慢性特发性荨麻疹相关抗体与发病的关系

【摘要】 目的 探讨抗高亲和力IgE受体（FcεRI）抗体、抗IgE抗体、抗幽门螺杆菌（HP）抗体和抗甲状腺球蛋白抗体（TGAb）与慢性特发性荨麻疹（CIU）发病的关系。 方法 设（CIU）组、急性荨麻疹（AU）组和健康对照组，每组100例受试者。每例受试者均进行自体血清皮肤试验，荧光酶联免疫吸附法检测过敏原，血清总IgE、抗FcεRI抗体、抗IgE抗体、抗HP抗体、TGAb水平及阳性率，将CIU组与AU组和健康对照组比较。结果 CIU组自体血清皮肤试验阳性率为53%，AU组为12%，健康对照组未发现阳性者。CIU组和健康对照组过敏原检测均为阴性，而AU组能检测到食物或吸入物过敏原，阳性率为86%。 CIU组抗FcεRI抗体和抗IgE抗体水平均高于AU组和健康对照组（P ＜ 0.05）； CIU患者IgE水平低于健康对照组（T = 190.00，P ＜ 0.05），而AU组IgE水平高于健康对照组（T = 226.00，P ＜ 0.05）； 自体血清皮肤试验阳性CIU患者抗FcεRI抗体水平较阴性患者高（T = 101.73，P ＜ 0.05），抗IgE抗体在自体血清皮肤试验阳性和阴性CIU患者间，差异无统计学意义（T = 312.04，P ＞ 0.05）； CIU组、AU组、和健康对照组抗HP抗体阳性率分别为29%、19%和23%，TGAb阳性率分别为18%、15%和11%，抗HP抗体和TGAb阳性率在三组间比较，差异均无统计学意义（P ＞ 0.05）； 抗HP抗体阳性的CIU患者中，抗FcεRI抗体阳性率较AU患者和健康人高（P ＜ 0.01）；抗IgE抗体阳性率与AU患者和健康人差异无统计学意义（P ＞ 0.05）。TGAb阳性的CIU患者中，抗FcεRI抗体阳性率较AU患者和健康人高（P ＜ 0.01），抗IgE抗体阳性率与AU患者和健康人比较，差异无统计学意义（P ＞ 0.05）。结论 CIU存在抗FcεRI和抗IgE自身抗体，可能在自身免疫性荨麻疹发病中起一定作用。 【关键词】 荨麻疹； 自身抗体； 免疫球蛋白E； 皮肤试验

Correlations between interrelated autoantibodies and the development of chronic idiopathic urticaria

SUN Li-wei *, LI Jie, KANG Er-xun, HAN Chun-yu, YAN Li-ping, JIN Wai-shu, XIA Xiu-juan. *Department of Dermatology, Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College, Yantai 264000, Shandong, ChinaCorresponding author: KANG Er-xun, Email: kangerxun2000@163.com 【Abstract】 Objective To estimate the correlations between chronic idiopathic urticaria （CIU）development and interrelated autoantibodies, including anti-high affinity immunoglobulin E receptor （anti-FcεRI） antibody, anti-immunoglobulin E （anti-IgE） antibody, anti-Helicobacter pylori （HP） antibody and anti-thyroglobulin antibody （TGAb）. Methods This study included 100 patients with CIU, 100 patients with acute urticaria （AU） and 100 healthy controls. Autologous serum skin test （ASST） was performed and allergens were detected by fluorescence-based enzyme linked immunosorbent assay （ELISA） in each subject. Serum levels of total IgE, antiv-FcεRI antibody, anti-IgE antibody, anti-HP antibody and TGAb were measured. Chi-square test, analysis of variance, and Wilcoxon rank sum test were conducted for statistical analysis. Results The positivity rate of ASST was 53%, 12% and 0 respectively in patients with CIU, patients with AU and healthy controls, respectively. Food or inhalant allergens were detected in 86% of the patients with AU, but not detected in any of the patients with CIU or healthy controls. Patients with CIU showed significantly higher levels of anti-FcεRI antibody and anti-IgE antibody compared with patients with AU and healthy controls （all P ＜ 0.05）. The serum IgE level in healthy controls was statistically lower than that in patients with AU （T = 226.00，P ＜ 0.05）, but higher than that in patients with CIU （T = 190.00，P ＜ 0.05）. ASST-positive patients with CIU had a higher level of serum anti-FcεRI antibody （T = 101.73, P ＜ 0.05）, but a similar level of serum anti-IgE antibody compared with ASST-negative patients with CIU （T = 312.04, P ＞ 0.05）. No significant differences were observed in the positivity rate of anti-HP antibody （29%, 19% and 23%, P > 0.05） or TGAb （18%, 15% and 11%, P > 0.05） between the patients with CIU, patients with AU and healthy controls. Both anti-HP antibody-positive patients and TGAb-positive patients with CIU showed a significantly higher positivity rate of anti-FcεRI antibody （all P < 0.01）, but a similar positivity rate of anti-IgE antibody compared with the patients with AU and healthy controls（all P > 0.05）. Conclusions Anti-FcεRI antibody and anti-IgE antibody are present in patients with CIU, and may play a certain role in the pathogenesis of CIU. 【Key words】 Urticaria; Autoantibodies; Immunoglobulin E; Skin tests