抗中性粒细胞胞浆抗体与抗核抗体谱联合检测对系统性红斑狼疮的临床意义

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者抗核抗体谱(antinuclear antibody spectrum,ANAs)与抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibody,ANCA)联合检测的临床意义。方法采用间接免疫荧光法(IIF)和免疫印迹法(Western blot)检测120例SLE组患者、60例疾病对照组患者和20位健康人的ANCA和ANAs。用ELISA法检测验证ANCA阳性率,用SLE活动指数(SLEDAI)判断SLE活动性,分析ANCA、SLEDAI和ANAS之间的关系。结果在120例SLE患者中IIF法检测ANCA的阳性率为27.5(33/120),且均为核周型(perinuclear ANCA,pANCA)。用ELISA法验证全部ANCA阳性患者血清,阳性率为81.8(27/33),且均为髓过氧化物酶(myeloperoxidase,MPO)即为pANCA。ANCA阳性组SLEDAI评分>10分者(即SLE活动期)占81.4%与ANCA阴性组(36.5%)相比差异有显著性意义(P<0.01)。ANCA阳性组在血沉升高,补体C3、C4降低,肾脏损害、肺损害、关节肿痛等方面与ANCA阴性组比较差异具有显著性(P<0.01)。ANCA阳性率与抗ds-DNA抗体、抗Sm抗体、抗核小体抗体(AnuA)及抗核糖体P蛋白抗体(ARPA)阳性率呈正相关。结论联合检测ANCA和SLE的各项特异性自身抗体可能对SLE患者的早期发现、治疗、病情活动判断具有重要的意义。     

自身抗体检测在儿童系统性红斑狼疮诊断中的意义

目的探讨抗核抗体(ANA)、抗双链DNA(ds-DNA)、抗ENA抗体检测在儿童系统性红斑狼疮(SLE)诊断中的价值.方法利用酶免疫斑点技术对56例SLE患儿的抗核抗体、抗ds-DNA、抗ENA抗体进行检测.结果56例SLE患儿ANA阳性率最高94.6%,抗ds-DNA阳性率为55.4%,抗Sm/RNP阳性率64.8%,抗SSA/SSB阳性率60.7%.结论SLE患者血清中存在多种自身抗体,自身抗体的联合检测对SLE的诊断和病情的监测有着重要的意义.     

264例系统性红斑狼疮患者抗磷脂抗体与抗核抗体、抗双链DNA抗体关系的研究

目的 分析系统性红斑狼疮(SLE)患者抗磷脂抗体(APL)特征及其与抗核抗体(ANA)核型、抗双链DNA抗体(anti-dsDNA)之间的关系，为SLE患者系统性治疗提供参考。方法 选取2018年1月至2021年12月就诊于首都医科大学附属北京同仁医院的SLE患者264例，回顾性分析患者APL[狼疮抗凝物(LA)、抗心磷脂抗体(ACA)、和抗β₂糖蛋白I抗体(anti-β₂GPI)]与ANA核型特征、anti-dsDNA的关系。结果 264例患者中164例(62.12%)LA阳性、22例(8.33%)ACA阳性、38例(14.39%)anti-β₂GPI阳性、260例(98.48%)ANA阳性和136例(51.52%)anti-dsDNA阳性。在164例LA阳性的SLE患者中，LA弱阳性表达92例(56.10%),LA阳性表达52例(31.71%),LA强阳性表达20例(12.19%)。ACA、anti-β₂GPI和LA均阳性16例。260例ANA阳性的SLE患者中，胞核均质型48例(18.46%)...     

自身抗体联合检测对系统性红斑狼疮的诊断价值

研究抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、抗Smith(Sm)抗体、抗核小体抗体(AnuA)和抗核糖体P蛋白抗体(ARPA)5种自身抗体单项及联合检测系统性红斑狼疮(SLE)诊断中的价值.测定了66例SLE患者和50例其他疾病患者(对照组)血清中的自身抗体.以间接免疫荧光法测定ANA;免疫印迹法测定抗ds-DNA抗体、抗Sm抗体、AnuA和ARPA.结果显示,在66例SLE患者中ANA、抗ds-DNA抗体、抗Sm抗体、AnuA和ARPA的阳性率分别为92.4%、27.2%、42.4%、71.2%和16.6%,均明显高于对照组(32%、2%、2%、4%和2%)(P＜0.01);ANA、AnuA的敏感性明显高于其他3种抗体(P＜0.01);ANA、抗ds-DNA抗体、抗Sm抗体、AnuA和ARPA的特异性分别为68.0%、98.0%、98.0%、96.0%和98.0%.结论:抗ds-DNA抗体、抗Sm抗体、AnuA和ARPA等4种自身抗体对SLE的检测有很高的特异性,且有明显的互补作用,联合检测能提高对SLE检测的敏感性.     

抗核抗体谱检测在诊断系统性红斑狼疮中的意义

探讨抗核抗体(ANA)和抗核抗体谱(ANAs)检测对诊断系统性红斑狼疮(SLE)患者的临床意义。用间接免疫荧光法(IIF)和免疫印迹法检测106例SLE组和30名对照组血清ANA及ANAs中的12种抗体。结果表明:SLE组ANA阳性率为86.8%,ANAs中抗ds-DNA、抗Scl-70、抗Jo-1、抗nRNP、抗Sm、抗SS-A、抗SS-B、抗Ro-52、抗CENP-B、抗AnuA、抗AHA和抗核糖体P蛋白的阳性率分别为28.3%、0.9%、0.9%、35.9%、17.0%、39.6%、18.9%、41.5%、9.4%、29.3%、31.1%和9.4%。ANA和ANAs联合检测提高了诊断的敏感性,对SLE的诊断和治疗有重要意义。     

自身抗体联合检测对系统性红斑狼疮诊断的意义

为了评价抗核小体抗体(anti-nucleosome antibody,AnuA)、抗Sm抗体、抗双链DNA(double stranded-DNA,dsDNA)抗体、抗核糖体P蛋白(ribosomal P protein,rRNP)抗体联合检测对系统性红斑狼疮(SLE)诊断的价值,采用酶联免疫吸附法(ELISA)测定123例SLE患者、61例其他结缔组织病患者和30名健康对照者血清中An.uA、抗dsDNA抗体、抗Sm抗体、抗rRNP抗体含量.结果显示,AnuA、抗dsDNA抗体、抗Sm抗体和抗rRNP抗体在SLE患者中的阳性率明显高于疾病对照组和正常对照组;AnuA与抗dsDNA抗体的敏感性显著高于其他两种自身抗体;抗dsDNA抗体、抗sm抗体和抗rRNP抗体阴性的SLE患者中,AnuA阳性率为52.6%～68.0%;SLE活动期患者与非活动期患者AnuA、抗dsDNA抗体阳性率有显著性差别.四种自身抗体在SLE的诊断中有明显的互补作用,特别是AnuA和抗dsDNA抗体可以弥补其他抗体的不足;AnuA、抗dsDNA抗体与疾病活动性密切相关.AnuA与抗sm抗体或AnuA与抗dsDNA抗体的二联检测可明显提高其对SLE诊断的敏感性.AnuA、抗dsDNA抗体、抗Sm抗体三联检测的阳性率可达87%.自身抗体联合检测提高了诊断的敏感性,对SLE的诊断和治疗有重要意义.     

系统性红斑狼疮患者血清抗核糖体P蛋白抗体的检测及其临床意义

目的: 观察抗核糖体P蛋白抗体(抗P蛋白抗体)在系统性红斑狼疮 (SLE)患者中的阳性率及其意义。方法:以含有核糖体磷酸蛋白P0、P1、P2全序列的合成蛋白作为抗原, 采用欧盟斑点法(EUROblot), 测定 150份SLE患者血清抗核糖体P蛋白抗体的阳性率, 并分析其与其他自身抗体(抗dsDNA抗体、抗Sm抗体和抗RNP抗体等), 以及患者的临床特征的相关性。结果: 150份患者血清中, 有 36例(24% )抗P蛋白抗体呈阳性。抗P蛋白抗体阳性组肾脏损害、中枢神经系统损害的发生率显著高于阴性组, 而与皮肤、关节、血液及肝脏的损害无关, 也与病情活动指数 (DAI)不相关。抗P蛋白抗体的阳性率与抗dsDNA抗体、抗Sm抗体及抗RNP抗体的阳性率相关。结论: SLE患者抗P蛋白抗体的阳性率高于欧美人群(13% )。该抗体与SLE患者的肾脏及中枢神经损害具有相关性。     

自身抗体联合体液免疫检测在SLE中的应用价值

目的 探讨联合检测自身抗体、免疫球蛋白和补体在系统性红斑狼疮(SLE)诊断和病情判断中的应用价值.方法 选取SLE患者54例、其他自身免疫性疾病患者32例和正常对照30例,采用间接免疫荧光法测定抗核抗体(ANA)、免疫印迹法测定抗核提取物抗体(抗ENA抗体)、散射免疫比浊法测定免疫球蛋白和补体C3、C4.结果 SLE患者的ANA、抗dsDNA、抗Sm、抗核小体、抗U1-nRNP、抗核糖体P蛋白、抗组蛋白抗体的检测阳性率分别为87.04％、59.26％、27.78％、29.63％,37.04％、12.96％、27.78％;SLE活动组中抗dsDNA和抗核小体抗体的阳性率高于SLE非活动组,差异具有统计学意义(P＜0.05);SLE活动组IgG、IgA、IgM水平高于正常对照组,C3、C4水平低于正常对照组,差异具有统计学意义(P＜0.01).结论 自身抗体联合免疫球蛋白和补体检测对SLE患者的临床诊断和病情判断有良好的参考价值.     

抗β2GPI抗体对系统性红斑狼疮患者血栓形成的影响

目的:探讨抗β2GPI抗体对系统性红斑狼疮患者血栓形成的作用及对疾病诊断的临床意义.方法:选取系统性红斑狼疮(SLE)并发血栓患者20例,单纯SLE患者30例,正常对照23例,采用AggRAM-四通道血小板聚集仪检测血小板聚集率,用酶联免疫吸附试验(ELISA)检测抗β2GPI抗体.结果:SLE血栓组患者和SLE非血栓组患者抗β2GPI抗体滴度和抗体阳性率都显著高于正常对照组(P＜0.05),并且SLE血栓组患者抗β2GPI抗体滴度和抗体阳性率高于SLE非血栓组患者;SLE血栓组患者血小板聚集率比SLE非血栓组和正常对照组显著升高(P＜0.05),SLE非血栓组患者血小板聚集率和正常对照组没有统计学差异;所有SLE患者中抗β2GPI抗体阳性组比抗体阴性组血小板聚集率升高,差异有统计学意义(P＜0.05).结论:抗β2GPI抗体和血小板聚集率升高可为SLE患者继发血栓性疾病提供辅助诊断;抗β2GPI抗体促进SLE患者血小板聚集率上升,加速SLE患者血栓形成.     

抗核抗体系列及补体检测对狼疮性肾炎的诊断意义

目的 探讨抗核抗体系列及补体检测对系统性红斑狼疮(SLE)伴狼疮性肾炎(LN)诊断的意义.方法 对1 699例SLE患者和120例健康体检者采用间接免疫荧光法测定抗核抗体(ANA),应用欧蒙印迹法测定抗核抗体系列,应用散射比浊法测定补体C3、C4.结果 1699例SLE患者,LN组921例,ANA阳性率为97.4％;不伴LN组778例,ANA阳性率为98.2％;与对照组比较,r=0.983,P=0.001,差异有统计学意义.LN组的抗组蛋白抗体,抗核小体抗体,抗双链DNA抗体阳性率分别为49.3％、59.8％、63.3％;不伴LN组分别为21.5％、35％、47.9％;差异有统计学意义(r=0.452,P=0.007).抗线粒体-2抗体和抗着丝点抗体阳性率,LN组与不伴肾炎组比较差异有统计学意义(r=0.291,P=0.015).当抗组蛋白抗体+抗核小体抗体+抗双链DNA抗体同时阳性时,LN患者其补体C3,C4水平比这三种抗体非同时阳性时的水平均更低,差异有统计学意义(r=0.583,P=0.009).结论 抗核抗体系列及补体的血清学检测对诊断LN及其预后判断、疗效观察等具有重要意义.     

In Vitro TNP-Specific Antibody Formation by Peripheral Lymphocytes from Patients with Systemic Lupus Erythematosus

Immunological reactivity in patients with systemic lupus erythermatosus (SLE) was assessed by investigating in vitro trinitrophenyl (TNP)-specific antibody formation by peripheral lymphocytes. Peripheral lymphocytes from 16 patients with SLE were cultured with TNP conjugated with horse erythrocytes (TNP-HRBC) in the presence of 2-mercaptoethanol. The hemolytic plaque assay was used to detect hapten (TNP)-specific antibody-forming cells. Peripheral lymphocytes from normal individuals failed to produce antibody to TNP, whereas SLE lymphocytes produced a significant number of plaque-forming cells. Co-culture experiments with SLE and normal lymphocytes suggested that patients with SLE have a defect in T lymphocytes, leading to abnormal antibody production.     

Frequency of anti-DNA antibody producing cells from normals and patients with systemic lupus erythematosus

The frequency of anti-DNA antibody producing cells from normals and patients with systemic lupus erythematosus (SLE) was determined. Peripheral blood lymphocytes (PBL) from normals and patients with SLE were cultured for 8 and 15 days with and without transformation by Epstein-Barr virus (EBV). Culture supernatants were examined for the presence of anti-DNA antibody using an enzyme-linked immunosorbent assay. We found that PBL from patients with SLE spontaneously produce anti-DNA antibodies whereas PBL from normals do not. After EBV transformation, anti-DNA antibody producing cells were detected in both cultures from patients with SLE as well as from normals. These data suggest that the high levels of anti-DNA antibody observed in patients with SLE represent activation of B cells committed to anti-DNA antibody production and that such cells are present but are not activated in normal individuals.     

In vitro effect of alpha-interferon on mononuclear cells of normal and autoimmune patients

The effect of lymphoblastoid interferon (IFN-alpha) on cell-mediated and humoral immunity was studied in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The base-line natural killer (NK) and antibody dependent cytotoxic cell (ADCC) activity was higher than normal in individuals with RA. The NK and ADCC activities were tested after IFN-alpha pretreatment and the augmentation of NK and ADCC activity was less in these patients than in normals. Lymphoblastoid IFN inhibited antigen induced T-cell proliferation in SLE to a lesser extent than in normal individuals. Finally, the addition of lymphoblastoid IFN was also less effective at suppressing in vitro polyclonal antibody formation by mononuclear cells from patients with SLE than from normals, with enhancement observed in some patients at the lower IFN-alpha concentrations tested.     

Defective B cell function in systemic lupus erythematosus.

The in vitro synthesis of specific anti-influenza virus antibody was measured in cultures of peripheral blood lymphocytes from 25 patients with systemic lupus erythematosus (SLE) and 23 control subjects. Whilst all cultures derived from normal individuals synthesized specific antibody, cultures from patients with SLE were consistently unable to produce anti-influenza antibody. This defect could not be corrected by manipulating the culture conditions or by in vivo immunization. Co-cultivation of separated SLE-B or control B cells, with SLE-T or control T cells showed that the immunodeficiency exhibited by the SLE peripheral blood lymphocytes resides in the B cells.     

SLE患者外周血T细胞亚群ICOS与CD28共表达水平与疾病的关系

目的观察系统性红斑狼疮(systemic lupus erythematosus，SLE)病人外周血CD4^ 及CD8^ T细胞表面可诱导共刺激分子(inducible co-stimulator，ICOS)及CD28共表达水平，探讨ICOS和CD28共表达水平与SLE疾病的关系。方法采用三色流式细胞术检测SLE病人(n=51)及正常人(n=30)外周血CD4^ 及CD8^ T细胞表面ICOS与CD28共表达水平，并结合SLE病人疾病活动程度、临床表现等进行分析。结果与正常人相比，SLE活动期和稳定期病人外周血CD4^ T细胞中仅表达ICOS不表达CD28(即CD28^-ICOS^ )的细胞比例明显升高，但活动期病人和稳定期病人之间并无差异；活动期病人外周血CD8^ T细胞上同时表达CD28和ICOS的细胞(即CD28^ ICOS^ 细胞)和CD28^-ICOS^ 细胞比例都明显升高；同一SLE病人在疾病活动期CD4^ 和CD8^ T细胞中CD28^ ICOS^ 的细胞比例和CD8^ T细胞中CD28-ICOS^ 细胞比例明显高于该病人经过治疗病情稳定时；初发未治疗SLE病人仅CD4^ T细胞中CD28^ ICOS^ 细胞的比例比复发病人明显升高；血清抗dsDNA抗体( )病人和血清免疫球蛋白含量(IsG、IgA和IgM中任何一种)异常升高的病人外周血CD4^ T细胞中CD28^ ICOS^ 细胞和CD8^ T细胞中CD28-ICOS^ 细胞比例分别明显高于血清抗dsDNA抗体(-)和血清免疫球蛋白含量正常的病人。结论CD28和ICOS在SLE病人外周血CD4^ 和CD8^ T细胞上共表达水平与SLE疾病的活动程度、病程及临床表现等存在一定的关联。     

Mitogenic responses to lipopolysaccharide by B lymphocytes from patients with systemic lupus erythematosus

Peripheral blood lymphocytes from 43 patients with systemic lupus erythematosus (SLE) and from age- and sex-matched normal controls were cultured with lipopolysaccharide (LPS) to examine the response to the polyclonal B-cell activator. Lymphocytes from active SLE patients incorporated 4840 +/- 471 (mean +/- SE) cpm in response to LPS, whereas lymphocytes from inactive SLE patients incorporated 6906 +/- 897 cpm. In contrast, lymphocytes from normal individuals incorporated 7452 +/- 1126 cpm. Ig synthesis of lymphocytes from active SLE in response to LPS stimulation was also less than that of normal individuals. The helper T-cell function of active SLE, as examined by co-culturing irradiated SLE lymphocytes with unirradiated normal lymphocytes, was normal. These results thus suggested that a defect of B lymphocytes exists in active SLE patients. This B-cell defect and T suppressor cells apparently play an important role in the pathogenesis of SLE.     

Mitogenic Responses to Lipopolysaccharide by B Lymphocytes from Patients with Systemic Lupus Erythematosus

Peripheral blood lymphocytes from 43 patients with systemic lupus erythcmatosus (SLE) and from age- and sex-matched normal controls were cultured with lipopolysaccharide (LPS) to examine the response to the polyclonal B-cell activator. Lymphocytes from active SLE patients incorporated 4840±471 (mean ± SE) cpm in response to LPS, whereas lymphocytes from inactive SLE patients incorporated 6906 ± 897 cpm. In contrast, lymphocytes from normal individuals incorporated 7452 ± 1126 cpm. Ig synthesis of lymphocytes from active SLE in response to LPS stimulation was also less than that of normal individuals. The helper T-cell function of active SLE, as examined by co-culturing irradiated SLE lymphocytes with unirradiated normal lymphocytes, was normal. These results thus suggested that a defect of B lymphocytes exists in active SLE patients. This B-cell defect and T suppressor cells apparently play an important role in the pathogenous of SLE.     

Loss of suppressor T-lymphocyte function in patients with systemic lupus erythematosus (SLE).

Immunological reactivity in patients with SLE was studied in vitro trinitrobenzene sulphonate (TNP) specific antibody formation by peripheral blood lymphocytes. Lymphocytes from patients with SLE could produce an increased number of TNP-specific plaque-forming cells (PFC), while no such response could be seen in normal controls. Co-culture of lymphocytes from active SLE patients and normal controls was performed with TNP-Horse red blood cells (TNP-HRBC). The number of PFC by B lymphocytes from active SLE patients was suppressed by T lymphocytes from normal controls. On the other hand, the number of PFC by B lymphocytes from normal controls was increased by T lymphocytes from active SLE patients. Co-culture of lymphocytes from identical twins discordant for SLE was also performed, and the same results were obtained. We further examined the effects of Con A on antibody formation. Con A-treated T lymphocytes from a normal control markedly suppressed TNP-specific PFC by peripheral lymphocytes from active SLE patients. However, Con A-treated T lymphocytes from an active SLE patient did not suppress TNP-specific PFC by lymphocytes from another active SLE patient. These results suggest that active SLE patients showed a loss of suppressor T-lymphocyte function.     

系统性红斑狼疮重症血小板减少患者血清对巨核祖细胞的影响

研究系统性红斑狼疮(SLE)合并重症血小板患者的血清对正常人巨核祖细胞增殖分化的影响。以12例SLE重症血小板减少患者为研究对象,12份正常骨髓单个核细胞,培养中分别加入患者血清或灭活补体的患者血清,免疫化学染色检测巨核细胞克隆形成单位(CFU-MK),流式细胞仪检测CD41+细胞数。结果是正常对照组骨髓CFU-MK集落数为(61.22±29.71)个/片,加入SLE重症血小板减少患者血清后减少为(29.44±23.35)个/片,P<0.05;加灭活补体血清后减少为(22.56±15.21)个/片,与正常对照相比P<0.05;灭活补体与否差异不显著,P>0.05。加入患者血清或灭活补体的血清后,CD41+细胞数由正常(2.30%±1.63%)分别减少为(1.15%±0.85%)和(1.07%±0.76%),与正常对照相比P<0.05;灭活补体与否差异不显著。SLE血小板正常但活动期病人的血清对正常人CFU-MK和CD41+细胞的生成均无显著抑制。提示SLE重症血小板减少患者血清能抑制正常人骨髓巨核祖细胞的增殖分化,这种抑制作用是非补体依赖性的。     

Distinguishable Patterns of Connectivity in Serum Immunoglobulins from SLE Patients and Healthy Individuals

Given that normal individuals maintain significant levels of serum autoantibodies that share many characteristics with those found in association with autoimmune diseases (AID), it has been proposed that disease could result from defects in supraclonal regulation, namely deviations of normal patterns of immunoglobulin (Ig) connectivity. Using conventional methods, together with a recently developed technique to quantitatively score a variety of V-region-dependent serum IgG interactions, the authors have now compared serum Ig connectivity in a group of patients with systemic lupus erythematosus (SLE) to healthy controls. The results demonstrate the existence of V-region interactions of serum IgG and IgM in SLE patients and healthy donors, with comparable connectivity titres, diversity and average affinities (μ m range), but a wider individual variation and a tendency for higher F(ab')2 directed reactivities in the group of SLE patients. Multivariate statistics analysis of the data derived from reactivity patterns on F(ab')2 subsets, however, distinguished the two groups of donors, and demonstrated a larger dispersion and wider time-dependent variations in the patient population, as compared to healthy controls. The authors conclude that SLE is associated with circulating antibody repertoires that deviate from the patterns and levels of V-region connectivity characteristic of healthy individuals. These findings may shed light on the mechanisms of disease maintenance, and on the basis for the therapeutic effects of normal polyclonal Igs at high doses.