输血前11606例患者HIV和HCV及TP抗体检测结果分析

目的为避免因输血传播疾病引起医疗纠纷和防止职业感染。方法采用酶联免疫吸附试验对2010-01～2011-03 11 606例就医患者进行输血前人类免疫缺陷病毒(HIV)抗体、丙型肝炎病毒(HCV)抗体、梅毒螺旋体(TP)抗体三项指标筛查。结果共检出阳性例数856例。结论患者输血前进行三项感染性指标检测,对诊断和预防医患交叉感染、减少医疗纠纷的发生具有重要意义。     

Detection of SARS-CoV-2 Nucleocapsid,Spike, and Neutralizing Antibodies in Vaccinated Japanese

Serological detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N), spike (S), and neutralizing antibodies (Abs) is commonly undertaken to evaluate the efficacy of vaccination. However, the relative efficiency of different SARS-CoV-2 Ab detection systems has not been extensively investigated. Here, we evaluated serological test systems in vaccinated Japanese. SARS-CoV-2 N, S, and neutralizing Abs in sera of 375 healthy subjects a mean 253 days after vaccination were assessed. The sensitivity of Elecsys Anti-SARS-CoV-2 S (Roche S) and Anti-SARS-CoV-2 S IgG (Fujirebio S) was 100% and 98.9%, respectively, with a specificity of 100% for both. The sensitivity of Anti-SARS-CoV-2 neutralizing Ab (MBL Neu) was 2.7%, and the specificity was 100%. Fujirebio S correlated with Roche S (rho = 0.9182, p = 3.97 × 10⁻¹⁵²). Fujirebio S (rho = 0.1295, p = 0.0121) and Roche S (rho = 0.1232, p = 0.0170) correlated weakly with MBL Neu. However, Roche S did correlate with MBL Neu in patients with COVID-19 (rho = 0.8299, p = 1.01 × 10⁻¹²) and in healthy subjects more recently after vaccination (mean of 90 days, rho = 0.5306, p = 0.0003). Thus, the Fujirebio S and Roche S results were very similar, but neither correlated with neutralizing antibody titers by MBL Neu at a later time after vaccination.     

Anti-RANA antibody in rheumatoid arthritis,seronegative polyarthritis,and normal controls

Summary Anti-RANA antibody was found in 76% and 69% of seropositive and seronegative rheumatoid patients. No correlation appeared between this antibody, rheumatoid factor or a positive fluorescent anti-nuclear antibody (FANA). Many sera from healthy individuals, paritcularly medical personnel, and other disease groups demonstrated the fine nuclear speckling by immunofluorescence on Raji cells, but with weaker fluorescence. Anti-IgG conjugate was more sensitive in detecting the presence of the antibody in these sera. The presence of other antibodies producing a diffuse nuclear fluorescent pattern on Raji cells made it difficult to assess underlying fine nuclear speckling. Many of these sera produced a positive FANA on rat liver substrate. Very little variation in anti-RANA antibody status occurred with time and any change that did occur did so independently of rheumatoid factor. In view of the presence of anti-RANA antibody in the sera of patients with a variety of underlying rheumatic disorders and in normal individuals, the exact role of the antibody in the pathogenesis or diagnosis of rheumatoid arthritis is in doubt.Funded by the Canadian Arthritis Association and the Alberta Heritage Trust Fund     

Immunotherapy-responsive Non-paraneoplastic Encephalitis with Antibodies against GAD,LGI1, and GABAA Receptor

A 62-year-old man showed abnormal behavior. Brain magnetic resonance imaging revealed multifocal lesions on T2-weighted images. Initial screening revealed that he was seropositive for antibodies against glutamate decarboxylase, which usually indicates treatment resistance to autoimmune encephalitis (AE). Intensive immunosuppressive therapies, however, improved the neurological symptoms. In line with this, we also detected seropositivity for antibodies against leucine-rich glioma-inactivated 1 and gamma-aminobutyric acid A receptor (GABA_AR). Brain imaging and treatment responsiveness suggested that antibodies against GABA_AR were the main cause of symptoms. Furthermore, the patient showed the presence of triple anti-neural antibodies in the absence of malignancy and had a favorable clinical course.     

The UK National External Quality Assessment Scheme in Blood Group Serology. ABO and D grouping,antibody screening,direct antiglobulin test and antibody identification 1984–1985

Summary In seven exercises of blood grouping the overall rates of major error were 0.19% and 0.25% in ABO and D grouping respectively. In ABO grouping this represents an increase in error rate over that observed in 1982–1983 but the increase was due to an unusually high error rate with one particular group A₂B cell. An improvement in performance was observed in simple D grouping and was largely due to a lower incidence of false positive grouping of D-negative cells in the antiglobulin test. An improvement in performance observed in D grouping IgG-coated D-negative cells appeared to be due to a better understanding of the problem rather than to any change in serological practice. Error rates in antibody screening were somewhat lower than in 1982–1983 but this may or may not represent an improvement in performance as the test materials were not the same in the two periods. The direct antiglobulin test with IgG-coated cells was reliably performed with polyspccific and with anti-IgG reagents but an excess of false positive results was obtained with anti-C3d. Error rates in antibody identification varied from 0.6% for anti-D to 74% for anti-c + E.     

Autoimmune diseases of the liver, autoimmune hepatitis and primary biliary cirrhosis: Unfinished business

Autoimmune liver diseases (AILD) including autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) have attracted much attention since their discovery 50 years ago, but there remain items of unfinished business. These relate to disease susceptibility including genetic influences (HLA and non-HLA genes, genes associated with female predisposition, and others) and environmental influences (infections, chemicals, xenobiotics and medications). Also needed is better characterization of autoantigenic molecules, particularly the anti-F-actin specificity characteristic of AIH, shown here to have functional effects in vitro . Deeper analysis of T-lymphocyte function in AILD should reveal relative contributions of eachof the multiple subsets of T cells now being defined in studies on laboratory animals, CD4⁺, CD8⁺, Th1, Th2, Th17, memory subsets and regulatory subsets. Diagnostic immunology providers now offer high-performance assay formats that call for systematic clinical assessments to achieve standardization, calibration and optimal information.     

抗Sa抗体、抗环瓜氨酸肽抗体、葡萄糖6-磷酸异构酶抗原和类风湿因子联合检测对类风湿关节炎的诊断意义

目的 探讨抗Sa抗体、抗环瓜氨酸肽(CCP)抗体、葡萄糖6-磷酸异构酶(GPI)抗原及类风湿因子(RF)联合检测对类风湿关节炎(RA)诊断的意义.方法 采用酶联免疫吸附试验(ELISA)检测抗Sa抗体、抗CCP抗体及RF亚型RF-IgA、RF-IgG、RF-IgM,免疫比浊法检测RF.结果 抗Sa抗体、抗CCP抗体、GPI抗原、RF对RA诊断的特异性和敏感性分别为95.69％和59.79％、98.28％和90.72％、76.14％和78.35％、67.24％和91.75％.RF-IgA、RF-IgG、RF-IgM对于RA诊断的特异性和敏感性分别为89.66％和58.76％、90.52％和68.04％、79.31％和79.38％.两项指标联合检测对RA诊断的特异性和敏感性为92.24％ ～ 100.00％和47.42％～86.60％;3项指标联合检测对RA诊断的特异性和敏感性为99.14％～100％和46.39％～71.13％;4项指标联合检测对RA诊断的特异性和敏感性为100.00％和46.39％.抗Sa抗体阳性组患者C反应蛋白水平高于阴性组(P＜0.05).结论 两项及两项以上指标联合检测可以显著提高RA诊断的特异性,有利于RA的早期诊断及治疗.     

四种抗体联合检测在类风湿关节炎早期诊断中的应用价值

目的 探讨抗核周因子抗体(APF)、抗角蛋白抗体(AKA)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗-CCP抗体)联合检测在类风湿关节炎(RA)早期诊断中的临床应用价值。方法 对RA患者127例、非RA其他风湿病患者102例及正常对照组43例，采用速率散射免疫比浊法检测RF；酶联免疫吸附法定量检测抗-CCP抗体；免疫荧光法检测AKA、APF，并采用四格表法计算敏感度及特异性。结果RA组的RF、APF、AKA、抗-CCP抗体敏感度分别为65．4％、48．8％、32．3％、83．5％，特异性分别为73．5％、92．2％、93．1％、94．1％，同时出现三种抗体和四种抗体的特异性为99．0％、100％；非RA组无四种抗体同时出现的情况。结论 RF敏感性较高，但特异性较差；APF、AKA、抗-CCP抗体三种自身抗体对RA具有高度特异性，且在RA早期即可出现。四种抗体联合检测有助于提高RA的早期诊断率。     

A New Antibody, Anti-Fy3, in the Duffy Blood Group System

Abstract. A new antibody that reacts with all human bloods except those of type F_y(a-b-) has been named anti-F_y3. It is believed to detect a previously unknown blood-group antigen, which is possibly a precursor of Fy^a and Fy^b.     

Prion Protein-Specific Antibodies-Development,Modes of Action and Therapeutics Application

Prion diseases or Transmissible Spongiform Encephalopathies (TSEs) are lethal neurodegenerative disorders involving the misfolding of the host encoded cellular prion protein, PrP^C. This physiological form of the protein is expressed throughout the body, and it reaches the highest levels in the central nervous system where the pathology occurs. The conversion into the pathogenic isoform denoted as prion or PrP^Sc is the key event in prion disorders. Prominent candidates for the treatment of prion diseases are antibodies and their derivatives. Anti-PrP^C antibodies are able to clear PrP^Sc from cell culture of infected cells. Furthermore, application of anti-PrP^C antibodies suppresses prion replication in experimental animal models. Major drawbacks of immunotherapy are immune tolerance, the risks of neurotoxic side effects, limited ability of compounds to cross the blood-brain barrier and their unfavorable pharmacokinetic. The focus of this review is to recapitulate the current understanding of the molecular mechanisms for antibody mediated anti-prion activity. Although relevant for designing immunotherapeutic tools, the characterization of key antibody parameters shaping the molecular mechanism of the PrP^C to PrP^Sc conversion remains elusive. Moreover, this review illustrates the various attempts towards the development of anti-PrP antibody compounds and discusses therapeutic candidates that modulate PrP expression.     

抗核心糖脂域MAb对脓毒症小鼠存活及其血中LPS、TNF-a和IL-6水平的影响

为进一步探讨抗核心糖脂域单克隆抗体（ＭＡｂ）的免疫保护效果及其可能的作用机制，以小鼠脓毒症为模型，用产色鲎试验法和细胞因子活性检测等方法，研究了抗核心糖脂域ＭＡｂ（ＥＬ１、ＥＬ３和３Ｈ４）对实验性脓毒症小鼠的存活及其血中ＬＰＳ、ＴＮＦ－ａ和ＩＬ－６水平的影响。结果表明，这三株ＭＡｂ均能显著提高受ＬＰＳ及Ｅ．ｃｏｌｉ攻击小鼠的存活率（Ｐ＜０．０５）；且有明显降低小鼠血中ＬＰＳ、ＴＮＦ－ａ和ＩＬ－６水平的作用，提示抗核心糖脂域ＭＡｂ的保护作用与其中和ＬＰＳ的活性，从而达到降低ＬＰＳ诱导小鼠效应细胞释放炎性细胞因子的作用有关。     

Prevalence,specificity and risk of red blood cell alloantibodies among hospitalised Hubei Han Chinese patients

Background

The prevalence, specificity and risk of red blood cell alloantibodies vary widely among different geographic areas, races, and diseases and according to different methods of study, but no data are available on the Chinese Han population, who were investigated in the present study.

Materials and methods

Antibody screening was conducted among 42,517 hospitalised Hubei Han Chinese individuals using column agglutination technology. Samples that were positive in antibody screening were subjected to antibody identification by the tube test. Clinical data, including gender, age, race, transfusion history and records of alloantibody detection, transfusion reactions or haemolytic disease of the newborn, were collected to analyse the prevalence and specificity of alloantibodies and complications associated with them.

Results

A total of 212 patients with alloantibodies were identified among 42,517 patients, yielding a prevalence of 0.50% in this study. Significantly different prevalence rates were observed according to age and sex. The most frequently identified alloantibodies were anti-E (87/212, 41.0%), anti-D (45/212, 21.2%), anti-M (41/212, 19.3%) and a combination of anti-E and anti-c (13/212, 6.1%). Haemolytic disease was observed in 13 infants with anti-D, three infants with anti-E and one infant with anti-Fy^a alloantibodies. Delayed haemolytic transfusion reactions occurred in four patients with alloantibodies.

Discussion

In hospitalised Hubei Han Chinese individuals, the overall prevalence of alloantibodies was 0.50%, with anti-E, anti-D and anti-M being the most frequently identified alloantibodies. These results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population.     

IgA Antiendomysial Antibodies on the Umbilical Cord in Diagnosing Celiac Disease Sensitivity,Specificity, and Comparative Evaluation with the Traditional Kit

Background: The possibility of assaying antiendomysial antibodies (EmA) on the human umbilical cord instead of monkey esophagus has recently been suggested. We therefore evaluated in patients with celiac disease (CD) the sensitivity and specificity of EmA and of antigliadin antibodies (AGA) for both umbilical cord and monkey esophagus. Methods: We studied 36 patients with CD and atrophy of the intestinal mucosa (median age, 1.4 years), 14 patients with CD on gluten-free diet for 8–12 months (median age, 3.0 years), 36 controls without gastrointestinal disease (median age, 4.0 years), and 72 patients with cow's milk protein enteropathy (CMPE) (median age, 1.2 years). AGA and EmA on monkey esophagus were assayed with commercially available kits; the slides with umbilical cord were prepared in our laboratory. Results: There was a perfect concordance between EmA results evaluated on umbilical cord and those on monkey esophagus; there was a doubtful result in only one case on human umbilical cord, which was positive with low liter on monkey esophagus. EmA specificity was 100%; the specificity of AGA IgG varied between 72% and 94% and of AGA IgA between 90% and 100% depending on whether controls without gastrointestinal disorders or patients with CMPE were considered. EmA sensitivity was 97%, AGA IgG was 89%, and AGA IgA 72% sensitive. The only false negative for EmA was positive for AGA IgG and AGA IgA. Conclusions: Using human umbilical cord as a substrate for EmA may provide the same sensitivity and specificity as offered by the test using monkey esophagus substrate, thus reducing costs and avoiding the use of endangered species.     

Prospective screening of 205 patients with ITP, including diagnosis, serological markers, and the relationship between platelet counts, endogenous thrombopoietin, and circulating antithrombopoietin antibodies

Immune thrombocytopenia purpura (ITP) is characterized by destruction of circulating platelets and the presence of antiplatelet antibodies. Many of the current immunomodulatory therapies act by reducing platelet destruction and usually do not have a lasting effect. This prospective, exploratory study characterized patients with ITP by identifying their demographic and comorbid clinical factors, use of treatments, serologic markers of autoimmunity, and possible relationships between platelet counts, concentrations of endogenous thrombopoietin (eTPO), and the presence of circulating anti-TPO antibodies. Data including medical history and laboratory evaluations were collected at a single patient visit on 205 patients (19 children, 186 adults). Reported histories revealed a 5% rate of thrombotic/ischemic events. Autoimmune markers including direct antiglobulin test and antinuclear antibodies were found more frequently than in the normal population; antiplatelet antibody testing was not done. eTPO concentrations were comparable to concentrations found in healthy volunteers. Our study confirmed that no significant inverse correlation occurred between circulating concentrations of eTPO and platelet counts in patients with ITP (Spearman r = -0.15). Two of the 205 patients tested (1%) had neutralizing activity of recombinant human TPO in a biological assay; however, this activity was confirmed to be anti-TPO antibody in only 1 patient.     

The preparation,characterization, and application of environment-friendly monoclonal antibodies for human blood cell

Objectives: Monoclonal anti-human blood group A (51A8) and B (63B6) antibody reagents were prepared using the serum-free technique. The aims of this research were to characterize the serum-free reagents and prove their reliabilities in routine use.

Methods: Experiments including antigen–antibody agglutination testing, stability testing, SDS–PAGE, protein and IgM quantification, flow cytometry, and variable domain sequencing were performed to characterize the anti-A (51A8) and anti-B (63B6) reagents. Over 12?000 samples were tested using these reagents as routine blood grouping reagents.

Results: Serum-free anti-A (51A8) and anti-B (63B6) reagents were stable in longitudinal and accelerated testing, and their high purity was shown in SDS–PAGE and IgM quantification. These reagents have high specificity to red blood cells in serologic agglutination testing and flow cytometric analysis. A1 and A2 subgroup antigens can be distinguished clearly by patterns of flow cytometric histograms. No discrepancy was found in clinical trials of 12?000 samples.

Discussion: To reduce the risk of being affected by any animal additives, a serum-free culture system was applied to get mass-production of monoclonal anti-A/B antibodies. The high specificity and the high purity of the reagents were verified by the lab experiments.

Conclusion: Lab research and clinical trial showed that serum-free monoclonal anti-A (51A8) and anti-B (63B6) reagents meet the requirements of routine blood grouping reagents. Moreover, these reagents featured ultra-high purity that is missing in other commercial counterparts, and therefore are recommended as more environment-friendly reagents.     

The production and characteristics of anti-insulin,anti-a-component and anti-proinsulin antibodies in patients treated with monocomponent or conventional insulin

Summary Highly purified pork monocomponent insulin produced less anti-insulin antibody than conventional insulins in diabetic patients. The smaller amount of anti-insulin antibody produced by MC insulin bound pork insulin more strongly than beef insulin in both displacement and direct binding studies of¹²⁵I-insulin. On the contrary, anti-insulin antibody which was produced by conventional insulins (beef insulin or mixture of pork and beef insulin) bound beef insulin more strongly. No significant anti-a-component and anti-proinsulin antibodies were detected in diabetics treated with highly purified monocomponent pork insulin about two years, compared to significant production of these antibodies in diabetics treated with conventional insulins. These results suggest that the species difference of the insulin molecule itself plays a significant role for the production of anti-insulin antibody, as the impurities do, in insulin-treated diabetic patients. The production of anti-insulin and anti-a-component antibodies decreased clearly after switching to highly purified monocomponent from conventional insulin. No effect of the switching on insulin requirement was found; however, better control of diabetes was accomplished in relation to the level of fasting blood sugar.     

血清抗角蛋白抗体抗环瓜氨酸肽抗体和类风湿因子在类风湿关节炎中的意义

目的 评价抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在类风湿关节炎(RA)中的意义.方法 收集82例RA患者及56例非RA患者,测定其抗CCP抗体、AKA和RF水平,评价对RA诊断的敏感性、特异性,比较RA患者中抗CCP抗体、AKA阳性组和阴性组的压痛关节数、肿胀关节数、红细胞沉降率(ESR)、C反应蛋白(CRP)、疾病活动指数(DAS)、Ritchie's指数(RAI).结果 单独检测AKA、抗CCP抗体、RF及联合检测的曲线下面积都较高(P<0.05).抗CCP抗体、AKA的特异度分别为92.9%、91.1%,联合检测AKA、抗CCP抗体和RF有任何一种及以上阳性的灵敏度最高,为95.1%.抗CCP抗体阳性组与阴性组的关节肿胀数、关节压痛数、ESR、CRP、DAS、RAI差异有统计学意义(P<0.05);AKA阳性组与阴性组的关节肿胀数、ESR、DSA差异均有统计学意义(P<0.05).结论 联合检测抗CCP抗体、RF、AKA对诊断RA有意义,抗CCP抗体、AKA可能与RA的活动度相关.     

2010年福建省肠道病毒71型血清流行病学调查

目的 了解经过2008及2009年手足口病流行之后,福建省普通人群血清肠道病毒71型的抗体水平。方法 采集2010年福建省390名普通人群的血清标本,采用中和试验检测血清EV71中和抗体。结果 390名普通人群中和抗体阳性186人,阳性率47.69%。男女性别之间中和抗体阳性率及抗体滴度均没有统计学差异(χ²=0.42,P=0.52>0.05;U=-0.24,P=0.81>0.05)。各个年龄组之间的抗体阳性率及抗体滴度均有统计学差异(χ²=55.69,P=0.00<0.05;H_C=50.36, P=0.00<0.05),抗体阳性率最低的为0~岁年龄组,为16.67%,抗体阳性率随年龄增大而增高。0~4岁年龄组的抗体阳性率为25.33%,5~年龄组的抗体阳性率为61.67%,两者之间的抗体阳性率及抗体滴度均有统计学差异(χ²=48.85, P=0.00<0.05;U=-6.39,P=0.00<0.05)。结论 经过2008及2009年手足口病流行之后,福建省普通人群血清肠道病毒71型的抗体水平仍较低,特别是0~4岁年龄组的儿童。今后福建省仍会出现EV71作为主要病原体之一引起的手足口病疫情,易感人群仍为5岁组以下儿童,应继续加强监测和防控。     

Distribution of IgE and IgG Antibody Levels Against House Dust Mites in Schoolchildren, and Their Relation with Asthma

Although asthmatic patients are known to have increased levels of IgG antibody against house dust mite (HDM), it is not clear whether or not the presence of HDM-specific IgG antibody is associated with the etiological mechanism of asthma. To address this problem, we evaluated the relationship between HDM-specific IgG antibody levels and incidence of asthma in a general pediatric population. IgE and IgG antibody levels against Dermatophagoides farinae (Df) were examined by RAST and ELISA in a total of 722 randomly selected schoolchildren including 26 subjects with asthma, and the relative prevalence rates of asthma in this population were evaluated in relation to both Df-specific IgE and IgG levels. The incidence of asthma correlated not only with levels of Df-specific IgE, but also with those of Df-specific IgG. There was a significant correlation between Df-specific IgE and IgG levels both in the total population and in the asthmatic children. Because IgG and IgE responses occurred in parallel in this population, the clinical significance of HDM-specific IgG antibody remains unclear. However, our findings have suggested that clinical expression of asthma in children is primarily dependent on their capacity to mount a immune response to HDM, which includes both IgE and IgG responses.     

单克隆抗体对高血压、冠心病及糖尿病患者血小板聚集的体外抑制作用

用抗血小板膜糖蛋白Ⅱb-Ⅲa复合物（GPⅡb-Ⅲa）CDw41单克隆抗体体外抑制ADP诱导血小板聚集方法，间接判断冠心病、高血压和糖尿病患者血小板表面Ⅱb-Ⅲa受体的密度。共测定51例，其中冠心病10例，高血压10例，糖尿病15例，正常对照16例。结果表明，三组患者富血小板血浆加入抗CDw41单抗后，ADP诱导的血小板聚集与正常对照组比较明显升高（P＜0．001），血小板聚集百分抑制率与正常对照组比较明显降低（P＜0．001）。本实验方法简单，结果可靠，值得临床应用。