大疱性类天疱疮患者血清总IgE与血清自身抗体的关系

目的分析大疱性类天疱疮患者血清总IgE与抗BP180IgG抗体、抗BP230IgG抗体、抗表皮基底膜IgG抗体滴度(即间接免疫荧光滴度)的关系。方法收集沈阳市第七人民医院2014年1月-2020年1月大疱性类天疱疮病例,进行回顾性分析,根据抗BP180IgG抗体、抗BP230IgG抗体阳性情况将患者分组,比较组间血清总IgE值的差异。同时分析血清总IgE值与抗表皮基底膜IgG抗体滴度的相关性。结果收集病例119例。抗BP230IgG抗体阳性伴抗BP180IgG抗体阳性组血清总IgE值升高更显著,且与抗BP180IgG抗体及抗BP230IgG抗体均阴性组及仅抗BP180IgG抗体阳性组差异有统计学意义(P=0.000);而抗BP180IgG抗体及抗BP230IgG抗体均阴性组与仅抗BP180IgG抗体阳性组比较,血清总IgE值差异无统计学意义(P=0.777);血清总IgE值与抗表皮基底膜IgG抗体滴度呈正线性相关(r=0.548,P=0.000)。结论大疱性类天疱疮患者中,血清总IgE水平与表皮基底膜抗原暴露程度有一定相关性,且IgE可能主要与BP230结合在大疱性类天疱疮发病过程中起作用。     

慢性特发性荨麻疹相关抗体与发病的关系

【摘要】 目的 探讨抗高亲和力IgE受体（FcεRI）抗体、抗IgE抗体、抗幽门螺杆菌（HP）抗体和抗甲状腺球蛋白抗体（TGAb）与慢性特发性荨麻疹（CIU）发病的关系。 方法 设（CIU）组、急性荨麻疹（AU）组和健康对照组,每组100例受试者。每例受试者均进行自体血清皮肤试验,荧光酶联免疫吸附法检测过敏原,血清总IgE、抗FcεRI抗体、抗IgE抗体、抗HP抗体、TGAb水平及阳性率,将CIU组与AU组和健康对照组比较。结果 CIU组自体血清皮肤试验阳性率为53%,AU组为12%,健康对照组未发现阳性者。CIU组和健康对照组过敏原检测均为阴性,而AU组能检测到食物或吸入物过敏原,阳性率为86%。 CIU组抗FcεRI抗体和抗IgE抗体水平均高于AU组和健康对照组（P ＜ 0.05）; CIU患者IgE水平低于健康对照组（T = 190.00,P ＜ 0.05）,而AU组IgE水平高于健康对照组（T = 226.00,P ＜ 0.05）; 自体血清皮肤试验阳性CIU患者抗FcεRI抗体水平较阴性患者高（T = 101.73,P ＜ 0.05）,抗IgE抗体在自体血清皮肤试验阳性和阴性CIU患者间,差异无统计学意义（T = 312.04,P ＞ 0.05）; CIU组、AU组、和健康对照组抗HP抗体阳性率分别为29%、19%和23%,TGAb阳性率分别为18%、15%和11%,抗HP抗体和TGAb阳性率在三组间比较,差异均无统计学意义（P ＞ 0.05）; 抗HP抗体阳性的CIU患者中,抗FcεRI抗体阳性率较AU患者和健康人高（P ＜ 0.01）;抗IgE抗体阳性率与AU患者和健康人差异无统计学意义（P ＞ 0.05）。TGAb阳性的CIU患者中,抗FcεRI抗体阳性率较AU患者和健康人高（P ＜ 0.01）,抗IgE抗体阳性率与AU患者和健康人比较,差异无统计学意义（P ＞ 0.05）。结论 CIU存在抗FcεRI和抗IgE自身抗体,可能在自身免疫性荨麻疹发病中起一定作用。 【关键词】 荨麻疹; 自身抗体; 免疫球蛋白E; 皮肤试验     

抗核抗体阴性的大疱性系统性红斑狼疮1例

报告１例抗核抗体阴性的大疱性系统性红斑狼疮。在整个病程中共查过７次抗核抗体均阴性。ＤＩＦ、ＩＩＦ，免疫印迹均无阳性发现。肾脏穿刺活检免疫荧光见ＩｇＧ颗粒状沉积。并讨论其诊断依据和大疱性系统性红斑狼疮抗核抗体为阴性的可能原因。     

抗幽门螺杆菌抗体阳性慢性荨麻疹患者血清对人皮肤肥大细胞释放组胺作用的研究

【摘要】 目的 探讨抗幽门螺杆菌（Hp）抗体与慢性荨麻疹（CU）发病的关系。 方法 选择13C呼吸实验阳性、抗Hp抗体阳性的CU患者为实验组,健康人为对照组。用CU患者血清孵育人皮肤肥大细胞原代细胞株（HMC）,检测血清是否可刺激HMC细胞释放组胺。用抗Hp抗体（IgG）刺激HMC细胞,检测其是否具有活化细胞释放组胺的作用。检测CU患者血清中是否也含有高亲和力受体（FcεRI）抗体或抗IgE抗体。分别用抗FcεRI抗体、抗IgE抗体刺激HMC细胞,检测其活化HMC细胞释放组胺作用。 结果 CU患者组血清活化HMC细胞释放组胺作用（3.13 ± 0.93）高于健康对照组（2.92 ± 0.75,t = 2.39,P < 0.05）,4例CU患者血清中同时存在抗FcεRI抗体、3例存在抗IgE抗体。分别用这两种抗体阳性的CU患者血清孵育HMC细胞,释放组胺量均高于健康对照组（t值分别为4.82、6.34,均P < 0.01）,但用只含有抗Hp抗体CU患者血清孵育HMC细胞无释放组胺作用（与健康对照组比较,t = 1.74,P > 0.05）。抗Hp抗体（IgG）无激活HMC细胞释放组胺作用（与阴性对照血清比较,t = 1.95,P > 0.05）,抗FcεRI抗体、抗IgE抗体均可激活HMC细胞释放组胺（与阴性对照血清比较,t值分别为3.72、3.02,均P < 0.01）。 结论 抗Hp抗体对CU无致病作用,血清中同时存在抗FcεRI抗体或抗IgE抗体可导致部分Hp感染者同时患有CU。     

成人皮肌炎患者抗核抗体与临床特征及肿瘤风险的关系

【摘要】 目的 探讨成人皮肌炎患者抗核抗体与临床特征及肿瘤风险的关系。方法 回顾性分析2008年4月至2018年4月在苏州大学附属第一医院皮肤科住院的101例皮肌炎患者的临床资料,分为抗核抗体阳性组和阴性组,比较两组之间肌病、肿瘤发生风险以及其他临床特征的差异。92例患者随访2年。采用卡方检验分析比较两组的临床特征,利用多因素回归分析模型分析抗核抗体和无肌病性皮肌炎及肿瘤之间的关系。结果 101例皮肌炎患者中,男42例,女59例,年龄（55.13 ± 14.63）岁;无肌病性皮肌炎14例,低肌病性皮肌炎6例,肌病性皮肌炎81例;抗核抗体阳性42例（41.58%）,阴性59例（58.41%）。抗核抗体阳性组颈部红斑（33.33%比59.32%,P = 0.010）、披肩征（14.28%比35.59%,P = 0.017）发生率低于阴性组。皮肌炎合并肿瘤28例（27.72%）。抗核抗体阳性者5例（11.9%）发生肿瘤,阴性者23例（38.98%）发生肿瘤。单因素分析显示,抗核抗体阴性皮肌炎患者发生肿瘤的相对危险度估计值比值比为7.52（95% CI 1.62 ~ 13.78,P = 0.003）。在多因素回归模型中,抗核抗体阴性（OR值4.34,95% CI 1.37 ~ 13.72,P = 0.012）和颈部红斑（OR = 3.27,95% CI 1.20 ~ 8.91,P = 0.020）与肿瘤高发概率显著相关,抗核抗体阴性与无肌病性皮肌炎的发生无统计学相关性（OR = 0.99,95% CI 0.32 ~ 2.99,P = 0.980）。结论 抗核抗体阴性且伴颈部红斑的成人皮肌炎患者发生肿瘤的风险明显增加,有必要对这类皮肌炎患者进行密切随访和定期肿瘤筛查。     

B淋巴细胞刺激因子对慢性特发性荨麻疹患者产生抗FcεRI抗体和抗IgE抗体的影响

【摘要】 目的 探讨B淋巴细胞刺激因子（BlyS）能否刺激慢性特发性荨麻疹（CIU）患者B淋巴细胞产生抗FcεRI抗体或抗IgE抗体。 方法 设CIU患者组和健康对照组。ELISA法测定血清中BlyS、抗FcεRI抗体和抗IgE抗体水平,分离培养受试者外周血B淋巴细胞,在培养液中加入BlyS,检测培养液中抗FcεRI抗体和抗IgE抗体水平,分析BlyS与抗FcεRI抗体和抗IgE抗体产生的相关性。结果 CIU患者血清BlyS水平显著高于健康对照组（t = 3.04,P < 0.01）,抗FcεRI抗体和抗IgE抗体水平均显著高于健康对照组（t = 3.51,P < 0.01;t = 3.29,P < 0.01）。CIU患者血清中抗FcεRI抗体和抗IgE抗体水平与BlyS水平呈正相关（r = 0.93,P < 0.01;r = 0.91,P < 0.01）;CIU患者外周血B淋巴细胞培养液中加入有效浓度BlyS后,B淋巴细胞培养液中抗FcεRI抗体和抗IgE抗体水平均显著高于不加BlyS的空白对照 （t = 3.67,P < 0.01;t = 3.56,P < 0.01）,2种抗体在培养液中的水平与BlyS浓度呈正相关（r = 0.96,P < 0.01;r = 0.91,P < 0.01）;抗FcεRI抗体和抗IgE抗体在CIU患者血清与培养液中的检出符合率分别为94.76%和87.84%。 结论 CIU患者血液中BlyS水平增高可刺激B淋巴细胞产生抗FcεRI抗体或抗IgE抗体,可能与CIU发病有关。 【关键词】 荨麻疹; B淋巴细胞刺激因子; 抗体,FcεRI; 抗体,IgE; B淋巴细胞     

荨麻疹

20140756 B淋巴细胞刺激因子对慢性特发性荨麻疹患者产生抗TeεRI抗体和抗IgE抗体的影响/康尔恂（青岛大学医学院附属烟台毓璜顶医院皮肤科）,李杰,孙丽伟…∥中华皮肤科杂志.-2013,46（10）.-707-710 设立CIU（慢性特发性荨麻疹患者）组和健康对照组。ELISA法测定血清中B淋巴细胞刺激因子（BlyS）、抗FcεRI抗体和抗IgE抗体水平;分离培养受试者外周血B淋巴细胞，在培养液中加入BlyS，检测培养液中抗FeεRI抗体和抗IgE抗体水平，分析BlyS与抗FεCRI抗体和抗IgE抗体产生的相关性。     

特应性皮炎患者血清中抗马拉色菌和白念珠菌特异性IgE抗体水平检测

目的:分析特应性皮炎(AD)患者血清抗马拉色菌及抗白念珠菌特异性IgE抗体水平与疾病严重程度的相关性.探讨其在AD发病中的作用.方法:收集符合Williams诊断标准的23例AD患者,对其严重程度以湿疹面积及严重度指数(EASI)评分法进行评分.以免疫荧光-酶技术测定23例AD患者、19名健康对照者的血清总IgE抗体水平、抗马拉色菌及抗白念珠菌特异性IgE抗体水平.分析该地区AD患者总IgE抗体水平、抗马拉色菌及抗白念珠菌特异性IgE抗体水平与疾病严重程度的相关性.结果:AD患者总IgE抗体水平、抗马拉色菌特异性IgE抗体水平高于健康对照者,并与EASI评分呈显著正相关(P＜0.01).结论:部分AD患者抗马拉色菌特异性IgE抗体水平升高,并与EASI评分呈正相关,提示马拉色菌在AD的发病中可能起一定作用.     

系统性红斑狼疮患者皮肤免疫球蛋白E的免疫组织学研究

系统性红斑狼疮(SLE)患者的表皮基底膜上有各种免疫球蛋白和补体成分等沉着,但还没有见到免疫球蛋白E(IgE)沉着的报导。在免疫球蛋白中,一般认为IgE与先天过敏性疾病,特别是与即刻过敏反应型疾病有密切关系。关于SLE,最近相继有报告发表,认为在病情发展期,血清中的免疫球蛋白E浓度升高,而与血中抗核抗体的变动相一致,另外,有IgE抗核抗体的患者,肾病变化发生恶化的情况较之皮疹要多,因此IgE和SLE的关系受到人们重视。作者证明IgE在SLE的皮损及健康皮肤上均有沉着。其情况:1.表皮基底膜上:7例SLE患者中5例IgE为阳性,荧光类型呈现颗粒状或细颗粒状,沿表皮基底膜可以看到有连续性的分布,2.血管上:7例中4例为阳性,发现在真皮毛细血管甚至小血管上。3.表皮细胞核:仅1例在表     

免疫细胞化学微波—SP法检测抗核抗体

用免疫细胞化学微波-SP法（MW－SP法）检测了39例自身免疫性疾病患者的5种抗核抗体（IgG、IgE、IgD、IgA、IgM）。结果发现：（1）ANA主要有3种类型：IgG－ANA、IgE－ANA和IgD－ANA，其中IgE－ANA和IgD－ANA的检测有助于IgG－ANA阴性的自身免疫性疾病的诊断：（2）近半数的病人其ANA表现为多克隆性，表明ANA的多种成分参与了这些疾病的病理过程；（3）MW－SP法是检测ANA的一种简便、快速、灵敏而特异的方法。     

Antinuclear antibodies during Puva therapy.

During PUVA therapy 7 patients out of 34 with severe psoriasis developed circulating antinuclear antibodies (ANA) (21%). Before treatment only 3 patients of 50 (6%) considered for PUVA had detectable ANA. The ANA titres were usually low. Antibodies against native DNA as studied with the Crithidia luciliae test, were not found, and blood and urinary screening for collagenosis was negative. All 7 patients responded well to the PUVA treatment. The significance of these findings remains to be determined.     

Serum soluble nucleosome and the broad family of antinucleosome antibodies are associated with organ and tissue damage in systemic lupus erythematosus in a Chinese population

Nucleosomes and the broad family of antinucleosome antibodies (ANAs; anti-double-stranded DNA, antihistone and antinucleosome antibodies) may contribute to the pathogenesis of systemic lupus erythematosus (SLE). We collected clinical information on 90 patients with SLE and 73 healthy volunteers and measured serum levels of the ANA family using a double-sandwich ELISA. The results showed that the levels of serum nucleosomes of patients with SLE was significantly lower and the levels of ANA were significantly higher than healthy controls. Negative correlations between serum nucleosomes and ANA, and positive correlations between individual ANAs were found. Patients with SLE with positive ANA had a significantly higher frequency of renal disorders than those with negative ANA. Determination of serum nucleosomes and ANAs contributes to SLE monitoring.     

Relevance of complement fixing antinuclear antibodies

Background Connective tissue diseases (CTDs) are a heterogeneous group of disorders defined by the association of a variety of clinical manifestations with immunologic and other laboratory findings. Overlap of syndromes and aberrant findings appear rather frequently. Methods Sera of eight antinuclear antibody (ANA) negative, cases of subacute cutaneous lupus erythematosus (SCLE) with antibodies to Ro (SS-A) and a ninth case with clinical and laboratory signs of Sjögren’s syndrome and systemic lupus erythematosus (SLE) were tested for complement (C′) fixing antinuclear antibodies (C-ANAs). The ninth case was examined in depth by direct immunofluorescence (DIF) and a two-step “C + DIF” test of biopsies for C′ fixation to in vivo bound ANAs, as well as serum tests for C-ANA, ANA, and SCLE markers. Results Sera of five of the eight ANA negative, Ro(SS-A) positive SCLE cases had C-ANAs. The ninth case, a 50-year-old woman with clinical and laboratory signs of Sjögren’s syndrome and SLE, gave a strong positive C + DIF reaction in the skin biopsy for in vivo bound ANAs that fix C′, but negative ANAs and C-ANAs in routine serum tests; they revealed antimitochondrial antibodies. Serum tests on normal skin, however, revealed weak ANA and strong C-ANA reactions with in vitro fixed C′. Conclusions ANA negative cases of SCLE or Sjögren’s syndrome may have C-ANAs. A case with Sjögren’s syndrome and signs of SLE had both in vivo and in vitro C′ fixing ANAs. C-ANA tests can aid in the identification of such cases.     

活化淋巴细胞的ENA免疫原性分析

目的 为了进一步分析活化淋巴细胞可浸出核抗原(ENA)的免疫原性。方法 按照Sharp法提取了正常淋巴细胞和活化淋巴细胞的ENA,分别免疫同系BALB/C小鼠。用ELISA法检测免疫血清中抗dsDNA抗体的动态变化,并进行了免疫血清的ENA多肽谱分析,用间接免疫荧光法观察抗核抗体的荧光核型,并用直接免疫荧光法观察了免疫小鼠的肾脏病理。结果 活性ENA免疫的小鼠血清中可检测出抗核抗体,包括抗ENA抗体和抗dsDNA抗体,抗核抗体核型有颗粒型、均质型、周边型及核仁型;免疫小鼠的肾脏切片可观察到肾小球有IgG类免疫复合物沉积。而正常ENA免疫的小鼠血清中始终检测不出抗核抗体、抗ENA抗体、抗dsDNA抗体,免疫小鼠的肾脏切片亦未见IgG类免疫复合物沉积。结论 活化淋巴细胞ENA亦具有免疫原性,可驱动抗核抗体生成,引起SLE样综合征。     

Positive direct immunofluorescence and autoantibody profiles in psoriasis patients

Psoriasis and systemic lupus erythematosus are common, but their coexistence is thought to be infrequent. Each of these diseases has a broad clinical spectrum, so that diagnosis may not be straightforward. This study aimed to investigate the following immunological parameters in psoriasis patients: (i) direct immunofluorescence (DIF); (ii) antinuclear antibody; (iii) anti-double-stranded DNA (dsDNA); (iv) anti-Ro; and (v) anti-nuclear ribonucleoprotein (nRNP). Of 300 cases, comprising 189 men (62.9%) and 111 women (37.1%), 17 (5.7%; 10 men, seven women) were positive for at least one immunological parameter. Nine of 300 (3%; seven male, two female) biopsy specimens from sun-exposed psoriatic lesions demonstrated bright continuous bands of granular IF along the dermoepidermal junction with immunoreactant immunoglobulin (Ig)G, IgM, C3 and fibrinogen. The intensity of IF at the dermoepidermal junction was graded 3+ and 2+. Three cases demonstrated IgM, two had IgG, two fibrinogen and six cases showed C3. Three cases demonstrated more than one immunoreactant. One case demonstrated C3 at the vessels. No specimen demonstrated IgA deposition. Three hundred sera were obtained from patients with psoriasis, of which five demonstrated elevated antinuclear antibody (ANA) titer; dilution titer varied from 1:80-640. Three had a homogeneous pattern and two had a speckled pattern. None had a peripheral pattern. Five (1.7%) of 300 demonstrated anti-Ro, two had negative ANA, and three were positive ANA, two of which were speckled and the other homogenous. Anti-dsDNA, anti-Sm and anti-nRNP were not detected. Ten patients had positive DIF but negative ANA, while five had positive ANA; all had negative DIF results. Thus, the incidence of psoriasis and lupus erythematosus coexistence is low and a baseline immunological screening test for psoriasis might not prove worthwhile.     

Hypereosinophilic syndrome

A 52-year-old woman suffering from eczematous, nodular, prurigo-like eruptions and systemic disorders including fever and weight loss revealed lymphadenopathy, hepatosplenomegaly, moderate eosinophilia, elevated levels of IgE, and positive ANA. Although the eosinophil count was not always “over 1500/mm³”, one of the criteria for diagnosis of hypereosinophilic syndrome (HES), this case may be considered as mild HES at present. The cause of eosinophilia in this syndrome remains uncertain.     

系统性硬皮病治疗前后血清ANA及ENA抗体检测的意义

目的：探讨ＡＮＡ、ＥＮＡ抗体与系统性硬皮病（ＳＳＤ）转归的关系。方法：免疫印迹法检测７种ＥＮＡ抗体，间接免疫荧光法检测ｄｓＤＮＡ、ＡＮＡ抗体。结果：ＳＳＤ中７种ＥＮＡ抗体阳性率为６４．７％，其中以抗Ｓｃｌ ７０抗体阳性率最高（４１．２％），治疗后抗Ｓｃｌ ７０抗体及抗Ｒｏ部分转阴，ＡＮＡ治疗前阳性率７３．５％，治疗后阳性率及滴度明显下降。结论：ＡＮＡ抗体可作为判断ＳＳＤ病情是否好转的参考指标，抗Ｓｃｌ ７０，抗Ｒｏ部分转阴是否与ＳＳＤ的好转有关，值得进一步观察。     

Large speckle-like thready and thready antinuclear antibody patterns as markers for different clinical presentations in lupus erythematosus

Fifty-one patients with lupus erythematosus were studied retrospectively. They were chosen on the basis of their antinuclear antibody (ANA) immunofluorescent pattern. Only those with the thready or the large speckle-like thready patterns were studied. Autoantibody profiles consisting of ANA, anti-single-stranded deoxyribonucleic acid (ssDNA) antibody, and anti-extractable nuclear antigen (ENA) antibody determinations were obtained. The patients with the thready ANA pattern and anti-ENA (Sm) antibodies had a significantly higher incidence of pulmonary, joint, and renal involvement than the anti-ENA negative patients with the large speckle-like thready pattern. There was also a significantly higher incidence of Raynaud's phenomenon in patients with the thready pattern than in those with the large speckle-like thready pattern. Photosensitivity was seen significantly more frequently in the patients with the large speckle-like thready pattern than in those with the thready pattern.