SLE患者血清抗亲环素A自身抗体及其特异免疫复合物的测定与意义

用离子交换色谱和凝胶过滤技术从小牛胸腺中提取、纯化亲环素 Ａ（ＣｙＰ Ａ）。 ＳＤＳ－ＰＡＧＥ分析为单一条带，分子量为 １７．８ＫＤ，与 ＣｙＰ Ａ标准品一致。用此 ＣｙＰ Ａ建立了检测抗 ＣｙＰＡ自身抗体（ＡＣＡ）的ＥＬＩＳＡ法。在免疫豚鼠获得抗血清基础上，又建工了ＥＬＩＳＡ法检测ＣｙＰＡ特异免疫复合物（ＣｙＰ Ａ－ＩＣ）。正常对照（ｎ＝１００） ＡＣＡ和 ＣｙＰ Ａ－ＩＣ阳性率均仅 １．０％． ＳＬＥ患者（ｎ＝１０１） ＡＣＡ阳性率为 ５０．５％， ＣｙＰ Ａ－ＩＣ为 ７４．２％。结果提示，血清 ＡＣＡ和 ＣｙＰ Ａ－ＩＣ测定对ＳＬＥ的诊断有较高的敏感性和特异性。     

CyP A三类Ig自身抗体测定方法的建立与临床应用

利用基因重组技术 ，大肠杆菌表达人环胞菌素Ａ结合蛋白，建立测定抗ＣｙＰＡ自身抗体的酶联免疫吸附试验，探讨抗ＣｙＰＡ抗体与临床疾病的关系。     

皮肤狼疮带试验的探讨

免疫荧光法皮肤狼疮带试验对系统性红斑狼疮（ＳＬＥ）的诊断价值已认可。本文３８例结果示ＳＬＥ组狼疮带阳性率是９２％，非ＳＬＥ组８％，两组有极显著差异。狼疮带中Ｃ１ｑ，免疫球蛋白（Ｉｇ）Ｍ及ＩｇＧ阳性率较ＩｇＡ和补体３（Ｃ３）成分敏感，与补体下降、免疫球蛋白升高密切相关，无单独ＩｇＧ阳性，故行皮肤狼疮带试验（ＬＢＴ）检测时应检测多种抗体，以便减少假阴性。     

抗心磷脂抗体与反复自然流产关系的探讨

应用间接ＥＬＩＳＡ法检测１０５例反复自然流产患者血清中的抗心磷脂抗体，同时对ＡＮＡ、扩ｄｓ－ＤＮＡ、抗－Ｓｍ，抗－ＲＮＰ、ＲＦ进行了测定。结果表明：ＲＳＡ组ＡＣＡ阳性率为２８．６％，明显高于其他自身抗体及对照组（Ｐ＜０．０１），ＡＣＡ与ＲＳＡ患者的孕龄及流产次数无相关性（Ｐ＞０．０５），三种类别Ｉｇ中，以ＩｇＧ、ＩｇＧ、ＩｇＭ型ＡＣＡ检出率较高，中等或高水平的阳性结果占３３．３％（１０／３０），其     

急慢性丙型肝炎患者抗—HCV—IgM测定临床意义

为了探讨抗－ＨＣＶ－ＩｇＭ抗体在临控ＨＣＶ相关疾病听意义，本文应用ＥＬＩＳＡ间接法检测急、慢性丙型肝炎患者的抗－ＨＣＶ－ＩgM，并同时检测了抗－ＨＣＶ－ＩｇＧ。结果发现在急性、慢性丙肝患者中抗０ＨＣＶ－ＩｇＭ阳性率为９３．３％和８８．９％，抗－ＨＣＶ－ＩｇＧ阳性率为８６．７％和７７．８％。对照组的两各抗体均未检出，结果表明，抗－ＨＣＶ－ＩｇＭ抗体在疾病的早期诊断中的作用优于抗－ＨＣＶ－Ｉdisplay stat     

自身免疫病患者可抽提核抗体谱与体液免疫的关系

目的　探讨可抽提核抗原（ Ｅ Ｎ Ａ） 抗体谱的临床意义及与其他免疫指标的关系。方法　对１５６ 份自身免疫病患者血清样本,采用免疫印迹法检测抗 Ｅ Ｎ Ａ 抗体,经免疫浊度法检测 Ｉｇ 和补体。结果　（１） 抗 Ｅ Ｎ Ａ 抗体在自身免疫病有较高的检出率,其中抗平滑肌（ Ｓｍ） 抗体、抗 Ｕ１ 核糖核蛋白抗体的阳性率在系统性红斑狼疮（ Ｓ Ｌ Ｅ） 中分别为３６ ．３ ％ 、２８ ．８ ％ ; 抗 Ｓ Ｓ Ａ 和抗 Ｓ Ｓ Ｂ 抗体的出现在干燥综合征（ Ｓ Ｓ） 患者中分别为５／１６ 和３／１６ 。（２） 与正常对照和抗体阴性组比较,抗 Ｅ Ｎ Ａ 阳性血清中 Ｉｇ Ｇ、 Ｉｇ Ｍ、 Ｉｇ Ａ 增高,分别为（２１ ．６ ±１５ ．０） 、（１ ．７ ±０ ．８） 、（２ ．２ ±１ ．２）ｇ／ Ｌ, 而 Ｃ３ 、 Ｃ４ 和总补体溶血活性（ Ｃ Ｈ５０）水平下降分别为（１ ．０８ ±０ ．３７） 、（０ ．２１ ±０ ．１２） 、（９８ ．±２９） ｇ／ Ｌ;（３） 随着抗 Ｅ Ｎ Ａ 抗体免疫印迹条带数的增多, Ｉｇ Ｇ 增高,而 Ｉｇ Ｍ、 Ｃ３ 、 Ｃ４ 及 Ｃ Ｈ５０ 与之相反,下降很明显;（４） Ｃ３ 、 Ｃ４ 、 Ｃ Ｈ５０ 与疾病活动性有相关关系。结论　抗 Ｅ Ｎ Ａ 抗体阳性者存在体液免疫应答增加,且与抗     

HEP-2细胞为靶细胞的ELISA检测血清抗核抗体

以ＨＥＰ－２细胞株为靶细胞包被塑料微孔扳，运用ＨＲＰ羊抗入ＩｇＧ为二抗对８例活动期ＳＬＥ，１例混合结缔组织病（ＭＣＴＤ），８例类风湿性关节炎，７例风湿性关节炎和３０例健康者做了血清抗核抗体的的ＥＬＩＳＡ检测，同时以间接免疫荧光法作对照。并对高滴度阳性血清作了稀释度与吸光度值的直线回归分析。结果表明，ＥＬＩＳＡ检测血清抗核抗体特异性为９８．５％，敏感性为１００％，值得推广应用     

血透患者检测抗HCV IgM的临床意义

为探讨丙型肝炎ＩｇＭ抗体测定在血液透析患者中的临床意义,采秀间接ＥＬＩＳＡ法检测抗ＨＣＶ ＩｇＭ。同时采用ＥＬＩＳＡ测抗ＨＣＶ ＩｇＧ,ＲＴ－ＰＣＲ法测ＨＣＶ ＲＮＡ,并进行比较。结果示６２例血液透析病人中,抗ＨＣＶ ＩｇＭ阳性２７例（４３．６％）,抗ＨＣＶ ＩｇＧ阳性２９例（４６．８％）,ＨＣＶ ＲＮＡ阳性３４例（５４．８％）,任一项阳性３７例（５９．７％）;抗ＨＣＶ ＩｇＭ与ＨＣＶ ＲＮＡ检测     

SLE免疫印迹抗体谱其与荧光NA及LET的关系

用免疫印迹技术（ＩＢＴ）对１５０例系统性红斑狼疮（ＳＬＥ）活动期活动患者进行了７种可提取性核抗原（ＥＮＡ）自 抗体的检测。１３０例（８６．７％）患者检出至少一种自身抗。抗Ｓｍ抗体的阳性率达５１．３％，抗Ｒｏ抗体阳性率为１８．７％（２８例），抗核糖体抗体阳性率为１７．３％。临床应用表明ＩＢＴ具有快速、简便、敏感、稳定和精确等优点。对ＳＬＥ患者ＩＢＴ检测７种ＥＮＡ抗体与荧光ＡＮＡ及ＬＢＴ的关系进行了讨     

血清中三种Ig类抗卵巢自身抗体的测定及其临床意义

用亲和层析柱纯化人卵巢抗原，建立ＥＬＩＳＡ间接法检测不孕、流产患者血清中三种Ｉｇ类抗卵巢抗体。结果表明：以健康孕妇（ｎ＝７０）Ａ值的Ｘ＋２ｓ为正常上限，不孕组患者血清中ＩｇＧ、ＩｇＡ、ＩｇＭ类抗卵巢抗体的阳性率分别为２２．７％（４８／２１１）、１４．２％（３０／２１１）和１２．３％（２６／２１１）；流产组患者血清中ＩｇＧ、ＩＧＡ、ＩｇＭ类抗卵巢抗体的阳性率分别为２０．６％（２２／１０７）、１５％（１６／１０７）和１２．１％（１３／１０７），均明显高于健康孕妇组（Ｐ＜０．０１）。不孕组以单独ＩｇＧ类或ＩｇＡ类抗体多见，流产组以ＩｇＧ、ＩｇＡ两类抗体为主。     

Antibodies to cytoskeletal proteins in patients with Crohn''s disease

The immunologic basis of inflammatory bowel disease has been the focus of interest of a series of studies on Crohn's disease and the process of immune sensitization at the gastrointestinal mucosal level is functionally poorly understood. To date only few contradictory reports concerning the incidence of autoantibodies in patients with this disease exist. The aim of this study was to investigate the sera drawn from 60 patients suffering from biopsy-proven Crohn's disease to evaluate the prevalence of autoantibodies against nuclear antigens and cytoskeletal proteins. Using standard methods, no anti-nuclear antibodies or antibodies to extractable nuclear antigens could be detected. All sera were also negative for antibodies to double-stranded DNA, anti-mitochondrial antibodies, and antibodies to gastric parietal cells. Using sensitive enzyme-linke immunosorbent assays with purified antigens and Western blotting with cytoskeletal proteins of human intestinal cells, the following antibodies could be demonstrated: cytokeratin 18 autoantibodies (IgG 20.0%; IgM 6.7%; IgA 13.3%), actin antibodies (IgG 36.7%; IgM 48.3%, IgA 26.7%), desmin antibodies (IgG 6.7%; IgM 15.08%; IgA 5.0%), vimentin antibodies (IgG 3.3%; IgM 16.7%; IgA 10.0%) and tropomyosin antibodies (IgG 3.3%; IgM 3.3%, IgA 5.0%). Statistically significant correlations could be found for levels of cytokeratin 18 antibodies (IgM-type) and the BEST index of activity, and for levels of desmin antibodies (IgM-type) and the van HEES index of activity. Highest levels could be measured for actin antibodies (IgG-type) in patients with isolated disease manifestation in the colon. The mechanism of induction of autoantibodies against cytoskeletal components in Crohn's disease still remains obscure. Unmasking of hidden antigens after cell injury during the inflammatory process of disease might lead to sensitization and antibody production. The pattern of antibodies in patients with Crohn's disease seems to be different compared with that of connective tissue diseases.     

系统性红斑狼疮患者血清 IgG水平正常及升高与相关免疫学实验室指标的相关分析

目的　探讨系统性红斑狼疮患者（ systemic lupus erythematosus,SLE）中免疫球蛋白 G (immunoglobulin G,IgG)正常与 IgG升高的患者,其抗核抗体 (antinuclear antibody, ANA）滴度、抗双链 DNA(double-strand DNA,ds-DNA)抗体及抗可溶性抗原抗体谱（ extractable nuclear antigen,ENA）,以便深入对 SLE的认识。方法　选择 2019年 6~12月在空军军医大学第一附属医院就诊的初诊 SLE患者 150例,其中狼疮性肾炎患者 62例,采用速率散射比浊法分别检测 SLE患者血清中免疫球蛋白 IgA,IgG,IgM及补体 C3,C4的水平。采用间接免疫荧光法和欧蒙印迹法检测抗核抗体 ANA,抗 ds-DNA抗体及 ENA。比较 IgG正常组与 IgG升高组患者间实验室指标的差异。结果　IgG正常组 SLE患者血清中免疫球蛋白 IgA,IgM水平低于 IgG升高组,补体 C3,C4水平高于 IgG升高组,其中 IgA差异具有统计学意义 (z=-3.64, P<0.05)。IgG正常组 SLE患者抗 ds-DNA抗体、抗舍格伦综合征 A（SSA）抗体、抗 Ro-52抗体、抗核小体抗体（AnuA）阳性率均低于 IgG升高组 (χ2=4.985,7.479,8.974和 5.637,均 P<0.05);而抗核糖核蛋白 /史密斯（ nRNP/ Sm）抗体、抗 Sm抗体、抗舍格伦综合征 B（SSB)抗体、抗组蛋白抗体（ AHA）、抗核糖体 P蛋白抗体 (ARPA)在两组之间差异无统计学意义 (χ2=0.005~2.050,均 P>0.05)。两组患者的狼疮性肾炎患病率相似,差异无统计学意义（ χ2=1.129, P>0.05）。结论　IgG正常 SLE患者与 IgG升高患者相比,其自身抗体阳性率降低,而狼疮肾炎发病率与 IgG升高组无差异,提示临床 IgG正常和 IgG升高的 SLE患者实验室指标之间存在差异,以便加深对 SLE的认识。     

IgM,IgG, and IgA anti‐DNA topoisomerase I antibodies in systemic sclerosis

Background: Anti‐DNA topoisomerase I (anti‐topo I) antibodies have been broadly studied in systemic sclerosis (SSc). The use of different native and molecularly cloned antigens has shown a predominant IgG response, and a variable frequency of positive IgM and IgA tests. We report herein the serological findings of SSc using a recombinant topo I obtained through a standard bacterial system. Methods: Anti‐topo I antibodies were studied in 45 SSc patients and 85 healthy controls through ELISA and western blot. Escherichia coli XL1‐blue strain and pT7‐7 vector were used to amplify a DNA topo I cDNA clone, and to obtain the recombinant polypeptide. The latter was purified by affinity chromatography, and the enzymatic and antigenic properties were evaluated through specific tests. A native antigen was included for comparison. Results: The SSc group disclosed positive IgM (20%), IgG (86.6%), and IgA (26.6%) anti‐topo I tests with the recombinant polypeptide, and a purified calf thymus antigen yielded similar results. IgG autoantibodies were frequently associated with skin involvement, esophageal dysfunction, and restrictive lung disease. The recombinant protein showed a molecular weight of 86.6 kDa, a positive topo I activity using a supercoiled pBR322 DNA relaxation test, and its carboxyl terminus region was recognized by specific antibodies. Conclusion: This report confirms that different immunoglobulin classes with anti‐topo I activity may occur in SSc. IgG was the predominant serological feature with both, the recombinant and native antigens. The study also demonstrates the association between high levels of these autoantibodies and some clinical manifestations of SSc. J. Clin. Lab. Anal. 23:408–416, 2009. © 2009 Wiley‐Liss, Inc.     

Evaluation of the diagnostic value of measuring IgG,IgM, and IgA antibodies to mycobacterial A60 antigen in active tuberculosis

The purpose of the present study was to evaluate the clinical usefulness of detection of serum immunoglobulin A (IgA), IgG, and IgM antibodies raised against the mycobacterial A60 antigen for the diagnosis and discrimination of active tuberculosis (TB) from other pulmonary diseases. Three commercially available ELISA kits (IgA, IgG, and IgM) (ANDA Biologicals, Strasbourg, France) were evaluated simultaneously in 246 serum samples from 3 groups of patients: group I, 171 patients with active TB (128 pulmonary TB and 43 extrapulmonary TB); group II, 73 patients with pulmonary non-TB diseases; and group III, 2 leprosies patients. The sensitivities of tests ranged from 31.3% (IgA) to 94% (IgG) in pulmonary TB patients and from 21% (IgA) to 84% (IgG) in extrapulmonary TB patients. The specificities of assays varied from 92% (IgG) to 96% (IgA) in the pulmonary non-TB group. Combination of IgG with IgA and/or IgM does not improve its sensitivity. Clinical use of the A60-based serodiagnostic IgG assay is of great value for the rapid diagnosis and discrimination between active TB and pulmonary non-TB diseases. Moreover, this test could be used to increase diagnostic accuracy, especially for smear-negative TB cases, which are difficult to diagnose.     

与免疫相关的血细胞减少患者骨髓造血细胞自身抗体的研究

目的　了解与免疫相关的血细胞减少患者骨髓造血细胞结合的自身抗体的类型、分布、数量及临床意义 ,考察骨髓单个核细胞直接抗人球蛋白试验 (BMMNC Coombs)的敏感性。方法　对 32例临床疑诊为免疫性全血细胞减少的患者进行BMMNC Coombs试验和流式细胞术 (FACS)双标法检测骨髓造血干 祖细胞、有核红细胞、粒细胞结合的自身抗体的种类及结合率。结果　FACS双标法检出的骨髓造血细胞自身抗体的阳性率为 90 .6 %,BMMNC Coombs试验检出的阳性率为 5 0 .0 %,前者显著高于后者 ( χ2 =12 .6 5 ,P <0 .0 5 )。FACS检测自身抗体阳性的 2 9例患者中IgG型占 6 .9%,IgM型占13 .8%,IgG +IgA型占 3 .4%,IgG +IgM型占 31.0 %,IgG +IgM +IgA型占 44 .8%;2 9例中含IgG型 2 5例 ,占 86 .2 %,含IgM型 2 6例 ,占 89.7%,含IgA型 14例 ,占 48.3 %。IgG型血红蛋白减少得最严重 ,含IgM型的患者可有血管内溶血的实验室发现 ,IgM和IgM +IgG型组治疗的起效时间明显短于其他组。91.3 %的患者可检出造血干 祖细胞上有自身抗体 ,而且多表现为全血细胞减少 ;约 5 0 .0 %的患者红、粒系细胞上有自身抗体 ,13例BMMNC Coombs试验阴性而FACS检测阳性的患者中有 11例在造血干细胞上有自身抗体。与有核红细胞和造血干 祖细胞结合的三种抗体     

The prediction of thrombosis development in patients with systemic lupus erythematosus: the role of antibodies to cardiolipin]

In patients with systemic lupus erythematosus (SLE), the synthesis of antibodies to cardiolipin (A-CL) is associated with the development of venous and arterial thromboses localized in minor and middle-sized vessels, in the venous system and capillaries. The determination of various A-CL isotypes may be used to predict thromboses in SLE patients. Overall 210 patients (185 women and 25 men) with a verified diagnosis of SLE were examined. The patients were not screened in accordance with some or other clinical signs of the antiphospholipid syndrome. The control group comprised 100 healthy subjects (donors). The IgG, IgA and IgM isotypes of A-CL were determined by ELISA. Sera of SLE patients showed an increase of the concentration of A-CL of both certain isotypes and their potential combinations. Among A-CL-positive patients, the IgG isotype of A-CL was detected in 75% of cases, the IgM isotype of A-CL in 61%, and the IgA isotype of A-CL in 36% of cases. Thrombotic complications were recorded in 19% of patients. They were induced by hyperproduction of the three combinations of the A-CL isotypes: A-CL IgM, IgM+IgA, and IgG+IgA+IgM. Patients whose sera contained A-CL of all three types at a time were most prone to thrombotic complications. It has turned out that the percentage of SLE patients with thromboses was higher than that of SLE patients without thromboses, starting from the definite A-CL concentration (21 GPL).(ABSTRACT TRUNCATED AT 250 WORDS)     

IgA red cell autoantibodies and autoimmune hemolysis

BACKGROUND: The objective of the study was to examine the interrelationships and clinical significance of IgA red cell antibodies in the autoimmune response. STUDY DESIGN AND METHODS: The records of 5235 patients referred to an immunohematology center over a 14-year period were critically examined for patients who had IgA autoantibodies, defined as elutable IgA immunoglobulins that would rebind to normal cells. RESULTS: One hundred twenty-four patients (61 male) aged 6 to 98 years had warm-reacting IgA autoantibodies. In 75 individuals, these were idiopathic; neoplasms were the most common associated conditions in the individuals with secondary IgA autoantibodies. IgA was the only immunoglobulin present in 6 patients; all others also had IgG and/or IgM coating their cells, and 102 individuals also had increased amounts of cell-bound complement. In a comparison by chi-square test of populations with haptoglobins of < 0.1 g per L, IgA was shown to act synergistically with IgG in producing hemolysis (p < 0.01). CONCLUSION: Autoimmune hemolysis due to IgA antibodies alone in rare, with red cell destruction occurring through mechanisms similar to those for IgG. Most commonly, IgA acts synergistically with other immunoglobulins (usually IgG) and complement; the hemolysis may be severe. Whether IgA autoantibodies alone can activate complement remains controversial, but increasing evidence suggests that they can, possibly via the alternative pathway, and that this activation may result in intravascular hemolysis.     

免疫相关指标及核抗原抗体在系统性红斑狼疮患者中的诊断价值

【目的】探讨免疫相关指标及核抗原(ENA)抗体在系统性红斑狼疮(SLE)患者中的诊断价值。【方法】SLE患者80例,根据患者病情分为活动期组(35例)和非活动期组(45例)。选取健康志愿者40例作为对照组。检测比较三组对象外周血免疫相关指标(IgA、IgM、IgG、C3、C4)以及ENA抗体(抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP)水平的差异。使用ROC曲线分析相关指标对活动期SLE的诊断价值。【结果】三组间IgA、IgM、C3、C4、IgG、抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP差异均具有统计学意义(P<0.05)。活动期组患者IgA、IgM、IgG分别高于对照组、非活动期组,C3、C4分别低于对照组、非活动期组,且差异有显著性(P<0.05);非活动期组IgA、IgG高于对照组,C3低于对照组(P<0.05)。活动期组、非活动期组患者抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP阳性率高于对照组,且差异有显著性(P<0.05);非活动期组、活动期组间各ENA抗体阳性率相比较差异无显著性(P>0.05)。IgA诊断活动期SLE的最佳临界点为4.5g/L。当IgA为4.5g/L时,IgA诊断活动期SLE的灵敏度为71.5%,特异度为80.1%;AUC曲线下面积为0.81。【结论】免疫相关指标及ENA抗体在SLE患者中诊断价值较高,且IgA、IgG及C3能较好提示病情进展情况。     

中国人群EB病毒感染与系统性红斑狼疮相关性的Meta分析

目的 通过Meta分析探讨中国人群EB病毒(EBV)感染与系统性红斑狼疮(SLE)相关性。方法 计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP),PubMed,EMbase,中国生物医学文献检索数据库(CBM)和万方科技期刊全文数据库,检索对中国人群SLE患者及对照血清中抗EB病毒抗体进行检测的病例-对照研究,检索时限均从建库至2017年7月。参照修改后的纽卡斯尔-渥太华量表(NOS)进行质量评价。采用Rev Man5.3和Stata 12软件进行Meta分析,利用M-H法计算抗EB病毒抗体比值比(OR)值,采用敏感性分析评估结果的稳定性。利用Egger检验分析发表偏倚。结果 最终纳入17项病例-对照研究,包括SLE患者1 392例,对照1 647例。对EB病毒衣壳抗原抗体(EBV-VCA)IgG进行检测的研究纳入12项,Meta分析结果显示SLE患者与健康对照EBV-VCA IgG阳性率差异有统计学意义(P=0.003),总体比值比OR为2.97(95% CI=1.43～6.15)。按SLE病例诊断方法、研究质量、病例与对照年龄是否匹配对其进行亚组分析后未发现任何亚组之间存在显著差异。Egger检验结果显示无显著发表偏倚。对EBV-VCA IgA,EBV-VCA IgM进行检测的研究分别纳入7项和6项。Meta分析结果显示EBV-VCA IgA,EBV-VCA IgM与SLE之间存在明显相关性(P<0.000 01),总体比值比OR分别为7.01(95% CI=4.61～10.66),9.34(95% CI=4.29～20.34)。但SLE患者EBV-VCA IgA(37.5%)和EBV-VCA IgM(28.5%)阳性率低于EBV-VCA IgG(90.3%)。SLE患者与健康对照核心抗原抗体(EBNA1)IgG阳性率差异无统计学意义(P=0.97),总体比值比OR为1.01(95% CI=0.61～1.67)。结论 先前发生EB病毒感染与SLE之间存在明显相关性。