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     

Human leukocyte differentiation antigens as therapeutic targets: the CD molecules and CD antibodies

The cell membrane presents an attractive target in a number of different disease situations. Most obviously, malignant cells may be killed by damaging their cell membranes. There are also more subtle, though effective, ways of rendering cells harmless by engaging proteins at the cell surface. The cells of the immune system may be targeted, for example to stop a damaging immune reaction, such as acute inflammation or rejection of a transplanted organ. If we are to make the best use of the opportunities to modulate disease by targeting the cell membrane, we need a detailed understanding of the many proteins, glycoproteins and glycolipids that are attached to or inserted in the cell membrane. The CD (cluster of differentiation) Workshops, more properly known as the HLDA (Human Leukocyte Differentiation Antigens) Workshops have, since 1982, focussed on the study of the membrane molecules of leukocytes, including the major cells of the immune system and malignant cells derived from them. The scope has extended to molecules on endothelium which are important in interaction with leukocytes. Many of the molecules characterised as leukocyte antigens are also expressed on other tissue. The approaches developed by the HLDA Workshops are useful in the study of the molecular composition and function of cells of other organ systems. Some of the antibodies produced in order to study the CD molecules have proved useful as therapeutic agents. This review describes the CD system, how it has developed and what it means and introduces the field of therapy based on antibodies against CD or similar molecules. The author is responsible for organising the next (8th) HLDA Workshop and invites readers to suggest ways in which the therapeutic relevance of the Workshop may be enhanced.     

乙型肝炎患者血清自身抗体检测的研究

目的　检测乙型肝炎患者血清自身抗体并分析其临床意义。方法　以 HEP- 2细胞、鼠胃和鼠肾组织为抗原 ,采用间接免疫荧光法对 1 1 7例乙型肝炎患者血清及 30例正常人血清作抗核抗体、抗平滑肌抗体和抗线粒体抗体检测。结果　乙型肝炎患者自身抗体总阳性率为 1 8.8% ,高于正常对照组 ,差异有显著性 (χ2 =4.1 9,P<0 .0 5 )。自身抗体以低滴度为主 ,多见于抗平滑肌抗体和抗核抗体。结论　乙型肝炎患者存在多种自身抗体 ,观察其自身抗体的滴度与类型对乙型肝炎患者的治疗有一定的参考价值。     

ANA,抗ds—DNA,抗ENA谱联合检测在诊断SLE病人中的应用

为了提高ＳＬＥ的检出率,应用免疫荧光法、金标法和免疫印迹法联合检测５０例ＳＬＥ患者血清中的ＡＮＡ、Ｄｄｓ－ＤＮＡ和ＥＮＡ谱,其结果单一检测阳性率为６０％－７４％,而联合检测的阳性率为９０％,表明联合检测在ＳＬＥ诊断中肯互补性,并能提高检出率。     

Anticardiolipin antibodies in migraine

Antiphospholipid antibodies have occasionally been observed in small series of migraine patients, possibly signalling an immunological pathogenesis in a subgroup. We have measured anticardiolipin antibody levels in a series of 94 migraine patients (35 patients having migraine with aura, 59 without aura), during acute attacks and between attacks. Platelet counts were normal and VDRL was negative in all patients. A low positive anticardiolipin antibody level was found in only one patient, which was negative six months later. There appears to be no association between the presence of anticardiolipin antibodies and migraine. Antiphospholipid antibodies are unlikely to have a material pathogenetic role. Statistically, the incidence of significantly raised anticardiolipin antibody levels in this group of patients does not exceed 4% at a 95% probability level.     

Prevalence of antiphospholipid and antiplatelet antibodies in human immunodeficiency virus (HIV)-infected Chilean patients

Antiphospholipid (aPL) and antiplatelet (aPlt) antibodies, found in patients with autoimmune diseases, are also detected in infectious diseases. The purpose of this study was to examine the prevalence of these antibodies in HIV patients and to evaluate an association of these antibodies with thrombocytopenia and/or thrombosis. Sixty-three HIV-seropositive patients and 52 normal controls were studied. Anti-cardiolipin (aCL), anti-beta(2) glycoprotein I (anti-beta(2)GPI), and antiprothrombin (aPT) antibodies were determined and the lupus anticoagulant (LA) test was performed. Antiplatelet antibodies (aPlt) were also determined. Seven out of 63 (12.7%) HIV patients were positive for aCL, four of 63 (6.3%) for anti-beta(2)GPI, and five of 63 (7.9%) for aPT. No patients studied were LA positive. Six out of 63 (9.5%) patients were positive for aPlt. One of them showed weak reactivity for GPIb-IX. The platelet count of patients (202+/-63 x 10(3) platelets/microL) was significantly lower than in the controls (343+/-6 x 10(3) platelets/microL) (P<0.001). There was no correlation between the presence of aPL and/or aPlt and thrombocytopenia. Of the HIV-infected patients, 22.2% presented aPL and 9.4% aPlt antibodies. In this study, the presence of aPL and aPlt antibodies was not associated with the development of thrombosis and/or thrombocytopenia.     

Therapeutic plasma exchange as a steroid‐sparing therapy in a patient with limbic encephalitis due to antibodies to voltage‐gated potassium channels

Autoantibodies to the voltage‐gated potassium channel (VGKC) complex cause a spectrum of non‐paraneoplastic neurologic syndromes including limbic encephalitis (LE). We report a case of a man with LE who underwent a course of therapeutic plasma exchange (TPE) in addition to other immunomodulatory therapies and experienced sustained clinical resolution of his symptoms. This report adds to the existing literature supporting TPE in cases of LE due to VGKC complex autoantibodies. J. Clin. Apheresis 31:63–65, 2016. © 2015 Wiley Periodicals, Inc.     

Association of CagA-Dositive infection with Helicobacter pylori antibodies of IgA class

cagA gene, the best known virulence factor of Helicobacter pylori, codes for an immunodominant CagA protein. In this study, CagA antibodies of the IgG class were measured by immunoblot or enzyme immunoassay in subjects with positive H. pylori serology, and the presence of CagA antibodies was compared with that of H. pylori antibodies of IgA and IgG classes. Serum samples were available for a total of 1481 subjects, including gastroscopied patients with biopsy-verified H. pylori infection, smoking men with a normal or low serum pepsinogen I level indicating atrophic corpus gastritis, and subjects who later developed gastric cancer and their matched controls. CagA antibodies were significantly more prevalent among individuals with elevated H. pylori antibody titres of the IgA class than in those with IgG antibodies only, with the exception of a small subgroup of individuals who later developed gastric cancer. CagA-positive H. pylori strains seem to induce an immune response with a markedly higher frequency of IgA than what is found in inflammation caused by CagA-negative strains. The presence of serum IgA antibodies to H. pylori seems to indicate a higher risk for CagA-positive H. pylori infection and possibly more severe late sequelae of the disease.     

抗Dia合并抗E抗体致交叉配血不合的临床分析

目的：探讨交叉配血中抗 Dia 合并抗 E 抗体致配血不合的原因。方法对该院1例因抗 Dia 合并抗 E 抗体致多次配血不合的患者进行分析。通过血型鉴定、直接抗人球蛋白试验、不规则抗体筛查、吸收放散实验来确定患者的血型、可能的不规则抗体、细胞谱反应格局。结果患者血型正定型：抗 A 抗体（－）、抗 B 抗体（－）;反定型：Ac（＋＋＋＋）、Bc（＋＋＋＋）、RBC （－）、Oc（－）;Rh 血型定型：抗 c 抗体（－）、抗 C 抗体（＋＋＋＋）、抗 D 抗体（＋＋＋＋）、抗 e 抗体（＋＋＋＋）、抗 E 抗体（－）。直接抗人球蛋白试验（－）。患者血清中含有抗 E、抗 c 抗体。结论患者血清中的不规则抗体是导致交叉配血不合的重要原因。     

Prevalence of antiphospholipid antibodies in Chilean patients with rheumatoid arthritis

Antiphospholipid (aPL) antibodies found in patients with autoimmune diseases are also detected in those with inflammatory diseases. The purpose of this study was to examine the prevalence of these antibodies in patients with rheumatoid arthritis (RA), and to evaluate the association of these antibodies with thrombosis and/or other clinical characteristics of this inflammatory disorder. Eighty-four patients with RA and 82 normal controls were studied. Anticardiolipin (aCL), anti-beta(2) glycoprotein I (anti-beta(2)GPI), and antiprothrombin (aPT) antibodies and the lupus anticoagulant (LA) activity were determined. Seven out of 84 (8.3%) patients were positive for aCL, six out of 84 (7.2%) for anti-beta(2)GPI, and six out of 84 (7.2%) for aPT, while in controls the overall prevalence of aPL antibodies was 3.6% (3 out of 82). All patients and controls were LA negative. There was no correlation between the presence of aPL with thrombosis and/or other clinical features of the antiphospholipid syndrome. We found aPL antibodies in 19.1% (16 out of 84) of the patients with rheumatoid arthritis and this prevalence was statistically higher than in normal controls (P<0.003). In this study, the presence of aPL antibodies was not associated with the development of thrombosis and/or thrombocytopenia. Whether the presence of aPL antibodies implies an increased risk for thrombosis and atherosclerosis in these patients should be studied further.     

原发性胆汁性肝硬化85例实验室检测指标的分析

目的探讨原发性胆汁性肝硬化（PBC）的免疫学实验诊断特点。方法观察85例PBC患者的临床表现,并分析有关实验室检查资料。结果本组患者临床症状不典型。所有患者γ-谷氨酰转移酶（GGT）升高,98．8％（84／85）的患者碱性磷酸酶（ALP）升高,87．1％（74／85）的患者总胆红素（TBil）和结合胆红素（CBil）升高,81．2％（69／85）的患者丙氨酸转氨酶（ALT）、78．8％（67／85）的患者门冬氨酸转氨酶（AST）、52．9％（45／85）的患者球蛋白（GLB）、95．7％（22／23）的患者总胆汁酸（TBA）、84．0％（21／25）的患者高密度脂蛋白胆固醇（HDL-C）升高。自身抗体检测有59例抗核抗体（ANA）阳性（69％）,其中32例为核膜型,20例为着丝点型;85例患者抗线粒体抗体（AMA）均为阳性,其中80例（94．1％）AMAM2阳性。结论PBC无典型性临床症状,医生可以通过临床表现结合AMA,尤其是AMAM2的检测结果获得诊断信息。     

原发性胆汁性肝硬化85例实验室检测指标的分析

目的探讨原发性胆汁性肝硬化(PBC)的免疫学实验诊断特点。方法观察85例PBC患者的临床表现,并分析有关实验室检查资料。结果本组患者临床症状不典型。所有患者γ-谷氨酰转移酶(GGT)升高,98.8%(84/85)的患者碱性磷酸酶(ALP)升高,87.1%(74/85)的患者总胆红素(TB il)和结合胆红素(CB il)升高,81.2%(69/85)的患者丙氨酸转氨酶(ALT)、78.8%(67/85)的患者门冬氨酸转氨酶(AST)、52.9%(45/85)的患者球蛋白(GLB)、95.7%(22/23)的患者总胆汁酸(TBA)、84.0%(21/25)的患者高密度脂蛋白胆固醇(HDL-C)升高。自身抗体检测有59例抗核抗体(ANA)阳性(69%),其中32例为核膜型,20例为着丝点型;85例患者抗线粒体抗体(AMA)均为阳性,其中80例(94.1%)AMA M2阳性。结论PBC无典型性临床症状,医生可以通过临床表现结合AMA,尤其是AMA M2的检测结果获得诊断信息。     

抗细胞膜DNA抗体、抗核抗体及抗双链DNA抗体联合检测在系统性红斑狼疮诊断中的应用价值

目的评价抗细胞膜DNA抗体(anti-cmDNA)、抗核抗体(ANA)、抗双链DNA抗体(anti-dsDNA)单指标及多指标联合方案在SLE诊断中的应用价值。方法选取2017年9月至12月中山大学附属中山医院门诊和住院的101例SLE患者,94例非SLE自身免疫病患者,78名健康人,检测血清anti-cmDNA、ANA及anti-dsDNA水平。其中anti-cmDNA和anti-dsDNA检测采用ELISA法,ANA检测采用间接免疫荧光法。检测方案分为单指标以及双指标、三指标检测,共18种方案。检测结果组间比较采用四格表配对卡方(χ~2)检验。结果 SLE患者组anti-cmDNA阳性率(68.3%)明显高于非SLE自身免疫病组和健康人对照组,差异均有统计学意义(P0.05)。在单指标检测方案中,anti-cmDNA检测的准确率(81.7%)、约登指数(0.58)均最高。在多指标联合检测方案中,anti-dsDNA/anti-cmDNA、ANA+(anti-dsDNA/anti-cmDNA)、anti-dsDNA/(ANA+anti-cmDNA)、anti-cmDNA/(ANA+anti-dsDNA)和(ANA+anti-cmDNA)/(anti-dsDNA+anti-cmDNA)/(ANA+anti-dsDNA)这5种方案的准确率(84.2%)、约登指数(0.65)最高。结论 Anti-cmDNA无论单指标还是以其为基础的多指标联合检测方案对SLE诊断均有较高价值。     

弥漫性毒性甲状腺肿患者抗中性粒细胞胞浆抗体临床分析及相关文献复习

目的:了解初诊弥漫性毒性甲状腺肿(Graves病,Graves disease,GD)患者抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibodies, ANCA)及甲状腺过氧化物酶抗体(thyroperoxidase antibodies, TPOAb)检出情况,并分析ANCA与TPOAb的关系.方法:将60例初诊未经治疗的GD患者设为研究组,40名体检健康者设为对照组,采用间接免疫荧光法检测血清ANCA,采用放射免疫分析方法检测TPOAb,比较2组ANCA及TPOAb的检出情况;检索1994～2005年有关初诊GD与ANCA关系的研究文章进行荟萃分析.结果:研究组仅2例(3%)初诊未治疗GD患者检测出ANCA(均为c-ANCA型),对照组均未检测出ANCA,2组检出率比较差异无统计学意义.34例(57%)GD患者TPOAb阳性,对照组无TPOAb阳性者,2组比较差异有统计学意义(P＜0.01).而GD患者中TPOAb阳性与阴性患者的ANCA检出率比较差异无统计学意义[2例(5.9%)与0].有关初诊未治疗GD的研究文章共9篇,ANCA检出率为0～50%(除1篇检出率为50%外,其余检出率0～6%).结论:初诊GD患者ANCA检出率较低,GD患者的ANCA可能与TPOAb无交叉反应.     

A study on associations between antiprothrombin antibodies, antiplasminogen antibodies and thrombosis

Summary.  Anti-prothrombin antibodies are a frequent cause of lupus anticoagulant (LAC), a thrombotic risk factor. Prothrombin shares structural homology with plasminogen, a kringle protein with an important role in fibrinolysis. Cross-reactivity between antiprothrombin antibodies and plasminogen has been described. To study associations between LAC, IgG and IgM class antiprothrombin and antiplasminogen antibodies, plasminogen activity levels and thrombosis in selected patients with systemic autoimmune diseases. Patients included forty-six consecutive LAC-positive patients (29 with systemic lupus erythematosus (SLE); 33 with a thrombotic history), 38 patients without LAC (36 with SLE; seven with a history of thrombosis) and 40 healthy controls. In the total group of 84 patient samples, the prevalence of antiprothrombin and antiplasminogen antibodies was 30 and 38%, respectively. There was no significant relationship between the presence of these antibodies. In contrast to presence of antiplasminogen antibodies, presence of antiprothrombin antibodies was statistically significant related to thrombosis. Thirteen samples had antiprothrombin and antiplasminogen antibodies of similar isotype (IgG, n = 4; IgM, n = 9). Of these, all but one had LAC and 11/13 came from patients with a history of thrombosis. Simultaneous presence of IgM-class antiprothrombin and antiplasminogen antibodies had a significant association with thrombosis. Levels of plasminogen activity were similar in samples from healthy controls and patients (with or without antiplasminogen antibodies or thrombosis). Anti-prothrombin antibodies and antiplasminogen antibodies occur frequently in patients with systemic autoimmune disease. Anti-prothrombin antibodies, but not antiplasminogen antibodies are a risk factor for thrombosis. Anti-plasminogen are in most cases unrelated to antiprothrombin antibodies.     

体内体外联合免疫法制备抗鼻咽癌单克隆抗体

目的】获得高特异性的抗鼻咽癌单克隆抗体。【方法】以湖南鼻咽癌细胞株HNE2细胞作免疫原 ,经体内体外联合免疫方法获得免疫脾细胞 ,并与SP2 /0骨髓瘤细胞融合获得抗鼻咽癌单克隆抗体的杂交瘤细胞系 ,用ELISA、免疫组化筛选阳性克隆。【结果】获得 10株稳定分泌抗鼻咽癌单克隆抗体的杂交瘤 ,其中HNL1和HNL5用免疫组化检测对鼻咽癌组织反应的阳性率分别为 6 0 .0 %和 6 5 .0 %。【结论】抗鼻咽癌单克隆抗体HNL1,HNL5对鼻咽癌有较好的选择性     

Clinical evaluation of a microsphere bead-based flow cytometry assay for the simultaneous determination of anti-thyroid peroxidase and anti-thyroglobulin antibodies

OBJECTIVES: Multiplexing technologies based on the use of microspheres as the solid phase have opened new possibilities for the analysis of autoantibodies. As an alternative to the traditional immunoassays, it is possible to use these methods in combination with flow cytometry for simultaneous measurement of anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies. DESIGN AND METHODS: We studied 127 serum samples sent to our laboratory for the quantitation of anti-TPO and anti-Tg antibodies. Clinical information was available for all of the patients studied. The samples were analyzed simultaneously for both antibodies by flow cytometry (FIDIS, BMD, France), and individually for each of the antibodies by an automated enzyme immunoassay (UniCap, Pharmacia Diagnostics, Germany). RESULTS: A significant association between the results was observed. The kappa agreement indices between the methods were 0.859 and 0.832 for anti-TPO and anti-Tg, respectively. Discrepant results between the two techniques were observed with no common cause. Anti-TPO and anti-Tg antibodies exhibited a non-Gaussian distribution. The areas under the ROC curves were similar for both methods used; for anti-TPO, 0.884 (Pharmacia) and 0.853 (BMD), and for anti-Tg, 0.833 (Pharmacia) and 0.837 (BMD). CONCLUSION: Cytometry multiplex technology offers a true alternative to conventional immunoassays in the analysis of anti-TPO and anti-Tg antibodies.     

7种抗体在原发性不孕不育妇女中的应用价值

目的：探讨抗精子抗体（AsAb）、抗心磷脂抗体（AcAb）、抗子宫内膜抗体（EMAb）、抗卵巢抗体（AO-Ab）、抗透明带抗体（AZPAb）、抗滋养层细胞膜抗体（TAAb）、抗 HCG 抗体检测在原发性性不孕不育妇女中的应用价值。方法采用 ELISA 法检测13840例女性不孕不育患者进行血清中 AsAb、AcAb、EMAb、AOAb、ZP-Ab、TAAb、抗 HCG 抗体,同时与健康组作对比研究。结果不孕不育组 AsAb、AcAb、EMAb、AOAb、AZPAb、TAAb、抗 HCG 抗体的阳性率分别为29．17％、1．5％、3％、1．4％、0．4％、0．4％、0．2％,健康组 AsAb、AcAb、EMAb、AO-Ab、AZPAb、TAAb、抗 HCG 抗体的阳性率分别为1％、0．2％、0．1％、0．1％、0％、0％、0％;两组结果中,AsAb、AcAb、EMAb、AOAb 结果差异有统计学意义（P ＜0．01）;而 AZPAb、TAAb、抗 HCG 抗体结果差异无统计学意义（P ＞0．05）。结论AsAb、AcAb、EMAb、AOAb 是引起女性原发性不孕不育的重要免疫因素,不孕不育者应进行免疫性抗体的检测,而 AZPAb、TAAb、抗 HCG 抗体在原发性免疫性不孕不育患者中不是重要的免疫因素。     

系统性红斑狼疮疾病活动性的血清学指标的评价

目的探讨抗核小体抗体(AnuA),抗C1q抗体和抗dsDNA抗体与系统性红斑狼疮(Systemic lupus erythemato-sus,SLE)活动性的关系。方法对33例狼疮肾炎(L nephritis,LN)患者血清进行检测抗核小体抗体,抗Clq抗体,抗ds-DNA抗体,以43例无肾炎临床表现的SLE患者做为对照组。同时将76例SLE患者按SLEDAI评分分为SLEDAI≥10分组与SLEDAI<10分组两组,进行抗核小体抗体,抗Clq抗体和抗dsDNA抗体与SLE活动度相关性的分析。结果LN患者血清中抗核小体抗体。C1q抗体浓和抗dsDNA抗体的阳性率显著高于非LN组(P<0.01),与SLE对照组比较差异也有统计学意义(P<0.05)。同时SLEDAI≥10分组,抗核小体抗体,抗C1q抗体和抗dsDNA抗体浓度及阳性率显著高于SLEDAI<10分组(P<0.01),3种抗体有较高的灵敏度,特异性。三者联合检测的灵敏度(66.7%),特异性(85.7%)。相关性分析表明血清中抗核小体抗体,抗C1q抗体和抗dsDNA抗体与SLEDAI评分呈正相关。分别以LN和SLEDAI作为因变量将抗核小体抗体,抗C1q抗体,抗dsDNA抗体,抗Sm抗体,抗nRNR抗体进行Logistic回归统计分析。结果显示以LN作为因变量入选的自变量有抗C1q抗体,抗Sm抗体(P<0.05),以SLEDAI作为因变量入选的自变量有抗核小体抗体,抗C1q抗体和抗dsDNA抗体(P<0.05)。结论在LN患者和SLEDAI≥10分组中,存在抗核小体抗体,抗C1q抗体和dsDNA抗体的高表达。3种血清标志物和SLE疾病的活动性密切相关。