慢性荨麻疹患者病情严重程度与免疫五项的相关性分析

目的:分析慢性荨麻疹患者病情严重程度与血清免疫五项的相关性。方法:对160例慢性荨麻疹患者进行荨麻疹活动度评分(Urticaria Activity Score,UAS)和皮肤病生活质量评分(Dermatology Life Quality Index,DLQI),判断患者病情严重程度并分别检测其血清免疫五项指标。80例正常对照组的血清免疫五项指标作对照。对临床病情严重程度和检验结果的相关性进行了分析。结果:慢性荨麻疹患者血清IgA,C3、C4均显著低于正常对照组(P0.05);IgM高于正常对照组,差异无统计学意义(P0.05);IgG显著高于正常对照组(P0.05)。CU患者UAS评分与血清C3/C4浓度呈负相关(P0.05),与血清IgA、IgM和IgG浓度不相关(P0.05);生活质量评分与血清IgA、IgM、IgG、C3、C4浓度无显著相关性(P0.05)。结论:血清IgA、IgG、C3、C4浓度与慢性荨麻疹发病有关,其中血清C3/C4浓度或可成为慢性荨麻疹病情严重程度的评估指标。     

体液免疫因素在痤疮瘢痕形成过程中的作用

目的通过检测中度以上痤疮患者血清中免疫球蛋白和补体水平,探讨痤疮瘢痕患者形成的免疫学方面机制。方法采集中度以上痤疮瘢痕患者(瘢痕组)的血清,用免疫速率散射比浊法检测受试者血清IgE、IgG、IgM和补体C3、C4水平,并以中度以上痤疮无瘢痕(无瘢痕组)、Ⅰ级(轻度)痤疮以及正常人作为对照组。分析痤疮瘢痕组患者血清免疫球蛋白和补体与瘢痕形成的相关性。结果瘢痕组血清IgG、IgE、IgM和C3水平高于其他3组,经比较差异均有统计学意义(P0.05)。痤疮瘢痕组患者血清3种免疫球蛋白相关性分析结果显示:IgG与IgM显著相关(P0.01),IgE与IgG相关(P0.05)。结论体液免疫中抗体和补体与痤疮瘢痕发生密切有关。     

SLE患者血清IL-15水平检测及其意义

检测系统性红斑狼疮（SLE）患者血清IL-15水平并探讨其临床意义。方法：用双抗体夹心ELISA法检测42例SLE患者和20例正常人外周血IL-15的水平、活动期与非活动期SLE患者外周血IL-15的水平，按常规方法检测了血清补体，抗ds—DNA抗体，抗ENA抗体谱，免疫球蛋白IgG、IgM、IgA等指标。结果：与正常人相比，SLE患者血清IL-15水平增高（P〈0．05）；且活动期SLE患者血清IL-15水平显著高于非活动期的水平；出现抗ds—DNA阳性、低补体C3血症、高IgG血症的IL-15水平均分别显著高于无上述表现者。SLE患者血清IL-15水平明显升高，且其血清水平与抗ds—DNA阳性、补体低下，高免疫球蛋白血症具有相关性，它可能在SLE的发病机制中起一定作用。     

系统性红斑狼疮女性患者血清免疫球蛋白和补体与年龄的关系

目的探讨系统性红斑狼疮(SLE)患者血清免疫球蛋白和补体与年龄的关系。方法用免疫散射比浊法检测218例女性SLE患者及98名正常对照组女性的血清免疫球蛋白和补体,分析其与年龄的关系。结果女性SLE患者血清IgM水平(1.069±0.553)与正常对照组(1.161±0.443)相比,差异无统计学意义(P>0.05),血清IgG(17.515±5.845)和IgA(3.282±1.672)水平均显著高于正常对照组(12.668±2.918和2.315±0.750),但血清C3(0.895±0.327)和C4(0.156±0.086)水平均显著低于正常对照组(1.160±0.183和0.245±0.065),差异均有统计学意义(P均<0.01);血清IgA,C3和C4水平与年龄呈正相关(P均<0.05),而正常对照组免疫球蛋白和补体水平则与年龄无关(P均>0.05)。结论女性SLE患者血清IgG,IgA,C3和C4存在异常,IgA,C3和C4的异常与年龄相关。     

系统性红斑狼疮患者甲状腺功能的改变

目的:了解系统性红斑狼疮患者甲状腺功能的改变。方法:检测26例系统性红斑狼疮(SLE)患者自身甲状腺抗体(IGab,PTOab)和甲状腺功能(T3、T4、FT3、FT4和TSH)。21例健康体检者和20例普通皮炎患者作为对照组。同时将(SLE)患者甲状腺功能与免疫球蛋白、补体C3、抗核抗体、DsDNA-Ab和血沉水平进行相关性分析。甲状腺增大患者做甲状腺病理检查。结果:SLE组甲状腺自身抗体TPOab增高,TGab变化不显著,SLE组T3、FT3和FT4水平均较两对照组降低,TSH和T4变化不明显。SLE多数患者甲状腺大小和质地均正常。SLE组甲状腺抗体、甲状腺功能和DsDNA-Ab、ANA、ESR、IgG、IgA、IgM和补体C3水平无相关性。结论:SLE患者活动期存在甲状腺功能的改变。     

慢性自发性荨麻疹免疫相关指标与病情的相关性分析

目的：探讨慢性自发性荨麻疹（ CSU）患者免疫相关指标：ASST、总IgE、免疫五项及甲状腺自身抗体与CSU病情的相关性。方法：收集79例确诊为CSU患者的血清标本,检测ASST、IgE、C3、C4、IgA、IgM、IgG及甲状腺自身抗体（ TPOAB、TGAB）水平,采用UAS7法评估患者病情,分析各指标与病情的相关性,并与正常对照组30例比较。结果：79例患者中ASST阳性率为54％,ASST、血清总IgE、C3、C4、IgA、IgM、IgG、TPOAB及TGAB水平与UAS7评分均无相关性（ P值均＞0.05）。病情为轻度的患者血清C3水平明显低于中度,差异有统计学意义（P＜0.05）。与正常对照组比较,CSU患者各指标中仅总IgE水平高于正常对照组,差异存在统计学意义（ P＜0.05）。结论：补体C3水平可为评估CSU患者病情提供一定的参考价值。     

女性寻常性痤疮患者免疫球蛋白补体及可溶性IL-2R的检测

目的：探讨女性寻常性痤疮患者细胞及体液免疫功能状况。方法：采用速率散射比浊法测定58例女性寻常性痤疮患者免疫球蛋白IgG,IgA,IgM及补体C3、C4；采用ELISA双抗体夹心法测定58例女性寻常性痤疮患者血清可溶性白细胞介不2受体(sIL-2R）水平；同时以30例正常女性作为对照。结果：患者组免疫球蛋白IgG,IgA,IgM及补体C3、C4无明显变化；但痤疮严重程度不同，IgG的变化差异有显著性（P＜0．001），其余指标差异无显著性，Ⅰ度组IgG明显低于正常对照组（P＜0．01）；Ⅱ度组与正常对照差异无显著性（P＞0．05）；Ⅲ度组较正常对照组明显升高（P＜0．001）。痤疮越严重，IgG越高，Ⅱ度组显著高于Ⅰ度组（P＜0．05），Ⅲ度组显著高于Ⅱ度组（P＜0．001），血清sIL-2R水平明显高于正常人对照（P＜0．001）。结论：免疫反应参与了痤疮的发病过程，免疫反应答涉及及到体液免疫及细胞免疫两个途径。     

血清正五聚素蛋白-3水平与系统性红斑狼疮患者活动期的关系

目的探讨正五聚素蛋白-3(PTX3)与系统性红斑狼疮(SLE)患者活动性的相关性。方法本次研究纳入75例SLE患者和75例健康对照组(HC),2组年龄、性别基本匹配。收集受试者一般资料并留取血清,采用酶联免疫吸附法(ELISA)检测所有受试者血清PTX3水平。结果血清PTX3水平在SLE患者中显著高于健康对照组(P0.05)。此外,活动期SLE患者的血清PTX3水平显著高于非活动期(P0.05),且随着SLE疾病活动指数(SLDAI)评分的增高血清PTX3逐渐升高。相关性分析结果显示血清PTX3水平与C-反应蛋白(CRP)、红细胞沉降率(ESR)和SLDAI呈显著正相关(均P0.05)。此外,多因素Logistic回归分析结果显示,PTX3可作为评估SLE疾病活动期的独立因素。进一步ROC曲线分析结果显示,PTX3诊断SLE的敏感性、特异性、曲线下面积(AUC)分别为69.3%、82.7%、0.754(95%CI为0.674～0.834);PTX3区分SLE活动期与非活动期的敏感性、特异性、AUC分别为58.9%、89.5%、0.732(95%CI为0.615～0.849)。结论血清PTX3水平在SLE患者中显著增高,且与疾病活动性相关。PTX3可作为SLE的一个新型生物标记物用于SLE的病情监测。     

银屑病患者红细胞天然免疫与免疫球蛋白、补体及可溶性IL-2R的相关性研究

目的 :　探讨银屑病患者红细胞天然免疫与细胞及体液免疫功能的状况及其相互关系。方法 :应用流式细胞仪检测银屑病患者新鲜红细胞表面CD35分子的表达水平 ,并同时采用速率散射比浊法对血清中IgG、IgA、IgM及C3、C4 含量进行测定 ,采用双抗体夹心法测定血清可溶性白细胞介素 - 2受体(sIL 2R)水平。结果 :　银屑病患者红细胞CD35定量和IgA、C3及C4 含量均较正常人明显增高 (P <0 .0 5 ,P <0 .0 1,P <0 .0 0 1,P <0 .0 1) ,红细胞CD35定量与IgA呈高度显著正相关 (γ =0 .6 6 8,P <0 .0 0 1) ,与sIL 2R呈显著正相关 (γ =0 .395 ,P <0 .0 5 ) ,与C4 呈显著正相关 (γ =0 .4 0 3,P <0 .0 5 )。结论 :　银屑病发病与免疫异常有关 ,红细胞天然免疫与细胞及体液免疫相互联系共同参与了银屑病的过程 ,并可能在发病机制中具有重要作用     

血清中抗酪氨酸酶抗体的检测与白癜风活动性的关系

目的：探讨白癜风患者血清中抗酪氦酸酶IgG、IgM抗体滴度与疾病活动程度的关系和意义。方法：抗酪氯酸酶IgG、IgM抗体检测采用酶联免疫吸附试验（ELISA）方法。结果：①白癜风患者血清抗酪氨酸酶IgG抗体、平均滴度为0．316，显著高于正常对照组0．082（P〈0．001）；抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常对照组0．065（P〈0．001），②活动期白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期白癫风患者（均P〈0.001）；泛发型白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于局限型白癜风患者（均P〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IGg抗体性呈正相关（均P〈0．001）；抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgM抗体阳性呈正相关（均P〈0．001）。①糖皮质激素治疗后患者抗酪氨酸酶IgG、IgM抗体滴度均低于治疗前（均P〈0．001）。结论：白癜风患并血清抗酪氨酸酶IgG、IgM抗体与疾病活动性和严重程度相关。     

Humoral and cellular immunity in children with active and quiescent atopic dermatitis

Serum immunoglobulins (IgG, IgM, IgA and IgE), C3, and C4, T lymphocyte subsets, neutrophil chemotaxis and natural killer cell-mediated cytotoxic activity were measured in 34 children with atopic dermatitis and 31 healthy controls. Twenty-four patients were re-evaluated when their dermatitis was quiescent. Serum levels of IgG, IgM and IgE were significantly higher in the patients with atopic dermatitis than in the controls, while levels of serum IgA did not differ significantly between the two groups. C3 levels were lower in the patients than in the controls and correlated inversely with clinical disease severity. C4 levels were not significantly altered. Numbers of suppressor/cytotoxic T lymphocytes and polymorphonuclear leukocyte chemotaxis were significantly reduced in the atopic patients. There was a significant inverse correlation between the natural killer cell-mediated cytotoxic activity and the severity and extent of the dermatitis. These results support the hypothesis that atopic dermatitis is connected with a defect in cellular immunity.     

系统性红斑狼疮患者血清sCD14测定

目的 通过检测ＳＬＥ患者血清ｓＣＤ１４水平,研究其与ＳＬＥ有关指标的关系,以ＣＤ１４在ＳＬＥ发病中的作用。方法 收集ＳＬＥ患者和正常人群血甭,用双抗体夹心ＥＬＩＳ法测Ａ值,在标准曲线上查ｓＣＤ１４含量。结果 ９４例ＳＬＥ患者血清ｓＣＤ１４较正常对照人群显著增高,且活动期高于缓解期,与疾病活动指数,ＡＮＡ滴度呈显著正相关,与Ｃ３显著负相关。     

Antidouble-stranded DNA isotypes in lupus erythematosus patients with prevalent cutaneous presentation

BACKGROUND: Antidouble-stranded DNA antibodies (anti-dsDNA Ab), in particular of the IgG isotype, are usually considered a marker of systemic lupus erythematosus and often correlate with the disease activity. OBJECTIVES: To determine IgG, IgA and IgM anti-dsDNA Ab in a group of 330 patients with lupus erythematosus and prevalent cutaneous lesions. METHODS: The titre of anti-dsDNA Ab was determined by enzyme-linked immunosorbent assay, and disease activity was assessed by means of the systemic lupus activity measure. RESULTS: One hundred and six patients had anti-dsDNA Ab. Thirty-nine patients had antibodies of all three isotypes of immunoglobulins, 17 had IgG + IgM, five IgG + IgA, and two IgA + IgM. Forty-three patients had a single isotype of anti-dsDNA Ab. Patients with systemic disease and higher disease activity had antibodies of all three isotypes of immunoglobulins or of IgG isotype. Remarkably, anti-dsDNA Ab of the IgA isotype, alone or associated with IgM, marked dermatological patients with low disease activity, but often with disquieting clinical and/or laboratory alterations. CONCLUSIONS: These results indicate a correlation between disease activity and both frequency and isotype of anti-dsDNA Ab.     

Serum immune complexes in erythema nodosum leprosum reactions of leprosy

Serum estimations of immunoglobulins, complement components and their presence in circulating immune complexes were carried out in 39 Lepromatous, 44 ENL and 22 Post ENL leprosy patients. Serum IgG, IgA, IgM, C3 and C4 levels were determined by single radial immunodiffusion. Serum immune complexes were precipitated with Polyethylene Glycol (PEG) and IgG, IgA, IgM, C3 and C4 were estimated by single radial immunodiffusion and expressed as % of precipitation of their serum level. Decreased IgG, IgM; increased IgA and C3; and no change in C4 levels are observed in ENL than Lepromatous and Post ENL patients. However, a gradual insignificant reduction of IgG, IgA, and IgM was found from Lepromatous to ENL and Post ENL patients in the PEG-precipitates. Similarly, C3 and C4 was found reduced insignificantly in ENL than Lepromatous and Post ENL patients. The significance of these estimations in relation to immune status of ENL reactions are discussed.     

HOW RELIABLE IS THE BASEMENT MEMBRANE PHENOMENON IN THE DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS?

Background. Although the basement membrane (BM) phenomenon is considered a good test to differentiate between systemic (SLE) and discoid lupus erythematosus (DLE), our observations question its reliability. Methods. Direct immunofluorescence stain was done to detect immunoglobulins and complement deposits in 10 SLE patients and in 10 healthy controls. Specimens were taken from the normal skin of the dorsa of hands. Results. The group of SLE patients showed deposits of IgG in 4, IgM in 7, IgA in 1, C3 in 7, and C4 in 1 patient. The group of healthy controls showed IgM in 2, C3 in 5, C4 in 2 cases, but no IgG or IgA deposits. Conclusion. A positive BM phenomenon test could be found in normal individuals and may be due to the effect of ultraviolet rays. We think that the BM phenomenon has a limited reliability in diagnosing SLE.     

系统性红斑狼疮患者外周血单一核细胞NF-kB信号通路活化检测

目的：检测系统性红斑狼疮（SLE）患者外周血单一核细胞（PBMC）NF－kB信号通路活化情况,并探讨其临床意义。方法：NF－kB活性检测采用电泳迁移率改变试验,IkBα蛋白及其磷酸化产物采用蛋白印迹,抗dsDNA抗体、IgG、IgM测定采用ELISA方法。结果：SLE患者PBMC NF－kB活性显著高于正常对照组（P＜0.05）,活动期显高于缓解期（P＜0.05）,SLE组IkBα蛋白表达显著低于正常对照组（P＜0.05）,活动期患者低于缓解期（P＜0.05）。SLE组IkBα磷酸化产物显著高于正常对照组（P＜0.05）,活动期患者高于缓解期（P＜0.05）。NF－kB活性和IkBα磷酸化产物均与抗dsDNA抗体、IgG和SLE疾病活动指数呈正相关,而与IgM无相关关系。结论：SLE患者PBMC存在NF－kB信号通路异常活化,且与抗dsDNA抗体、IgG分泌密切相关。检测SLE PBMC内NF－kB信号通路蛋白表达可能有助于SLE疾病活动的判断。     

Patients with psoriasis often have increased serum levels of IgA antibodies to gliadin

It was recently observed that in six patients with psoriasis and one with palmoplantar pustulosis. with newly discovered gluten intolerance, a gluten-free diet had a remarkable effect on the skin lesions. This prompted us to undertake a screening investigation to discover whether increased levels of serum antibodies to gliadin are more common in patients with psoriasis than in healthy persons. IgA and IgG antibodies to gliadin (IgA AGA and IgG AGA) were quantified by a micro-ELISA method. Out of 302 patients with psoriasis. 16% (18 females, 31 males) showed serum IgA AGA levels above the 90th percentile value (51 u/ml) of the reference group. This tendency was even more marked when the proportion of patients with values >70 u/ml was compared with the corresponding proportion of 99 reference subjects. Thus, 3% of the reference subjects but 7.9% of the patients had values >70 u/ml. The corresponding figures for men were 1.6% and 8.9%. respectively. Men with psoriasis had a significantly bigher mean IgA AGA than the male reference group. The means based on logarithmic values of the individual IgA AGA values were significantly higher in the psoriatic groups than in the reference groups. Although the mean level of IgG AGA was not increased in the psoriasis group, there was a correlation between the values for IgA AGA and IgG AGA. The serum concentrations of IgG, IgA and IgM were also measured. In the male patients, the mean IgA value was significantly increased. Women in whom IgA AGA was elevated also showed a significantly increased mean IgA. There was no correlation between the IgA AGA and the IgA values. The IgG levels were significantly elevated in both men and women with psoriasis, whereas the IgM levels did not differ from those in the reference group. Studies on the clinical relevance of the findings in this report, both with regard to the activity of the psoriasis and to the presence of intestinal abnormalities, are in progress.