生物素─链霉亲和素系统在检测巨细胞病毒抗体中的应用

本文用自制ＣＭＶ抗原和生物素－链霉亲和素系统试剂，通过最适条件的对比，建立了检测人血清中抗巨细胞病毒ＩｇＭ、ＩｇＡ类抗体的ＢＳＡ－ＥＬＩＳＡ，并与普通ＥＬＩＳＡ作比较，结果表明，ＢＳＡ－ＥＬＩＳＡ的非特异性吸附明显低于普通ＥＬＩＳＡ，与普通ＥＬＩＳＡ相比，抗体效价分别提高５和７倍，阳性率分别提高６８％和１５３．５％。在实际工作中曾用ＢＳＡ－ＥＬＩＳＡ检测临床样品１６５份，就所得结果进行分析。表明ＢＳＡ－ＥＬＩＳＡ检测ＣＭＶＩｇＭ和ＩｇＡ可提高特异性和灵敏度，值得推广应用。     

生物素─链霉亲和素系统在检测巨细胞病毒抗体中的应用

本文用自制ＣＭＶ抗原和生物素－链霉亲和素系统试剂，通过最适条件的对比，建立了检测人血清中抗巨细胞病毒ＩｇＭ、ＩｇＡ类抗体的ＢＳＡ－ＥＬＩＳＡ，并与普通ＥＬＩＳＡ作比较，结果表明，ＢＳＡ－ＥＬＩＳＡ的非特异性吸附明显低于普通ＥＬＩＳＡ，与普通ＥＬＩＳＡ相比，抗体效价分别提高５和７倍，阳性率分别提高６８％和１５３．５％。在实际工作中曾用ＢＳＡ－ＥＬＩＳＡ检测临床样品１６５份，就所得结果进行分析。表明ＢＳＡ－ＥＬＩＳＡ检测ＣＭＶＩｇＭ和ＩｇＡ可提高特异性和灵敏度，值得推广应用。     

双抗原夹心ELISA检测抗结核杆菌抗体及初步应用

双抗原夹心ＥＬＩＳＡ检测抗结核杆菌抗体及初步应用鲁严，彭晓红，盛裕芬目前用ＥＬＩＳＡ检测血清中的抗结核杆菌抗体（ＴＢＡｂ）大多为二步法，孵育时间较长，我们建立了双抗原夹心快速ＥＬＩＳＡ检测ＴＢＡｂ获得较好结果，并已制成试剂盒。材料和方法临床确诊的活动...     

SLE患者血清抗眼肌抗体的检测

ＳＬＥ患者血清抗眼肌抗体的检测马东生，王艾丽，武建国南京军区南京总医院南京２１０００２抗眼肌抗体（ＥＭ－ａｈ）是一组对眼肌细胞膜多种膜蛋白抗原起反应的自身抗体，对眼肌细胞具有细胞毒作用［１］。为探讨ＳＬＥ眼病与ＥＭ－ａｈ的关系，我们用间接ＥＬＩＳＡ法...     

用基因工程表达的抗原早期诊断鼻咽癌

目的为了建立鼻咽癌（ＮＰＣ）早期诊断方法。方法以基因工程表达的、经纯化的ＥＢ病毒（Ｅｐｓｔｅｉｎ－Ｂａｒｖｉｒｕｓ，ＥＢＶ）早期抗原（ＥＡ）成分ＥＡ－Ｄ和ＥＡ－Ｒ作为诊断抗原，建立了酶联免疫吸附试验（ＥＬＩＳＡ），检查３０例ＮＰＣ病人及４９例正常人血清中的ＥＡ／ＩｇＡ抗体。结果用ＥＬＩＳＡ检测抗体较用细胞涂片免疫酶方法（ＩＥ）敏感。ＥＬＩＳＡ检测ＮＰＣ病人血清中ＥＡ／ｌｇＡ抗体，阳性率为１００％，ＥＡ／ｌｇＡ抗体效价均≥１∶１００。而用ＩＥ法，平行检测３０例ＮＰＣ病人血清中ＥＡ／ｌｇＡ抗体效价，结果６例为阴性（＜１∶１０），抗体阳性率为７０％。ＥＬＩＳＡ明显地提高了ＮＰＣ的检出率。以ｐ１３８（ＥＡ－Ｒ）和ｐ５４（ＥＡ－Ｄ）分别或混合包被，检测对ＥＢＶ特异的ＥＡ－Ｄ和ＥＡ－Ｒ的抗体。结论表明在ＮＰＣ病人血清中存在对ＥＡ两种抗原的抗体，对ＥＡ－Ｄ的抗体滴度高于对ＥＡ－Ｒ的抗体。因此，以两种抗原混合包被作为诊断抗原建立的ＥＬＩＳＡ方法，为ＮＰＣ的早期诊断提供更敏感、特异和简便的手段。     

弓形虫IgM抗体检测方法的研究

本文以鼠抗人μ链单克隆抗体捕获被测人血清中ＩｇＭ抗体，再以辣根过氧化物酶标记的弓形虫抗原进行直接酶联免疫吸附试验，检测人血清中特异性抗弓形虫ＩｇＭ抗体，并以阻断试验证实该方法的特异性。与风疹病毒ＩｇＭ抗体阳性血清，巨细胞病毒ＩｇＭ抗体阳性血清和类风湿因子等无交叉反应。与进口试剂盒以酶联免疫吸附试验双夹心法（ＤＳ－ＥＬＩＳＡ－Ｔｏｘ－ＩｇＭ）进行比较检测了临床血清样品１０５３份，两者阳性符合率为９５．５６％，ＤＳ－ＥＬＩＳＡ阴性血清在Ｄ－ＥＬＩＳＡ法亦阴性，而且后者灵敏度略高。酶标记抗原和包被抗体的酶标板在４℃中保存６个月仍稳定。试剂盒操作简便，快速，适用于弓形虫病的早期诊断。     

胃肠道癌患者血清中抗癌胚抗原(CEA)抗体的检测及意义

目的：探讨循环中抗癌胚抗原（ＣＥＡ）特异性抗体的情况，评价ＣＥＡ及抗体的联合检测在胃肠道癌诊断中的作用。方法：用放免法检测血清中 ＣＥＡ含量，用酶联免疫吸附法（ＥＬＩＳＡ）检测抗 ＣＥＡ ＩｇＧ抗体，用竞争抑制法检测抗体的特异性。结果：胃肠道癌患者血清 ＣＥＡ含量升高者（≥１５ ｎｇ／ｍｌ）为 ３０．９％（２１／６８），抗 ＣＥＡ ＩｇＧ抗体阳性者为３５．３％（２４／６８），ＣＦＡ及抗 ＣＥＡ抗体的联合检测可使阳性率提高到５４．３％（３７／６８）；胃肠道良性疾病患者（多发性息肉、溃疡、胰腺炎等）血清ＣＥＡ升高者为３．３％（１／３０），抗 ＣＥＡ　ＩｇＧ抗体阳性者为 ３．３％（１／３０）；健康对照组血清 ＣＥＡ升高者为 ０，抗 ＣＥＡ ＩｇＧ抗体阳性者为 ２．５％（１／４０）。结论：胃肠道癌患者血清中抗癌胚抗原（ＣＥＡ）抗体的检出率较高，这些抗体可作为胃肠道癌的一种肿瘤标志物。     

双抗体夹心ELISA法检测人血清弓形虫抗体

本文报告了双抗体夹心竞争ＥＬＩＳＡ法检测人血清弓形虫抗体，并与间接ＥＬＩＳＡ法进行了比较。结果二法阳性符合率为９１．７％。夹心ＥＬＩＳＡ法特异性、稳定性优于间接ＥＬＩＳＡ法，间接ＥＬＩＳＡ法阳性检出率略高于夹心法，但无统计学差异（Ｐ＞０．０５）。     

sIL－2R与SLE的临床表现和自身抗体的相关性

用双抗体夹心ＥＬＩＳＡ检测６６例ＳＩＥ病人血清叽ｓＩＬ－２Ｒ水平，ＳＬＥ病人显著高于正常人，疾病活动期高于非活动期。血清ｓＩＬ－２Ｒ水平与ＡＮＡ、抗ｄｓ－ＤＮＡ抗体、抗Ｓｍ、ＳＳ－Ａ、ＳＳ－Ｂ抗体无关，而与ＳＬＥ患者的发热、贫血、白细胞减少、关节受累及肾脏损害相关，且与ＳＬＥ疾病活动性和ＥＳＲ成正相关，与补体Ｃ＿３、Ｃ＿４和ＣＨ＿（５０）成负相关。提示血清ｓＩＬ－２Ｒ水平是监测ＳＬＥ疾病活动性的一个良好指标。     

化学发光免疫测定抗dsDNA抗体的实验条件分析和初步应用

采用正交设计确定了化学发光免疫测定抗ｄｓＤＮＡ抗体的最适实验条件，并与免疫荧光法（ｌＦ）、酶联免疫吸附测定法（ＥＬＩＳＡ）和放射免疫测定法（Ｆａｒｒ）比较。结果表明，最适条件：ｄｓＤＮＡ包被浓度为１０μｇ／ｍｌ、ＡＢＥＩ－ＳａＨＩｇＧ结合物使用发光强度为１．０×１０￣４ｍｖ坎德拉，氯化高铁血红素（Ｈｅｍｉｎ）浓度为５μｍｏｌ／Ｌ，Ｈ＿２Ｏ＿２浓度为０．３％，５６份ＳＬＥ患者血清中，化学发光免疫测定法（ＣＬＩＡ）检测抗ｄｓＤＮＡ抗体阳性率为８３．９％，高于ＩＦ和ＥＬＩＳＡ法，接近Ｆａｒｒ法水平。阻断试验证明，本方法检测抗ｄｓＤＮＡ抗体具较高特异性。     

Antiendothelial cell antibodies can be cytotoxic to endothelial cells without cytokine pre-stimulation and correlate with ELISA antibody measurement in Kawasaki disease

To confirm the presence of antiendothelial cell antibodies (AECA) and study the clinical value of their measurement in Kawasaki disease (KD), sera from patients with KD were assessed for binding to human umbilieal vein endothelial cells (HUVEC) using a cellular based ELISA, and for complement-mediated cytotoxiety using in-labelled HUVEC. In the ELISA assay, IgM AECA were detected in 16/22 sera, whereas IgG AECA were only present in one out of 19 sera. There was a significant difference in IgM AECA titres when comparing patients with controls. Eight out of 16 sera showed cytotoxicity against HUVEC, and this was significantly enhanced when HUVEC were pretreated with tumour neerosis factor (TNF). IgM AECA titres measured by ELISA were positively correlated with their cytotoxieity. The findings suggest that IgM class AECA in sera from patients with KD are detectable by ELISA method, and that some of these antibodies. 50% in this study, can mediate complement-dependent cytotoxicity against endothelial cells.     

Anti-endothelial cell antibodies from patients with thrombotic thrombocytopenic purpura specifically activate small vessel endothelial cells

Thrombotic thrombocytopenic purpura (TTP) is an uncommon disease of an unknown etiology, characterized by consumptive thrombocytopenia, microangiopathic hemolytic anemia, fever and acute thrombotic complications, especially within the cerebral circulation. Although anti-endothelial cell antibodies (AECA) have occasionally been shown to be present in TTP, their role in the pathogenesis of the disease has never been ascertained. In the current study we demonstrated the pathogenic activity of affinity-purified anti-endothelial cell F(ab)2 antibodies (AECA/TTP) from four consecutive patients with active TTP. These AECA/TTP bound to and activated only microvascular endothelial cells (EC) and not large vessel EC. The specificity of AECA/TTP binding to microvascular EC was confirmed by competition assay employing membranes derived from small and large vessels EC. Activation included enhanced IL-6 and von Willebrand factor release from the EC followed by increased expression of adhesion molecules P-selectin, E-selectin and vascular cell adhesion molecule-1 on the EC, as evaluated by ELISA. Increased expression of adhesion molecules was followed by an increase in monocyte adhesion to EC. The level of soluble thrombomodulin (TM) also increased in the culture medium of activated microvascular EC upon exposure to AECA/TTP antibodies and was directly correlated to a decrease in cell-associated TM. Our data suggest that AECA/TTP directed against microvascular EC could play a pathogenic role in the development of endothelial injury in TTP that leads to thrombosis.     

Anti-endothelial cell antibodies (AECA) in systemic sclerosis--increased sensitivity using different endothelial cell substrates and association with other autoantibodies.

OBJECTIVE: One of the main features of systemic sclerosis (SSc) is vascular damage, the mechanism of which is not understood. In the present study we examined whether screening of SSc patients for different anti-endothelial cells antibodies (AECA) of various origins increase the sensitivity of AECA detection in SSc patients. Secondary aim was an attempt to correlate AECA with other common autoantibodies. MATERIALS & METHODS: 478 SSc patients were studied for the presence AECA, anti-cardiolipin (aCL), anti-dsDNA, anti-heparin (AHA), anti-pyruvate dehydrogenase (PDH) and anti-PDC-E2 autoantibodies. AECA levels were detemined using human umbilical vein EC (HUVEC), bone marrow EC (BMEC), EC hybridoma (EA.hy 926) and Kaposi sarcoma EC (KS). RESULTS: Positive AECA were found in 49.5% of SSc patients (27.1% HUVEC; 34.3% BMEC; 26.3% EaHy 926 and 22.7% KS). The highest percent reactivity of AECA was obtained using microvascular BMEC. When combining BMEC and either other cell lines the reactivity ranged from 41.4% to 46%. A significant association between AECA on the one hand and AHA (p<0.001)) and anti-PDH (p<0.05) on the other was secn. Cross-reactivity with anti-PDC-E2 was excluded by inhibition tests, but AHA and anti-PDH may be part of the spectrum of AECA. CONCLUSIONS: Since false-negative AECA may result from lack of expression of various antigens on a specific EC, analysis of AECA in SSc patients requires using several EC types, including microvascular EC.     

Vascular damage in Wegener''s granulomatosis and microscopic polyarteritis: presence of anti-endothelial cell antibodies and their relation to anti-neutrophil cytoplasm antibodies.

To define mechanisms of vascular injury in Wegener's granulomatosis and microscopic polyarteritis, anti-endothelial cell antibodies (AECA) were sought in serum from 168 patients, all of whom had anti-neutrophil cytoplasm antibodies (ANCA) detectable by indirect immunofluorescence. Using an ELISA with human umbilical vein endothelial cells (HUVEC), IgG AECA were demonstrated in 59% and IgM AECA in 68% of patients. Pretreatment of HUVEC with tumour necrosis factor (TNF), IL-1 or interferon-gamma (IFN-gamma) led to increased binding. Adsorption of AECA/ANCA-containing serum with HUVEC or neutrophils demonstrated that AECA and ANCA recognized different targets. von Willebrand factor (vWf) antigen levels in the patient samples were markedly elevated, with a mean of 3.10 +/- 1.89 U/ml (control population mean 1.04 +/- 0.36 U/ml), suggesting widespread endothelial cell damage. Studies using an 111In-labelled HUVEC release assay with 29 AECA-containing sera did not demonstrate complement-mediated cytotoxicity, even following activation of HUVEC with TNF. Four out of 16 AECA-containing sera tested showed antibody-dependent cellular cytotoxicity with unfractionated peripheral blood mononuclear cells. These data suggest that patients with Wegener's granulomatosis or microscopic polyarteritis can develop AECA to constitutively expressed but cytokine modulated determinants on HUVEC. These antibodies do not appear to support complement-mediated cytotoxicity, but a proportion can support antibody-dependent cellular cytotoxicity, suggesting that they may contribute to vascular injury.     

Antiendothelial Cells Autoantibodies in Vasculitis-Associated Systemic Diseases

Antiendothelial cell antibodies (AECA) have been detected in healthy individuals, as well as in autoimmune and systemic inflammatory diseases, including systemic vasculitides. AECA have been reported in large vessel vasculitides such as giant cell arteritis and Takayasu arteritis; medium-sized vessel vasculitides, such as polyarteritis nodosa related to hepatitis B virus infection and Kawasaki disease; and small-sized vessel vasculitides, such as Wegener's granulomatosis, microscopic polyangiitis, and Henoch-Schonlein purpura. In Takayasu arteritis and antineutrophil cytoplasm antibody-positive vasculitides, AECA have been reported to correlate with disease activity. A cell-based enzyme-linked immunosorbent assay (ELISA) using cultured human umbilical vein endothelial cells (HUVEC) represent one of the reference techniques for AECA detection, although flow cytometry and immunobloting have also been proposed. AECA might contribute to the pathogenesis of systemic vasculitides and vasculitis-associated diseases through (1) activation of endothelial cells (EC), (2) direct cytotoxic effect due to complement-dependent cytotoxicity or indirect cytotoxic effect secondary to antibody-dependent cytotoxicity, (3) induction of coagulation, (4) induction of apoptosis through the binding of phospholipids or heat-shock protein 60, and (5) induction of EC activation. None of the identified target antigens of AECA is specific for EC, and EC-specific target antigens of AECA remain to be identified in systemic vasculitides.     

Induction of elastin expression in vascular endothelial cells relates to hepatoportal sclerosis in idiopathic portal hypertension: possible link to serum anti-endothelial cell antibodies

Hepatoportal sclerosis accompanied by dense elastic fibre deposition is generally regarded as the primary lesion in the development of idiopathic portal hypertension (IPH). This study was performed to clarify the mechanism of elastic fibre deposition in the peripheral portal tracts of IPH liver in relation to serum anti-endothelial cell antibodies (AECA). In-vitro experiments were performed using human dermal microvascular endothelial cells (HMVEC) and patients' sera. The presence of serum AECA was assayed by a cell-based enzyme-linked immunosorbent assay (ELISA) using HMVEC. Immunohistochemical analysis of elastin was performed using liver tissue sections of IPH patients. IPH sera contained one or more AECA that could bind to the vascular endothelial cells of the peripheral portal tracts of the liver. When the value of AECA greater than the mean ± 2 standard deviations of healthy controls was regarded as positive, the positive detection rate of either immunoglobulin (Ig)G, IgA or IgM AECA in IPH sera was 30% (10 of 33 cases). IPH sera induced the expression of elastin in HMVEC, which appeared to be associated with the presence of AECA. Apoptosis was also induced in HMVEC by the stimulation with IPH sera. In vivo, elastin expression was observed in the endothelial cells of the peripheral portal tracts of IPH livers in a proportion of cases. The disease pathogenesis of IPH seems to be heterogeneous, and this study elucidated a possible contribution of the induction of elastin expression in the portal vessels to hepatoportal sclerosis of IPH, which might be linked to serum AECA as a causative factor.     

Anti-endothelial cell antibody in preeclampsia: clinical findings and serum cytotoxicity to endothelial cell.

BACKGROUND: The role of anti-endothelial cell antibody (AECA) in systemic vasculitis has been reported. One candidate which may disrupt vascular function is AECA. In order to investigate the role of AECA in preeclampsia, the incidence of AECA positive patients, the characteristics of the clinical findings of AECA positive patients and also the cytotoxicity of AECA positive serum for cultured endothelial cells was studied. METHODS: Serum samples were taken from 57 preeclampsia (including 37 severe cases) and 46 normal pregnant women. The AECA were measured by ELISA using human umbilical vein endothelial cells. The cytotoxicity for cultured endothelial cells by test serum was measured by using 51Cr release assay. RESULTS: The incidence of IgG and IgM AECA were revealed in 26.3% and 10.5% of preeclampsia respectively. AECA was detected more frequently in severe (29.7%) than in mild preeclampsia (20.0%). In cases with severe proteinuria of greater than 200 mg/dl we detected a significantly higher incidence of AECA than in mild cases (p < 0.04). The incidence of AECA was not significantly increased in cases with severe hypertension or IUGR. The AECA positive sera had greater cytotoxic activity on endothelial cells than AECA negative sera (p < 0.03). CONCLUSIONS: The appearance of AECA is related to the severity of proteinuria and the cytotoxicity to endothelial cells by AECA positive sera may play a role in causing the endothelial damage in preeclampsia.     

Human monoclonal anti-endothelial cell IgG-derived from a systemic lupus erythematosus patient binds and activates human endothelium in vitro

Our objectives were to obtain monoclonal anti-endothelial cell antibodies (AECA) from systemic lupus erythematosus (SLE) patients, to characterize their antigen specificity, and their capability to induce a pro-inflammatory and pro-adhesive endothelial phenotype, and to investigate the mechanism of endothelial cell (EC) activation in vitro. Monoclonal IgG AECA were generated by hybridoma formation with human SLE B cells. Antigen specificity was characterized by immunoblotting with enriched cell membrane fractions, by cytofluorimetry and by cell solid-phase ELISA. Endothelial activation was evaluated by measuring increases in U937 cell adhesiveness, adhesion molecule (E-selectin and ICAM-1) expression and IL-6 production. In addition, mechanisms of endothelial activation were investigated by assessment of NF-kappaB by measuring the loss of its inhibitor I-kappaB. mAb E-3 bound live EC and recognized a 42 kDa EC membrane protein, it enhanced U937 adhesiveness, E-selectin and ICAM-1 expression and IL-6 production, and caused the loss of I-kappaB. We conclude this is the first in vitro demonstration that a human monoclonal AECA from a SLE patient reacts with a constitutive endothelial membrane antigen and induces a pro-inflammatory endothelial phenotype through NF-kappaB activation.     

Antibodies to endothelial cells in Kawasaki disease lyse endothelial cells without cytokine pretreatment

Kawasaki disease (KD) is characterized by diffuse vasculitis and marked immune activation. To confirm the presence of antiendothelial cell antibodies (AECA) and cytotoxicity of AECA, we investigated the presence of AECA using ELISA and cytotoxicity of AECA in KD. Sera from patients with acute KD were assessed for binding to human umbilical vein endothelial cells (HUVEC) using a cell-based ELISA, and for cytotoxicity against HUVEC as indicated by the conversion of a tetrazolium salt (MTT) into a coloured product. IgM AECA were detected in 8/19 KD sera, IgG AECA were detected in 5/19 KD sera. Significant differences in both AECA titres existed between patients and febrile and afebrile controls. Six out of 19 patients showed complement-dependent cytotoxicity against HUVEC. Cytotoxicity was significantly enhanced by pretreating HUVEC with tumour necrosis factor (TNF), and reduced by incubation with gammaglobulin. Serum titres of IgM AECA in the KD patients were positively correlated with cytotoxicity. Findings suggest that IgM AECA mediates complement-dependent cytotoxicity against endothelial cells in patients with KD, and gammaglobulin may reduce complement-dependent cytotoxicity of AECA against endothelial cells.     

类风湿关节炎患者抗血管内皮细胞抗体、血管内皮生长因子和白细胞介素-17的检测及意义

目的 通过对类风湿关节炎(RA)患者血清抗血管内皮细胞抗体(AECA)、血浆血管内皮生长因子(VEGF)和白细胞介素-17(IL-17)的检测,旨在探讨AECA、VEGF、IL-17在RA患者发病、病情进展中的相关性及其内在联系.方法 采用间接免疫荧光法(IIF)和双抗体夹心酶联免疫吸附试验(ELISA)法检测86例RA、45例骨关节炎(OA)、30例健康对照AECA的阳性率和VEGF、IL-17水平,VEGF、IL-17水平与红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)等指标进行相关性分析.结果 RA患者AECA阳性率为8.1%,高于OA患者的阳性率2.2%(t:2.133,P<0.05)和健康对照的阳性率0(t=2.562,P<0.05);RA活动期AECA阳性率为16.7%,高于RA缓解期的阳性率3.6%(t=2.105,P<0.05);RA患者血浆IL-17和VEGF水平显著高于OA组(t=2.02、t=2.106,P<0.05)和健康对照组(t=2.413、t=2.469,P<0.05);RA患者活动期血浆IL-17和VEGF水平明显高于RA缓解组(t=2.315、t=2.232,P<0.05)及健康对照组(t:2.985、t=2.753,P<0.01);RA缓解组与健康对照组无明显差异(t=1.475、t=1.326,P>0.05);RA患者AECA滴度、血浆IL-17、VEGF水平与ESR、hs-CRP、RF的指标呈正相关.结论 AECA、VEGF、IL-17三者与RA的发病、病情活动存在一定的关系,IL-17、VEGF水平变化及AECA的滴度可作为临床观察RA病情活动、判断疗效及预后等方面的参考指标.