无锡地区3类人群弓形虫感染调查

目的　了解无锡地区类风湿性关节炎、恶性肿瘤、精神分裂症等3类人群刚地弓形虫感染情况,为后续该人群弓形虫感染防控提供数据支撑。方法　2016–2019年选择无锡地区经确诊的205例类风湿性关节炎病例、257例恶性肿瘤病例、235例精神分裂症病例作为调查对象,以250例健康体检者作为对照。采集全部研究对象人口学特征等相关数据,并采集血清。采用酶联免疫吸附试验检测研究对象血清弓形虫特异性IgG和IgM抗体水平,比较类风湿性关节炎、恶性肿瘤和精神分裂症病例与健康体检者血清抗弓形虫IgG和IgM抗体阳性率差异。结果　无锡地区类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgG抗体阳性率分别为20.98%、24.12%和24.68%,均显著高于健康对照者（χ2 = 31.54、42.12和42.98,P均< 0.01）;类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgM抗体阳性率分别为1.46%、2.72%和1.70%,与健康对照者血清抗弓形虫IgM抗体阳性率比较,差异均无统计学意义（χ2 = 0.06、1.52和0.21,P均> 0.05）。结论　无锡地区类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgG抗体阳性率均显著高于健康体检者,后续应加强刚地弓形虫感染筛查,防止并发弓形虫感染引起的危害。     

无锡地区3类人群弓形虫感染调查

目的　了解无锡地区类风湿性关节炎、恶性肿瘤、精神分裂症等3类人群刚地弓形虫感染情况，为后续该人群弓形虫感染防控提供数据支撑。方法　2016–2019年选择无锡地区经确诊的205例类风湿性关节炎病例、257例恶性肿瘤病例、235例精神分裂症病例作为调查对象，以250例健康体检者作为对照。采集全部研究对象人口学特征等相关数据，并采集血清。采用酶联免疫吸附试验检测研究对象血清弓形虫特异性IgG和IgM抗体水平，比较类风湿性关节炎、恶性肿瘤和精神分裂症病例与健康体检者血清抗弓形虫IgG和IgM抗体阳性率差异。结果　无锡地区类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgG抗体阳性率分别为20.98%、24.12%和24.68%，均显著高于健康对照者（χ2 = 31.54、42.12和42.98，P均< 0.01）；类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgM抗体阳性率分别为1.46%、2.72%和1.70%，与健康对照者血清抗弓形虫IgM抗体阳性率比较，差异均无统计学意义（χ2 = 0.06、1.52和0.21，P均> 0.05）。结论　无锡地区类风湿性关节炎、恶性肿瘤和精神分裂症患者血清抗弓形虫IgG抗体阳性率均显著高于健康体检者，后续应加强刚地弓形虫感染筛查，防止并发弓形虫感染引起的危害。     

妇科恶性肿瘤患者弓形虫感染血清流行病学调查

目的 了解妇科恶性肿瘤患者弓形虫感染情况,为后续该类人群弓形虫感染防控提供依据。方法 收集327例临床妇科恶性肿瘤患者血清样本,同时收集200例女性体检正常者血清作为对照,采用酶联免疫吸附试验（ELISA）检测血清抗弓形虫IgG和IgM抗体,分析不同人群抗弓形虫抗体阳性率差异。结果 327例妇科恶性肿瘤患者总体弓形虫感染率为26.91%（88/327）,高于健康体检者的5.00%（[χ2] = 39.36,[P< 0.01]）;其中血清抗弓形虫IgG抗体阳性率高于健康体检者（26.30% vs. 5.00%;[χ2] = 37.79,[P< 0.01]）,血清抗弓形虫IgM抗体阳性率与健康体检者差异无统计学意义（0.92% vs. 0;校正[χ2] = 0.58,[P> 0.01]）。卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgG抗体阳性率分别为27.68%、25.47%和25.69%,均高于健康体检者（[χ2] = 32.35、27.32、28.00,P 均 < 0.01）,但卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgG抗体阳性率差异无统计学意义（[χ2] = 0.17,[P> 0.05]）。卵巢癌、子宫颈癌和乳腺癌患者血清抗弓形虫IgM抗体阳性率分别为1.79%、0和0.92%,与健康体检者差异均无统计学意义（P 均 > 0.05）。结论 妇科恶性肿瘤患者弓形虫感染率较高,应加强妇科恶性肿瘤患者弓形虫感染防控。     

海南地区消化道恶性肿瘤患者弓形虫感染调查

目的　了解海南地区消化道恶性肿瘤患者血清抗弓形虫抗体水平,为消化道恶性肿瘤患者弓形虫病防控提供参考依据。方法　2016–2019年收集海南省1 932例消化道恶性肿瘤患者作为调查对象,其中食管癌患者376例、胃癌患者475例、结直肠癌患者401例、肝癌患者427例、胰腺癌患者253例,以400例健康体检者作为对照。采用酶联免疫吸附试验检测消化道恶性肿瘤患者和健康体检者血清抗弓形虫IgG和IgM抗体,比较组间抗体阳性率差异。结果　消化道恶性肿瘤患者总体血清抗弓形虫IgG抗体阳性率为19.82%,显著高于健康对照的3.75%（χ2 = 60.49,P < 0.01）,两者总体抗弓形虫IgM抗体阳性率差异无统计学意义（1.09%和0.50%;χ2 = 1.17,P > 0.05）。食管癌、胃癌、结直肠癌、肝癌和胰腺癌患者抗弓形虫IgG抗体阳性率分别为15.16%、19.58%、21.70%、23.65%和17.79%,均显著高于健康对照（χ2 = 29.97、50.29、58.03、67.85、36.59,P均< 0.01）;抗弓形虫IgM抗体阳性率分别为1.06%、1.47%、0.75%、1.17%和0.79%,与健康对照差异均无统计学意义（χ2 = 0.80、2.02、0.20、1.11、0.21,P均> 0.05）。不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率差异有统计学意义（χ2 = 10.65,P < 0.05）,但抗弓形虫IgM抗体阳性率差异无统计学意义（χ2= 1.33,P > 0.05）。结论 　海南地区消化道恶性肿瘤患者血清抗弓形虫IgG抗体阳性率较高,不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率间存在显著差异。建议今后应加强消化道恶性肿瘤患者弓形虫感染筛查,从而有效防控弓形虫感染对消化道恶性肿瘤患者造成的危害。     

海南地区消化道恶性肿瘤患者弓形虫感染调查

目的　了解海南地区消化道恶性肿瘤患者血清抗弓形虫抗体水平，为消化道恶性肿瘤患者弓形虫病防控提供参考依据。方法　2016–2019年收集海南省1 932例消化道恶性肿瘤患者作为调查对象，其中食管癌患者376例、胃癌患者475例、结直肠癌患者401例、肝癌患者427例、胰腺癌患者253例，以400例健康体检者作为对照。采用酶联免疫吸附试验检测消化道恶性肿瘤患者和健康体检者血清抗弓形虫IgG和IgM抗体，比较组间抗体阳性率差异。结果　消化道恶性肿瘤患者总体血清抗弓形虫IgG抗体阳性率为19.82%，显著高于健康对照的3.75%（χ2 = 60.49，P < 0.01），两者总体抗弓形虫IgM抗体阳性率差异无统计学意义（1.09%和0.50%；χ2 = 1.17，P > 0.05）。食管癌、胃癌、结直肠癌、肝癌和胰腺癌患者抗弓形虫IgG抗体阳性率分别为15.16%、19.58%、21.70%、23.65%和17.79%，均显著高于健康对照（χ2 = 29.97、50.29、58.03、67.85、36.59，P均< 0.01）；抗弓形虫IgM抗体阳性率分别为1.06%、1.47%、0.75%、1.17%和0.79%，与健康对照差异均无统计学意义（χ2 = 0.80、2.02、0.20、1.11、0.21，P均> 0.05）。不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率差异有统计学意义（χ2 = 10.65，P < 0.05），但抗弓形虫IgM抗体阳性率差异无统计学意义（χ2= 1.33，P > 0.05）。结论 　海南地区消化道恶性肿瘤患者血清抗弓形虫IgG抗体阳性率较高，不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率间存在显著差异。建议今后应加强消化道恶性肿瘤患者弓形虫感染筛查，从而有效防控弓形虫感染对消化道恶性肿瘤患者造成的危害。     

系统性红斑狼疮和类风湿性关节炎患者ANA、ENA多肽谱及抗ds—DNA抗体联合检测的意义

系统性红斑狼疮（SLE）患者81例,类风湿性关节炎（RA）患者46例,健康体检者30例,抽取血液,分离血清,分别用间接免疫荧光法检测ANA、免疫印迹法检测ENA多肽谱、金标免疫斑点法检测抗ds—DNA抗体。发现SLE患者中,ANA阳性率为90．1％,ENA阳性率为85．2％,抗ds—DNA抗体阳性率为61．7％,三种抗体联合检测阳性率达97．5％;RA患者阳性率分别为34．8％、19．6％、15．2％、52．2％。提示自身免疫性疾病患者体内存在多种自身抗体,联合检测ANA、ENA、抗ds—DNA三项指标有助于疾病的诊断和鉴别诊断。     

杭州市肝病患者弓形虫感染调查

目的 了解杭州市肝病患者弓形虫感染情况,为弓形虫病防治提供参考依据。方法 选择肝癌、乙型肝炎、肝纤维化和肝脂肪变性4类肝脏疾病患者各300例,以1 200例体检健康人群作为对照,检测并比较肝病患者和健康对照人群抗弓形虫IgG和IgM抗体阳性率。结果 1 200例肝病患者中,抗弓形虫IgG抗体阳性288例,阳性率为24.00%;抗弓形虫IgM抗体阳性14例,阳性率为1.17%。1 200例健康对照中,抗弓形虫IgG抗体阳性137例,阳性率为11.42%;抗弓形虫IgM抗体阳性13例,阳性率为1.08%。肝病患者和健康对照抗弓形虫IgG抗体阳性率差异有统计学意义（[χ2] = 65.19,P < 0.01）,但两者抗弓形虫IgM抗体阳性率差异无统计学意义（[χ2] = 0.04,P > 0.05）。肝癌、乙型肝炎、肝纤维化和肝脂肪变性患者抗弓形虫IgG抗体阳性率分别为26.00%、25.00%、23.33%和21.67%,差异无统计学意义（[χ2] = 1.79,P > 0.05）。 结论 杭州市肝病患者抗弓形虫IgM抗体阳性率较高,应加强肝病患者弓形虫病防治和健康教育。     

杭州市糖尿病患者弓形虫感染血清流行病学调查

目的　了解杭州市糖尿病患者弓形虫感染情况。方法　以2017年3月至2020年5月杭州市收治的337例1型糖尿病患者、624例2型糖尿病患者和384例妊娠糖尿病患者作为调查对象,按1∶1的比例分别选择同期年龄和性别相匹配的健康体检者及无妊娠糖尿病孕妇作为对照。采用酶联免疫吸附试验检测糖尿病患者和对照者血清抗弓形虫IgG和IgM抗体,比较糖尿病患者及相应对照血清抗体阳性率差异。结果　杭州市1型糖尿病患者血清抗弓形虫抗体总体阳性率（18.10% vs. 4.45%,[χ2] = 31.38,P < 0.01）和IgG抗体阳性率（14.54% vs. 2.97%,[χ2] = 28.28,P < 0.01）均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义（3.56% vs. 1.48%,[χ2] = 2.96,P > 0.05）。2型糖尿病患者血清抗弓形虫抗体总体阳性率（23.56% vs. 6.57%,[χ2] = 70.37,P < 0.01）和IgG抗体阳性率（21.15% vs. 5.45%,[χ2] = 66.73,P < 0.01）均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义（2.40% vs. 1.12%,[χ2] = 2.96,P > 0.05）。妊娠糖尿病患者血清抗弓形虫抗体总体阳性率（26.30% vs. 19.53%,[χ2] = 4.98,P < 0.05）和IgG抗体阳性率（23.70% vs. 17.71%,[χ2] = 4.20,P < 0.05）均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义（2.60% vs. 1.82%,[χ2] = 0.54,P > 0.05）。结论　杭州市糖尿病患者弓形虫感染血清学阳性率显著高于健康对照,应加强糖尿病患者弓形虫感染筛查和相关健康教育。     

东台市猪肉食品加工企业从业人员弓形虫感染血清流行病学调查

目的 了解东台市猪肉食品加工企业从业人员弓形虫感染情况。方法 以东台市某肉食品加工企业从业人员200例作为调查对象,采集其静脉血并分离血清,采用酶联免疫吸附法检测血清抗弓形虫IgG抗体。 结果 200例肉食品加工企业从业人员中,血清抗弓形虫IgG抗体阳性36例,阳性率为18.0%。不同工龄者血清抗弓形虫IgG抗体阳性率差异有统计学意义（[χ2] = 9.813,P ＜0.05）;随着工龄的增加,血清抗弓形虫IgG抗体阳性率逐渐升高。与动物直接接触频繁者血清抗弓形虫IgG抗体阳性率明显升高。结论 东台市猪肉食品加工从业人员血清抗弓形虫IgG抗体阳性率较高,对此类人群应加强弓形虫感染检测及健康教育。     

杭州市糖尿病患者弓形虫感染血清流行病学调查

目的了解杭州市糖尿病患者弓形虫感染情况。方法以2017年3月至2020年5月杭州市收治的337例1型糖尿病患者、624例2型糖尿病患者和384例妊娠糖尿病患者作为调查对象,按1:1的比例分别选择同期年龄和性别相匹配的健康体检者及无妊娠糖尿病孕妇作为对照。采用酶联免疫吸附试验检测糖尿病患者和对照者血清抗弓形虫IgG和IgM抗体,比较糖尿病患者及相应对照血清抗体阳性率差异。结果杭州市1型糖尿病患者血清抗弓形虫抗体总体阳性率(18.10% vs.4.45%,χ~2=31.38,P 0.01)和 IgG抗体阳性率(14.54% vs.2.97%,χ~2=28.28,P 0.01)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(3.56% vs.1.48%,χ~2=2.96,P 0.05)。2型糖尿病患者血清抗弓形虫抗体总体阳性率(23.56% vs.6.57%,χ~2=70.37,P 0.01)和IgG抗体阳性率(21.15% vs.5.45%,χ~2=66.73,P 0.01)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(2.40% vs.1.12%,χ~2=2.96,P 0.05)。妊娠糖尿病患者血清抗弓形虫抗体总体阳性率(26.30% vs.19.53%,χ~2=4.98,P 0.05)和IgG抗体阳性率(23.70% vs.17.71%,χ~2=4.20,P 0.05)均显著高于健康对照,但两者抗弓形虫IgM抗体阳性率差异无统计学意义(2.60% vs.1.82%,χ~2=0.54,P0.05)。结论杭州市糖尿病患者弓形虫感染血清学阳性率显著高于健康对照,应加强糖尿病患者弓形虫感染筛查和相关健康教育。     

Autoantibodies to human stress proteins. A survey of various rheumatic and other inflammatory diseases

Unselected sera from patients with various rheumatic, inflammatory bowel, and autoimmune skin diseases (n = 268) were examined against human cell lysate by immunoblotting procedures, to determine the prevalence of autoantibodies to stress proteins (heat-shock proteins) hsp60 (homolog of Escherichia coli groEL and mycobacterial 65K antigens), hsp73, and hsp90. Using standard, sensitive and specific assay conditions, IgG and IgM autoantibodies to these stress proteins were not demonstrable, or were detected infrequently, in sera from control subjects (n = 36) and from patients with rheumatoid arthritis, Sj?gren's syndrome, ankylosing spondylitis, Reiter's syndrome, systemic lupus erythematosus, and systemic sclerosis. Autoantibodies to hsp60 were relatively more common (greater than or equal to 20% of sera) in patients with mixed connective tissue disease, polymyositis/dermatomyositis, psoriatic arthritis, inflammatory bowel disease, epidermolysis bullosa acquisita, and bullous pemphigoid. Anti-hsp73 autoantibodies were detected in 20% or more of the sera from patients with Lyme disease and ulcerative colitis. Taken together, these data extend the spectrum of autoimmune and inflammatory diseases in which humoral anti-stress protein autoreactivity develops. However, the paucity of humoral autoreactivity to stress proteins in patients with systemic lupus erythematosus and rheumatoid arthritis argues against a direct role of anti-stress protein autoantibodies in the pathogenesis of these disorders.     

Demonstration of increased influenza-A-antibody levels in the serum of patients with chronic polyarthritis

Patients with rheumatoid arthritis show increased levels of anti-influenza-A antibodies in their sera compared to healthy controls and patients with other inflammatory rheumatic diseases (systemic lupus erythematosus, ankylosing spondylitis and psoriatic arthritis). These antibody levels are dependent on the activity of rheumatoid arthritis.     

Antibodies to and elevations of beta 2 microglobulin in the serum of ankylosing spondylitis patients

Antibodies to beta 2 microglobulin are found in systemic lupus erythematosus patients and are important in the lymphocytotoxic reactions of sera from such patients. In this study, beta 2 microglobulin antibodies were measured with the use of an enzyme-linked immunosorbent assay with purified beta 2 microglobulin antigen and peroxidase-labeled anti-human IgG or IgM. IgG antibodies to beta 2 microglobulin were found in 68% of 22 patients with ankylosing spondylitis. This incidence was higher than the 5% in 80 controls (P less than 0.01) and similar to the 71% incidence found in 35 patients with systemic lupus erythematosus. Eleven (27%) of 41 patients with rheumatoid arthritis had elevated levels of antibodies to beta 2 microglobulin (P less than 0.01). The mean antibody levels expressed in enzyme units were 0.125 for patients with ankylosing spondylitis, 0.157 for those with systemic lupus erythematosus, 0.101 for those with rheumatoid arthritis, and 0.067 for controls. IgM anti-beta 2 microglobulin was not significantly different from controls. A competitive binding assay with enzyme-labeled beta 2 microglobulin was used to determine serum beta 2 microglobulin. These values were also found to be elevated in 48% of patients in all 3 disease categories (P less than 0.01). Beta 2 microglobulin antibodies and serum beta 2 microglobulin did not correlate with each other, renal diseases or antinuclear antibodies in patients with systemic lupus erythematosus, with rheumatoid factor or severity of articular disease in patients with rheumatoid arthritis, or with peripheral arthritis or iritis in those with ankylosing spondylitis. Although antibodies to beta 2 microglobulin might reflect a general disturbance of immune regulation in patients with systemic lupus erythematosus, their presence in those with ankylosing spondylitis, a disease closely associated with a specific HLA allotype and not usually associated with formation of autoantibody, suggests that they might play a role in the pathogenesis of the latter disease.     

Anti-MAM antibodies in rheumatic disease: evidence for a MAM-like superantigen in rheumatoid arthritis?

OBJECTIVE: Superantigens (SAg) are potent immunomodulatory microbial proteins that can activate T cells, B cells, natural killer cells, and monocytes and are known to trigger experimental autoimmune disease. We investigated whether sera from patients with rheumatic diseases contained elevated antibodies to Mycoplasma arthritidis mitogen (MAM) or staphylococcal enterotoxins A and B (SEA and SEB). METHODS: Standard ELISA were used to measure IgG responses to SAg and IgM and IgG rheumatoid factors and total IgM and IgG levels. Modifications of standard lymphocyte proliferation assays were used to determine functional consequences of the observed antibodies. Results: Antibodies to MAM were elevated in sera from patients with rheumatoid arthritis (RA) compared to sera from patients with systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, Reiter's syndrome, or healthy controls. Responses to other SAg were also elevated in rheumatic disease sera, but the levels were not specific for a given rheumatic disease. Anti-superantigen antibody levels did not correlate with the presence of rheumatoid factor. CONCLUSION: The selected elevation of antibodies to MAM in RA sera suggests that MAM or a MAM-like molecule might be associated with RA, whereas elevation of antibodies to SEA and SEB in sera from patients with rheumatic diseases was less specific.     

Anti-Clq antibodies in patients with chronic hepatitis C infection

OBJECTIVE: Extrahepatic autoimmune features of HCV infection include autoantibody production and the development of mixed cryoglobulinemia. Anti-Clq antibody, detected with high frequency in systemic lupus erythematosus and hypocomplementemic urticarial vasculitis, may have a direct pathogenic role in complement mediated autoimmune diseases. In this study, we investigate the prevalence of anti-Clq antibody in a population of patients with chronic HCV infection. METHODS: Serum was obtained from a group of 50 patients with chronic HCV infection and control groups comprised of patients with SLE, rheumatoid arthritis (RA), scleroderma (PSS), Sj?gren's syndrome (SS), mixed connective tissue disease (MCTD), and healthy individuals. RESULTS: Anti-Clq antibody was detected in 38% of HCV patients compared with 2% of healthy controls (p < 0.0001). Levels were also significantly elevated in patients with SLE (61%), RA (20%), PSS (15%), SS (15%) and MCTD (15%). CONCLUSION: In addition to numerous other autoantibodies, patients with chronic HCV infection exhibit increased production of anti-Clq IgG antibodies. This observation may have implications for the pathogenesis of the mixed cryoglobulinemic vasculitis syndrome.     

Rheumatoid factors specific for active rheumatoid arthritis.

To measure rheumatoid factors specific for patients with rheumatoid arthritis an enzyme linked immunosorbent assay (ELISA) was developed to measure rheumatoid factors in human serum that bind a cross-reactive determinant shared on human and other mammalian IgG. Rheumatoid factors that cross link human IgG and sheep IgG in a double binding ELISA were almost completely specific (greater than 99%) for rheumatoid arthritis in assays of 108 sera from patients with rheumatoid arthritis compared with 231 sera from patients with other connective tissue diseases and 365 sera from healthy subjects and patients without these diseases. Moreover, positive tests occurred primarily in patients with active arthritis (r = 0.68). In contrast, these rheumatoid factor autoantibodies were not detected in sera from most of the patients with other autoimmune diseases, including patients with systemic lupus erythematosus. These results show that rheumatoid factors identified in human sera by the double binding test are specific for active rheumatoid arthritis.     

Malignancy and autoimmunity

PURPOSE OF REVIEW: The association of cancer with autoimmune disease has been under investigation for several years. Reports have appeared suggesting increased cancer risk in autoimmune rheumatic diseases. Evidence has been accumulating recently in rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, and scleroderma/systemic sclerosis. This review focuses on recent publications regarding risk of cancer in these conditions. RECENT FINDINGS: Despite a lack of a strong association between rheumatoid arthritis and cancer overall, studies show an increased risk for the development of lymphoma in rheumatoid arthritis. There are data suggesting an increased risk for rheumatoid arthritis patients regarding lung cancer. In Sjogren's syndrome-related malignancies, most publications in the past year relate to non-Hodgkin's lymphomas, and suggest possible mechanisms driving the association. Data substantiate an increased risk of certain cancers in systemic lupus erythematosus; the risk appears to be most heightened for lymphoma. A recent cohort study examined cancer risk in scleroderma; the estimates were lower than previous studies had suggested, and the confidence intervals relatively imprecise, making a definitive conclusion difficult. SUMMARY: There have been several papers published related to cancer in the rheumatic diseases, particularly inflammatory arthritis, Sjogren's syndrome, systemic lupus erythematosus, and scleroderma/systemic sclerosis. Continuing interest in the association between autoimmune rheumatic diseases and malignancy is likely, given the potential impact in terms of understanding both rheumatic diseases and cancer.