Chikazawa H, Nishiya K, Matsumori A, Hashimoto K
Second Department of Internal Medicine, Kochi Medical School, Nankoku City, Japan.
J Clin Immunol. 2000 Jul;20(4):279-86. doi: 10.1023/a:1006667703202.
To investigate the prevalence and clinical relevance of immunoglobulin (Ig) isotypes of antimyeloperoxidase (MPO) and antilactoferrin (LF) antibodies in collagen diseases, enzyme-linked immunosorbent assay was employed to detect the Ig isotypes of both antibodies. The purified proteins of MPO and LF were used as two major representative antigens for anti-neutrophil cytoplasmic antibodies (ANCA) with a perinuclear staining pattern by an indirect immunofluorescent technique. We examined 131 serum samples from 79 patients with rheumatoid arthritis (RA), 32 with systemic lupus erythematosus (SLE), 14 with progressive systemic sclerosis (PSS), 6 with polymyositis/dermatomyositis (PM/DM), and 5 with idiopathic crescentic glomerulonephritis who served as positive controls and 36 healthy subjects who served as controls. A limited number of patients with RA (4-10%), SLE (6-9%), and PSS (7-14%) but not PM/DM showed positive IgG or IgA anti-MPO antibody (MPO-ANCA) but not IgM MPO-ANCA. However, 10-20% of RA, 40-60% of SLE, 20-36% of PSS but none of the PM/DM patients showed positive IgG, IgA, or IgM anti-LF antibody (LF-ANCA). MPO- and LF-ANCA positivity in RA patients was correlated with markers of disease activity such as the erythrocyte sedimentation rate, C-reactive protein, and serum Ig levels. IgG LF-ANCA but not MPO-ANCA positivity in SLE patients also was correlated with the disease activity index but not with clinical features. Neither MPO- nor LF-ANCA positivity in PSS patients was correlated with any clinical features. Overall, both MPO- and LF-ANCA were found mainly in RA, SLE, and PSS patients but not in PM/DM patients. The Ig isotypes of MPO- and LF-ANCA frequently belonged to both IgG and IgA and rarely to the IgM class. Both MPO- and LF-ANCA positivity reflected disease activity in RA and SLE rather than specific organ involvement.
为研究胶原病中抗髓过氧化物酶（MPO）和抗乳铁蛋白（LF）抗体的免疫球蛋白（Ig）亚型的患病率及其临床相关性，采用酶联免疫吸附测定法检测这两种抗体的Ig亚型。通过间接免疫荧光技术，MPO和LF的纯化蛋白被用作具有核周染色模式的抗中性粒细胞胞浆抗体（ANCA）的两种主要代表性抗原。我们检测了79例类风湿关节炎（RA）患者、32例系统性红斑狼疮（SLE）患者、14例进行性系统性硬化症（PSS）患者、6例多发性肌炎/皮肌炎（PM/DM）患者的131份血清样本，以及作为阳性对照的5例特发性新月体性肾小球肾炎患者和作为对照的36名健康受试者的血清样本。少数RA患者（4 - 10%）、SLE患者（6 - 9%）和PSS患者（7 - 14%），而非PM/DM患者，显示出IgG或IgA抗MPO抗体（MPO - ANCA）阳性，但IgM MPO - ANCA阴性。然而，10 - 20%的RA患者、40 - 60%的SLE患者、20 - 36%的PSS患者，但PM/DM患者均未显示IgG、IgA或IgM抗LF抗体（LF - ANCA）阳性。RA患者中MPO - ANCA和LF - ANCA阳性与疾病活动标志物如红细胞沉降率、C反应蛋白和血清Ig水平相关。SLE患者中IgG LF - ANCA而非MPO - ANCA阳性也与疾病活动指数相关，但与临床特征无关。PSS患者中MPO - ANCA和LF - ANCA阳性均与任何临床特征无关。总体而言，MPO - ANCA和LF - ANCA主要见于RA、SLE和PSS患者，而非PM/DM患者。MPO - ANCA和LF - ANCA的Ig亚型常见于IgG和IgA两类，很少属于IgM类。MPO - ANCA和LF - ANCA阳性反映了RA和SLE的疾病活动，而非特定器官受累情况。
