摘要
目的研究抗肾小球基底膜(GBM)抗体的亲合力及其与临床病理表现的关系。方法以纯化的牛IV型胶原α链非胶原区1[α(IV)NC1]为靶抗原,采用抗原抑制性酶联免疫吸附法对我科近11年来确诊的52例抗GBM抗体相关疾病患者的血清抗体亲合力进行检测,并分析其与临床和病理表现的关系。结果使52例患者血清抗体百分结合率从相同水平下降50%所需的α(IV)NC1从0·02μg^20μg不等,平均为0·625μg。不同患者血清抗体亲合力与肾脏病理中新月体所占比例相关(P=0·001),且为独立决定因素(R2=0·58,P=0·000)。即抗体亲合力越高,肾小球中新月体的比例越高。发病年龄、性别、临床表现不同的患者,抗体亲合力之间差异无统计学意义(P>0·05)。起病后不同时间检测血清抗体亲合力基本稳定,未见增加。结论起病时抗GBM抗体的亲合力成熟过程已经完成。不同患者之间抗GBM抗体的亲合力存在差异,该亲合力与病理肾脏损伤的程度高度相关,提示抗GBM抗体的亲合力在抗GBM抗体相关疾病的发病机制中起了重要作用。
Objective To investigate the avidity of anti-glomerular basement membrane (GBM) antibodies and their association with clinical and pathological parameters of patients with anti-GBM disease.Methods Sera from 52 patients and serial samples from 11 patients with anti-GBM disease, diagnosed in our hospital in the last 11 years, were collected.Purified bovine α chain non-collagen 1 domains of type IV collagen [α(IV)NC1] was employed to exam avidity of anti-GBM antibodies using antigen-inhibition enzyme-linked immunosorbent assay (ELISA).The amount of α(IV)NC1 needed for 50% inhibition of antibody binding was compared between patients with different clinical and pathological manifestations.Results After the sera were diluted to give the same absorbance, the amount of α(IV)NC1 used was different among different patients, with an average at 0.625 μg (0.02-20 μg).A significant correlation was observed between the amount of α(IV)NC1 used and the percentage of glomerular crescents (P=0.001).Higher avidity of anti-GBM antibodies predicted a higher percentage of glomerular crescents (R2=0.58,P=0.000).No correlation was observed between avidity and age, gender, interval between onset and diagnosis and other clinical data.No changing avidity was observed in serial samples with time.Conclusion Affinity maturation might have been completed by the time that patients presented with anti-GBM disease.The different avidity of anti-GBM antibodies was associated with the degree of renal damage and might play a key role in the pathogenesis of anti-GBM disease.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2005年第13期903-907,共5页
National Medical Journal of China
基金
中华医学基金专项人才基金资助项目(ORF9802)
