SSA抗原及其不同阳性表位的临床意义

目的 区别与SSA抗原不同阳性表位结合的抗SSA抗体在疾病中对机体损伤的不同性,探讨抗60000SSA抗体在相关自身免疫病中的致病作用。方法 用按已知60000SSA抗原多肽链中20个阳性表位和1个阴性片段的氨基酸序列人工合成的不同表位寡肽(MAPs)为抗原,以ELISA方法检测59例抗SSA抗体阳性的患者血清,分析引起机体不同损伤的抗SSAMAPs抗原抗体的特点。结果 抗60 000SSA抗体是一种多克隆抗体,不同病人所具备的抗体与60000SSA抗原发生免疫反应的表位可以不同。抗21个MAPs抗体的阳性与否和皮肤损伤无明显相关性;抗2、14、15、21号MAPs抗体阳性与否与唾液腺损伤具有正相关性;抗7、16号MAPs抗体阳性与否和肾脏损伤具有负相关性;抗6号MAPs抗体阳性与否和心脏损伤具有负相关性。结论某些MAPs抗体的出现提示一定器官受损;某些MAPs抗体的出现则对一定的器官具有保护作用。由此提示：可能是不同病人具有抗不同MAPs的抗体,从而导致出现不同的临床症状。

The clinical significance of SSA antigen and its different positive expressions

OBJECTIVE: To distinguish the difference among the pathogenesis of 60 000 SSA antigen mono-antigen peptides (MAPs), and to discuss the nosogenesis of anti-60 000 SSA antibodies in correlative rheumatic diseases. METHODS: MAPs were artificially synthesized according to the amino acid sequence of 20 positive epitopes and 1 control segment of 60 000 SSA antigen. ELISA against recombinant 60 000 SSA antigen MAPs were done to detect anti-MAPs antibodies in 59 sera with anti-SSA antibodies, and analyzing the relations of anti-MAPs antibodies and organism injuries. RESULTS: Anti-60 000 SSA antibodies are multiple clone autoantibodies. Different patients have different immune response to MAPs. Anti-MAP(1 approximately 21) antibodies have no relation to skin lesion; anti-MAP(2,14,15,21) antibodies have positive relation to salivary gland lesion; anti-MAP(7,16) antibodies have negative relation to kidney lesion; anti-MAP(6) antibodies have negative relation to heart lesion. CONCLUSIONS: The appearance of some anti-MAPs antibodies implies the lesions of some organs, while the appearance of some other anti-MAPs antibodies have the protection to some organs. We concluded that it is maybe the different anti-MAPs antibodies that result in different clinical manifestations.