combined-CCL19}=3.066， P=0.002； Z_{combined-sCD163}=2.087， P=0.037）. Conclusion The serum levels of CCL19 and sCD163 in the SLE patients during pregnancy are significantly increased， which may cause the poor outcomes in the patients.

Key words: Systemic lupus erythematosus, Pregnancy, C-C chemokine ligand 19, Soluble CD163, Maternal and infant outcome