与Graves眼病有关的眼肌自身抗原抗体的分子免疫学研究

为探讨Ｇｒａｖｅｓ眼病（ＧＯ）的发病机理，我们对新近发现的眼肌自身抗原及存在于ＧＯ患者血清的眼肌抗体进行了研究。血清取自１８例正常人、１８例活动性ＧＯ、１０例无限征的Ｇｒａｖｅｓ甲亢（ＧＨ）和３例桥本甲状腺炎（ＨＴ）患者。人眼肌膜蛋白经ＧＯ患者混合ＩｇＧ亲和层析后进行ＳＤＳ－聚丙烯酰胺凝胶电泳，显示分子量为４５、２８、５５和６４ｋＤ等蛋白条带。经正常人混合ＩｇＧ亲和层析未能显示上述结果。Ｗｅｓｔｅｒｎ印迹杂交虽然未能证实仅与患者血清作用的独特的眼肌抗原的存在，但６４ｋＤ印迹存在于６１％的ＧＯ、３０％的ＧＨ、０％的ＨＴ患者，正常人仅２２％阳性。抗６４ｋＤ阳性率ＧＯ组明显高于对照组（Ｐ＜０．０５）。眼肌抗体（ＥＭＡｂ）特别是抗６４ｋＤ抗体对于ＧＯ发病机理的作用值得进一步研究。

Molecular Immunological Studied of Eye Muscle Autoantigens and Antibodies Related to Graves'' Ophthalmopathy

To explore the pathology of Graves' ophthalmopathy (GO), we have explored the recently discovered eye muscle autoantigens and their antibodies, eye muscle antibodies (EMAb), in the sera of patients with GO. Sera from normais (n=18), Patients with active GO(n=18),Graves'hyperthyroidism (GH) without eye signs (n = 10),and Hashimoto thyroiditis (HT)(n =3) were investigated. Affinity chromatography of human eye muscle membrane proteins to pooled IgG from patients with GO followed by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) Ied to the appearance of proteins with molecular weights of about 45 kD, 28 kD, 55 kD,and 64 kD (especially the firot two), which were not present in the chromatography to pooled IgG from the controls. Western blot was unable to demonstrate a unique human eye muscle antigen that would react with antibodies present only in the sera of patients with GO. However, a band around 64 kD was detected in 61 % of patients with GO, 30% with GH , 0 % with HT, and only in 22% of the normals. There was significantly more of this anti-64 kD reactivity in the sera from GO Patients compared with the normals (P<0. 05). Further studied are required to determine the function of EMAb, especially the anti-64 kD antibody in the pathogenesis of GO.