狼疮性肾炎中抗中性粒细胞胞浆抗体及其靶抗原的分析

目的通过对于抗中性粒细胞胞浆抗体(ANCA)在活动期狼疮性肾炎(LN)患者中的发生率及其靶抗原的分析,探讨ANCA在LN发病机制中所起的作用。方法通过间接免疫荧光法(IIF)及酶联免疫吸附分析法(ELISA)检测33例处于活动期的LN患者和20例正常对照血清ANCA,并分析ANCA与LN临床表现及其他实验室检查结果之间的关系。结果用IIF方法检测时,ANCA在LN的阳性率为45.4%,全部是核周型ANCA(p-ANCA)。用ELISA方法检测靶抗原,乳铁蛋白(LF)为主要的靶抗原,占80.0%,且其荧光模型全为甲醛敏感型。其余靶抗原为髓过氧化物酶(MPO),占20.0%,其荧光模型为甲醛抵抗型。而正常对照血清ANCA及其靶抗原全部阴性。ANCA阳性组中LN患者平均年龄为24.3岁±4.5岁,而ANCA阴性组中LN患者平均年龄为31.9岁±9.3岁,ANCA阳性组合并皮肤血管炎、病情活动及抗ds-DNA抗体的阳性率均显著高于ANCA阴性组,具有统计学差异。但2组间病理分型未见显著差异。结论 ANCA可能参与了LN的发病过程,且与LN的进展有关。

Antineutrophil cytoplasmic antibodies and their target antigens in lupus nephritis

In this paper,we aimed to investigate the roles of antineutrophil cytoplasmic antibodies(ANCA) and their target antigens in patients with lupus nephritis(LN).The serum ANCA levels of 33 LN patients in activity and 20 healthy controls were detected by indirect immunofluorescence(IIF) and enzyme-linked immunosorbent assay(ELISA).Correlations between ANCA and clinical manifestations and other autoantibodies were also analyzed.Our results showed that 45.4% of the sera samples in LN patients were ANCA-positive and all of them were perinuclear ANCA;80.0% of sera samples with ANCA-positive were lactoferrin(LF) when recognized by ELISA,and their fluorescence model showed formaldehyde-sensitive type,while 20.0% of the sera samples with ANCA-positive were myeloperoxidase(MPO),and their fluorescence model displayed formaldehyde resistance type.Moreover,ANCA and their target antigens were not found in the serum of healthy controls.The age of ANCA-positive LN patients was significantly lower than that of ANCA-negative patients.Cutaneous vasculitis,disease activity,and anti ds-DNA antibody positive rates of ANCA-positive patients were significantly higher than those of ANCA-negative patients.However,there was no significant difference of pathology types between the two groups.The results above indicated that ANCA may play a pathogenetic role in LN.