摘要
目的以α-胞衬蛋白(α-Fodrin)多肽为抗原,采用ELISA检测干燥综合征(Sjgren's syndrome,SS)患者血清抗α-Fodrin多肽IgA抗体(α-Fodrin-derived polypeptide antibody,αF5-IgA),并分析其与SS临床表现和其他实验室指标的关系。方法以固相法合成的α-Fodrin 37-59多肽(αF5)为包被抗原,ELISA定量检测169例原发性干燥综合征(primary Sjgren's syndrome,pSS)、31例继发性干燥综合征(secondary Sjgren syndrome,sSS)、221例其他结缔组织病患者及88名健康对照者血清抗α-Fodrin37-59多肽IgA(αF5-IgA)抗体水平,并分析其与SS患者临床表现及自身抗体、IgG、IgA、血沉及血常规等的相关性。结果 ELISA定量检测抗αF5-IgA抗体,pSS和sSS组的阳性率分别为73.4%和64.5%,而类风湿关节炎、系统性红斑狼疮和健康对照组的阳性率分别是27.3%、17.8%和2.3%,抗αF5-IgA抗体在SS患者的阳性率显著高于其他结缔组织病患者及健康对照组(χ2=114.5～234.1,P<0.01)。抗αF5-IgA抗体对SS诊断的特异性为86.1%,在抗SSA、抗SSB抗体和ANA阴性的pSS患者中,抗αF5-IgA抗体的阳性率分别为48.9%、46.6%和57.1%。抗αF5-IgA抗体阳性pSS患者的肾脏受累率高于抗αF5-IgA抗体阴性患者(χ2=3.0,P<0.05)。抗αF5-IgA抗体阳性pSS患者IgG、IgA升高,血沉增快,白细胞与血小板下降的概率明显高于抗体阴性的患者(χ2=17.9～73.5,P<0.05)。结论 ELISA法可用于检测SS患者血清抗αF5-IgA抗体,该抗体为诊断SS较为特异的自身抗体之一,且抗αF5-IgA抗体对其他自身抗体阴性的SS的诊断有参考意义。
Objective To detect anti-IgA-α-fodrin-derived polypeptide antibody （αF5-IgA） antibody in Sjgren＇s syndrome （ SS） and evaluate the relationship between anti-αF5-IgA antibody and clinical manifestations, serologic abnormalities.Methods Serum samples were obtained from 169 patients with primary Sjgren syndrome （pSS）, 31 patients with secondary Sjgren syndrome （sSS）, 111 systemic lupus erythematosus （SLE）, 110 rheumatoid arthritis （RA）, and 88 healthy individuals.The presence of anti-αF5-IgA antibody was examined by enzyme-linked immunosorbent assay （ ELISA）.The associations between anti-αF5-IgA antibody and the clinical features of SS were evaluated.Results Antibody against anti-αF5-IgA were present in 73.4% of primary SS patients, 64.5% of secondary SS patients, 17.8% of SLE patients, 27.3% of RA patients, and 2.3% of normal blood donors.The positivity of anti-αF5-IgA was significantly higher than those in SLE, RA, and normal controls （χ2=114.5-234.1, P0.01）.The specificity of anti-αF5-IgA was 86.1%.The presence of anti-αF5-IgA was significantly correlated with clinical manifestations , such as kidney involvement.The incidence of IgG, IgA elevation, ESR increasing, WBC and PLT reduction in αF5-IgA positive group are much higher than anti-αF5-IgA negative group of SS, （χ2=17.9-73.5, P0.05）.Conclusion The α-Fodrin may be an autoantigen in SS patient.Anti-αF5-IgA is likely to be an useful diagnostic marker in SS.
出处
《中华临床免疫和变态反应杂志》
2010年第2期91-96,共6页
Chinese Journal of Allergy & Clinical Immunology
基金
北京市自然科学基金(7102155)
国家十一五科技支撑计划(2008BA159B03)
