白癜风患者血清抗人黑素浓集素受体-1自身抗体的检测及分析

目的检测白癜风患者血清中抗黑素浓集素受体-1(MCHR1)的自身抗体,探讨其在白癜风发病中的意义。方法构建真核表达载体pcDNA3.1/MCHR1,经限制性内切酶双酶切及DNA测序鉴定后,用阳离子脂质体介导转染CHO细胞,经G418筛选,利用ELISA,RTPCR及蛋白印迹法鉴定表达MCHR1蛋白的阳性克隆。采用活细胞ELISA法检测白癜风患者血清抗MCHR1及抗黑素细胞(MC)膜表面抗原的自身抗体。结果白癜风患者血清中抗MCHR1自身抗体阳性率为17.1%,抗MC膜表面抗原的自身抗体阳性率为41.4%,所有抗MCHR1自身抗体阳性的血清抗MC膜表面抗原自身抗体均为阳性,正常人血清中抗MC膜表面抗原及抗MCHR1抗体均为阴性。结论白癜风患者血清中存在抗MCHR1的自身抗体,MCHR1是MC膜表面的白癜风相关抗原。     

色素障碍性皮肤病

20 0 1394 2　白癜风患者血清中抗黑素细胞膜表面抗原自身抗体的检测 /李志强 (三军大西南医院皮肤科 )…∥中华皮肤科杂志 .- 2 0 0 1,34(4) .- 2 6 8～ 2 70采用体外培养的正常人黑素细胞 ,使用活细胞ELISA检测了 334例不同亚型及病期的白癜风患者血清中抗黑素细胞膜表面抗原 Ig G自身抗体。结果 :活动期寻常型白癜风患者血清有 6 7.0 0 %检出抗黑素细胞 Ig G抗体 ;稳定期患者阳性率 30 .80 % ;活动期节段型阳性率为 4 0 .5 4 % ;稳定期节段型阳性率为2 1.4 2 %。说明自身免疫机制可能在寻常型和节段型白癜风的发病中起一定作用。表 1…     

白癜风患者血清中抗黑素细胞膜表面抗原自身抗体的检测

目的：检测白癜风患者血清中的抗黑素细胞抗体并分析其与疾病活动性及亚型之间的关系。方法：采用体外培养的正常人黑素细胞,使用活细胞ELISA检测了334例不同亚型及病期的白癜风患者血清中抗黑素细胞膜表面抗原IgG自身抗体。结果：活动期寻常型白癜风患者血清有67％检出抗黑素细胞IgG抗体,稳定期寻常型白癜风患者IgG抗黑素细胞抗体阳性率为30．3％;活动期节段型白癜风阳性率为40．54％,稳定期节段型白癜风的阳性率为21．42％。活动期寻常型白癜风患者血清中抗黑素细胞IgG抗体水平明显高于稳定期寻常型白癜风、活动期节段型白癜风患者及正常人;活动期节段型白癜风患者抗黑素细胞水平亦明显高于正常人。结论：白癜风患者体内广泛存在抗黑素细胞自身抗体,自身免疫机制可能在寻常型和节段型的发病中起一定作用。     

三种表达肽检测进展期白癜风患者血清酪氨酸酶抗体的比较

目的 应用三种表达肽TYR240-300,TYR240-479和TYR检测进展期白癜风患者血清酪氨酸酶IgG抗体,比较三者的抗体检测差异,筛选优势抗原.方法 原核表达、纯化三种表达肽TYR240-300,TYR240-479和TYR,Western印迹鉴定纯化蛋白;以纯化的三种表达肽作为抗原,以提取的黑素细胞总蛋白作为阻断抗原,进行阻断ELISA分析;以纯化的三种表达肽作为抗原,检测100例进展期白癜风患者血清中酪氨酸酶IgG抗体,比较三种表达肽的抗体检测阳性率及滴度差异.结果 三种表达肽均能被天然的黑素细胞抗原所阻断,100例进展期白癜风患者血清中,抗TYR240-300 IgG抗体与抗TYR240-479 IgG抗体阳性率分别为32.0%和62.0%,不同型别患者两种抗体检出阳性率差异较大,泛发性(8例)分别为4例和7例,局限性(8例)分别为3例和4例,散在性(48例)分别为31.3%和60.4%,肢端性(19例)分别为20.0%和52.6%,节段型(17例)分别为47.1%和82.4%.40例进展期白癜风患者血清中抗TYR240-479 IgG抗体与抗TYR IgG抗体的阳性率相近,分别为62.5%和60.0%.表达肽TYR240-479和TYR检测的进展期白癜风患者血清中IgG抗体最高滴度均为1:320,而表达肽TYR240-300检测的进展期白癜风患者血清中IgG抗体最高滴度均为1:160.结论 TYR 240-479是用于白癜风患者中酪氨酸酶抗体检测的优势抗原.     

三种表达肽检测进展期白癜风患者血清酪氨酸酶抗体的比较

目的 应用三种表达肽TYR240-300,TYR240-479和TYR检测进展期白癜风患者血清酪氨酸酶IgG抗体,比较三者的抗体检测差异,筛选优势抗原。方法 原核表达、纯化三种表达肽TYR240-300,TYR240-479和TYR,Ｗestern印迹鉴定纯化蛋白;以纯化的三种表达肽作为抗原,以提取的黑素细胞总蛋白作为阻断抗原,进行阻断ELISA分析;以纯化的三种表达肽作为抗原,检测100例进展期白癜风患者血清中酪氨酸酶IgG抗体,比较三种表达肽的抗体检测阳性率及滴度差异。结果 三种表达肽均能被天然的黑素细胞抗原所阻断,100例进展期白癜风患者血清中,抗TYR240-300 IgG抗体与抗TYR240-479 IgG抗体阳性率分别为32.0%和62.0%,不同型别患者两种抗体检出阳性率差异较大,泛发性（8例）分别为4例和7例,局限性（8例）分别为3例和4例,散在性（48例）分别为31.3%和60.4%,肢端性（19例）分别为20.0%和52.6%,节段型（17例）分别为47.1%和82.4%。40例进展期白癜风患者血清中抗TYR240-479 IgG抗体与抗TYR IgG抗体的阳性率相近,分别为62.5%和60.0%。表达肽TYR240-479和TYR检测的进展期白癜风患者血清中IgG抗体最高滴度均为1 ∶ 320,而表达肽TYR240-300检测的进展期白癜风患者血清中IgG抗体最高滴度均为1 ∶ 160。结论 TYR 240-479是用于白癜风患者中酪氨酸酶抗体检测的优势抗原。     

沈阳地区275例白癜风患者血清抗酪氨酸酶IgG抗体及其亚类的检测与分析

目的探讨白癜风患者血清抗酪氨酸酶Ig G抗体(TYR sIgG)及其4种亚类与白癜风疾病的关系。方法采用酶联免疫吸附法(ELISA)检测沈阳地区275例白癜风患者和50例健康人血清中抗酪氨酸酶Ig G抗体及其4种亚类的含量。结果白癜风组与健康对照组TYR sIgG的阳性率比较差异有统计学意义(P0.01)。白癜风组中TYR sIgG亚类的阳性率为IgG3Ig G1Ig G4,≥2种TYR sIgG亚类同时阳性61例,占TYR sIgG阳性白癜风的51.26%(61/119)。白癜风男女患者TYR sIgG及其4种亚类的阳性率比较差异均无统计学意义。结论酪氨酸酶可能刺激白癜风患者免疫系统产生TYR sIgG,与白癜风发病有关,检测TYR sIgG可为自身免疫性白癜风的诊断和免疫治疗提供一种科学的依据。TYR sIgG主导亚类为IgG3和IgG1。     

广东地区白癜风患者309例血清甲状腺功能相关指标分析

目的回顾性分析广东地区白癜风患者血清甲状腺功能指标水平,探讨白癜风与自身免疫性甲状腺疾病的相关性。方法回顾性分析309例白癜风患者血清抗甲状腺球蛋白抗体(Anti-TG)、抗甲状腺过氧化物酶抗体(Anti-TPO)的水平与患者性别、年龄、分期、分型的临床特征的关系并统计患者的甲状腺功能异常率。结果白癜风患者中Anti-TG阳性率为32.04%,Anti-TPO阳性率为27.18%,其中女性患者的抗体阳性率以及检测水平均高于男性(P0.01),抗体阳性组的平均年龄高于阴性组(P=0.02);稳定期与进展期白癜风患者的以上两种抗体水平差异未见统计学意义,节段型白癜风患者的Anti-TG和Anti-TPO水平显著低于非节段型(P0.01)。从亚型水平进行分析,节段型白癜风患者的Anti-TG和Anti-TPO检测值显著低于散发型(P0.01);同时,白癜风患者甲状腺功能的异常率高于体检人群(P0.01)。结论白癜风与自身免疫性甲状腺疾病存在一定相关性,定期筛查尤其是女性和散发性白癜风患者的甲状腺功能相关指标显得尤为重要。     

白癜风发病与自身免疫性甲状腺病的相关性探讨

目的探讨白癜风与自身免疫性甲状腺病(AITD)的发生是否存在相关性。方法用化学发光分析法测定38例白癜风患者和35名正常人群的甲状腺功能(包括抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体),比较白癜风患者和正常对照组间甲状腺自身抗体阳性率,同时比较甲状腺自身抗体阳性的白癜风患者与甲状腺自身抗体阴性的白癜风患者间AITD患病率。结果白癜风患者T3和T4与正常对照组比较差异无显著性(P>0.05),而白癜风患者FT3和FT4与正常对照组比较差异均有显著性(P<0.05)。白癜风患者血清TSH与正常对照组比较差异有显著性(P<0.01)。白癜风患者甲状腺自身抗体阳性率与正常对照组比较均有增高趋势(P<0.05)。甲状腺自身抗体阳性的白癜风患者AITD患病率(41.18%)与甲状腺自身抗体阴性的白癜风患者(9.52%)间比较明显增高(P<0.05)。结论白癜风的发病与甲状腺功能的改变和自身免疫有着密切的联系。     

色素障碍性皮肤病

990361 白癜风患者血清抗黑素瘤细胞抗体的检测/兰凤华(四军大生化教研室)…//中华皮肤科杂志.-1998,31(4).-247用免疫组化方法,对白癜风患者血清抗黑素瘤细胞抗体进行了检测。观察20例活动期非节段型白癜风患者中有13例阳性,阳性率65％,证明患者体内存在抗黑素瘤细胞抗体。31例非白癜风住院患者3例阳性,阳性率10％,23％体检健康者无1例出现阳性结果。白癜风患者阳性血清不与食道癌细胞反应,说明它们与黑素瘤细胞的结合是特异性的。图1参4(贾泰元)     

白癜风患者血清中抗黑素细胞IgG,IgM抗体的检测及补体介导的血清细胞毒反应

为探讨白癜风血清中的抗黑素细胞抗体类型和反应模式以及对黑素细胞的损伤作用 ,以免疫组化法检测了白癜风患者血清中抗黑素细胞IgG、IgM抗体 ,并以吖啶橙 /溴化乙锭细胞染色法观察补体介导的白癜风血清对黑素细胞损伤作用。结果发现 2 5例活动性寻常型白癜风患者血清中有 19例检出IgG型抗体 ,2 1例检出IgM型抗体 ,明显高于稳定期和正常对照组血清 ;2 5例活动期血清 9例出现对黑素细胞的明显细胞毒作用 ,高于正常人血清 ,对照的成纤维细胞未出现明显的细胞毒作用。结果提示白癜风患者血清内有抗黑素细胞IgG、IgM抗体 ,这些抗体可以通过补体选择性的损伤体外培养的黑素细胞 ,支持白癜风是一种自身免疫性疾病的假设。     

Autoantibodies against tyrosine hydroxylase in patients with non-segmental (generalised) vitiligo

Vitiligo is an acquired idiopathic hypomelanotic skin disorder characterised by depigmented macules because of loss of cutaneous melanocytes. Although the exact cause of vitiligo remains obscure, evidence suggests that autoimmunity plays a role in the pathogenesis of the disease. Previously, tyrosine hydroxylase (TH) was identified as a putative autoantigen in vitiligo using phage-display technology. In this study, the prevalence of TH antibodies in patients with vitiligo was investigated. A radioimmunoassay (RIA) was used to detect TH antibodies in sera from patients with either non-segmental vitiligo (n=79), segmental vitiligo (n=8) or other autoimmune diseases without concomitant vitiligo (n=91). Sera from healthy individuals (n=28) were also tested. Patients with segmental vitiligo, healthy controls and patients with other autoimmune diseases without concomitant vitiligo were all negative for TH antibody reactivity. Of 79 patients with non-segmental vitiligo, 18 (23%) were positive for TH antibodies in the RIA, and a significant increase in the prevalence of TH antibodies in patients with non-segmental vitiligo was evident when compared with controls (P=0.003). TH antibody prevalence was also significantly elevated in patients with active vitiligo compared to those with stable disease (P=0.009). Overall, the results indicate that TH is an antibody target in non-segmental but not in segmental vitiligo and that TH antibodies appear to be more frequent in patients with active vitiligo.     

Epitopes, avidity and IgG subclasses of tyrosine hydroxylase autoantibodies in vitiligo and alopecia areata patients

Background We previously detected antibodies against tyrosine hydroxylase (TH) in 23% of patients with nonsegmental vitiligo and in 19% of patients with alopecia areata (AA). Objectives To identify TH epitopes recognized by TH antibodies in patients with vitiligo and AA. Methods Recombinant plasmids containing defined fragments of TH cDNA were constructed. The cloned TH cDNA fragments were subsequently translated in vitro to produce a series of [³⁵S]‐labelled TH protein fragments which were then used in radioimmunoassays to analyse the immunoreactivity of sera from 18 TH antibody‐positive patients with vitiligo and so initially define TH epitope domains. Further localization of TH epitopes was investigated by antibody absorption experiments using synthetic TH peptides and nonradiolabelled, in vitro‐expressed TH protein fragments. Antibody binding to identified epitopes was confirmed in TH peptide enzyme‐linked immunosorbent assays. Results Analysis of the results obtained indicated the presence of two major antibody‐binding sites on TH between amino acids 1 and 14 (epitope 1–14) and between amino acids 61 and 80 (epitope 61–80). Of 18 patients with vitiligo and six with AA, 17 (94%) and five (83%), respectively, had antibodies against epitope 1–14. In addition, 11/18 (61%) vitiligo and 2/6 (33%) AA patient sera displayed immunoreactivity against epitope 61–80. Conclusions Two major binding sites for human TH antibodies are located at the N‐terminus of the protein. The humoral immune response to TH in vitiligo and AA is heterogeneous in nature in that patients may have antibodies to more than one TH epitope. TH antibodies from patients with vitiligo or AA can recognize identical epitopes.     

Vitiligo in an urban academic setting*

Background Vitiligo is a depigmenting disease of unknown etiology. A more complete understanding of vitiligo and associated conditions will provide better insight into the etiology and potential treatment options for this condition. We sought to gather information regarding associated conditions and other epidemiologic data on vitiligo. Methods A retrospective chart review was performed of 135 patients with vitiligo seen between July 1, 2002 and June 30, 2005 at an academic medical center. Epidemiologic characteristics were recorded. Results The patient population consisted of 80 women and 55 men with mean age of presentation of 36.8 years and average disease duration of 5.7 years. Vitiligo vulgaris was the predominant type of vitiligo and hypothyroidism was the most common co‐morbidity. Anti‐thyroid peroxidase and anti‐thyroglobulin antibodies were found in 37% and 18% of patients, respectively. The highest proportion of thyroid abnormalities was found in age of onset category 21–30. Anti‐nuclear antibodies were found in 33% of patients. Conclusion The prevalence of anti‐nuclear and anti‐thyroid peroxidase antibodies was higher in our vitiligo study than that reported elsewhere. In addition, autoimmune thyroid disease may be more common in adult‐onset vitiligo.     

Low yield of routine screening for thyroid dysfunction in asymptomatic patients with vitiligo

Background Nonsegmental vitiligo is considered to be an autoimmune disease and is known to be associated with other autoimmune diseases, particularly affecting the thyroid. Screening patients with nonsegmental vitiligo for thyroid function and for the presence of thyroid autoantibodies has been recommended. Objective To investigate the prevalence of thyroid dysfunction and thyroid peroxidase‐specific (TPO) antibodies in a large cohort of patients with nonsegmental vitiligo in order to help decide whether routine screening is justified. Methods A total of 434 adults with nonsegmental vitiligo who were referred to our institute were enrolled. Thyroid function and anti‐TPO antibody titres were assessed in those patients who had no history of thyroid disease or recent thyroid screening. Results Forty‐three patients had already been diagnosed with thyroid dysfunction, and in 27 patients the general practitioner had performed a thyroid function test with negative results < 3 months previously. In these patients, thyroid function assessment was not repeated. The remaining 364 patients were screened for thyroid dysfunction. Overt hypothyroidism was newly diagnosed in three (0·8%) patients; subclinical disease was found in 10 (2·7%) patients and increased levels of TPO antibodies, without thyroid disease, were found in 49 (13·5%) patients. An elevated risk for thyroid disease was found among older women and in women with a positive family history of thyroid disease. Conclusion The overall prevalence of thyroid dysfunction in adult patients with nonsegmental vitiligo was higher than reported in the general population. However, the number of newly diagnosed cases with overt and subclinical thyroid dysfunction in our population was low. Most patients had already been diagnosed by their general practitioner and had symptoms indicative for thyroid disease. Thyroid disease was found predominantly among older women and in subjects with a positive family history of thyroid disease. Thyroid screening including anti‐TPO antibodies is advisable in these high‐risk subpopulations.     

Relation between the incidence and level of pigment cell antibodies and disease activity in vitiligo.

Patients with vitiligo often have antibodies to pigment cells. To examine whether there is a relation between the presence of such antibodies and disease activity, sera of 24 patients with vitiligo (10 with active and 14 with inactive disease) and 19 normal individuals were tested for antibodies to pigment cell surface antigens using a live cell enzyme-linked immunoabsorbent assay. IgG pigment cell antibodies were present in 80% (eight of 10) of patients with active vitiligo but in none of those with inactive disease or in normal individuals. The antibody level of patients with active vitiligo (mean binding index [BI] 3.3 +/- 0.59) was significantly higher than in patients with inactive disease (BI 0.96 +/- 0.04) or normal individuals (BI 1.0 +/- 0.04, p less than 0.001). Antibodies present in eight patients with high titers of pigment cell antibodies reacted to three of four pigment cells but to only one of six unrelated cells. These findings indicate that a correlation exists between the incidence and level of pigment cell antibodies and the activity of vitiligo, and support the hypothesis that vitiligo is an autoimmune disease mediated by an immune reaction to pigment cells.     

Vitiligo and autoantibodies: a systematic review and meta‐analysis

Many studies have reported the prevalence of autoantibodies in patients with vitiligo; however, results were inconsistent for some autoantibodies. This study aimed to conduct a systematic review and meta‐analysis of the prevalence of autoantibodies in vitiligo patients. A systematic review and meta‐analysis of the literature published from inception to Dec 31, 2016 was conducted. Case‐control studies with vitiligo patients and a control group were included. The prevalence of anti‐thyroperoxidase (ATPO) antibodies, anti‐thyroglobulin (ATG) antibodies, antinuclear antibodies (ANA), anti‐gastric parietal cell antibodies (AGPCA), anti‐smooth muscle antibodies (ASMA), anti‐mitochondrial antibodies (AMA), and anti‐adrenal antibodies in vitiligo patients were 15.1 %, 9.7 %, 12.5 %, 11.7 %, 12.6 %, 0.2 %, and 2.5 %, respectively. The prevalence of ATPO antibodies (odds ratio [OR]: 3.975; 95 %; confidence interval [CI]: 3.085–5.122), ATG antibodies (OR: 3.759; 95 % CI: 2.554–5.531), ANA (OR: 1.797, 95 % CI: 1.182–2.731), AGPCA (OR: 2.503; 95 % CI: 1.497–2.896), and anti‐adrenal antibodies (OR: 9.808, 95 % CI: 1.809–53.159) (Figure 2a–e) were significantly higher in vitiligo patients than in the control group. The routine screening of anti‐thyroid antibodies should be performed in vitiligo patients to identify those at high risk of developing autoimmune thyroid disease.