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[部分肝移植受者血液中抗肝型精氨酸酶自身抗体的临床意义]

[Clinical significance of anti-liver-type arginase autoantibody in blood of recipients after partial liver transplantation].

作者信息

Ikemoto M, Tsunekawa S, Kasai Y, Tanaka K, Ueda K, Totani M

机构信息

Division of Medical Technology, College of Medical Technology, Kyoto University, Kyoto 606-8507.

出版信息

Rinsho Byori. 2001 Jul;49(7):651-6.

Abstract

Autoantibody against human liver-type arginase was detected in blood of patients treated with partial liver transplantation and consisted of all subclasses of IgG, i.e., IgG1, IgG2, IgG3 and IgG4, and IgM. We newly constructed an ELISA system for the antibodies by the aid of arginase protein immunopurified from extracts of human liver tissues. Addition of 2.0 mol/l urea in 0.1 mol/l citrate buffer(pH 4.5) was effective for elimination of immunoglobulins, such as IgG and IgM, and rheumatoid factors adsorped non-specifically to liver-type arginase-autoantibody complexes on the plate. We found that, during a short period of about two months after operation, in successful cases, liver-type arginase increased, remarkably and repeatedly, in blood of recipients followed by elevation of IgM level within a week and also IgG2 level two or three weeks later. Thus the change in IgG2 level seemed to depend on those of the arginase and/or IgM. However, in unsuccessful cases, such fluctuation was not so clear as the successful cases. To be noteworthy was production of autoantibodies directed to liver-type arginase in blood of patients with liver injury although the arginase, as well as AST and ALT, is an enzyme which leaks out of liver tissue. Appearance of the autoantibodies in blood supports occurrence of liver injury, in part, in graft liver because the enzyme exists exclusively in the liver. Among immunoglobulins to liver-type arginase, IgG2 seemed to be the most helpful index to know rightly postoperative conditions of recipients of liver transplantation, and its measurement could be useful for long-term follow-up of the patients.

摘要

在接受部分肝移植治疗的患者血液中检测到了抗人肝型精氨酸酶自身抗体,其由IgG的所有亚类即IgG1、IgG2、IgG3和IgG4以及IgM组成。我们借助从人肝组织提取物中免疫纯化的精氨酸酶蛋白新构建了一种针对这些抗体的ELISA系统。在0.1 mol/l柠檬酸盐缓冲液(pH 4.5)中添加2.0 mol/l尿素可有效去除免疫球蛋白,如IgG和IgM,以及非特异性吸附在平板上肝型精氨酸酶-自身抗体复合物上的类风湿因子。我们发现,在术后约两个月的短时间内,成功病例中,受者血液中的肝型精氨酸酶显著且反复升高,随后IgM水平在一周内升高,IgG2水平在两到三周后升高。因此,IgG2水平的变化似乎取决于精氨酸酶和/或IgM的变化。然而,在不成功的病例中,这种波动不如成功病例明显。值得注意的是,肝损伤患者血液中产生了针对肝型精氨酸酶的自身抗体,尽管精氨酸酶与AST和ALT一样,是一种从肝组织中泄漏出来的酶。血液中自身抗体的出现部分支持了移植肝中肝损伤的发生,因为该酶仅存在于肝脏中。在针对肝型精氨酸酶的免疫球蛋白中,IgG2似乎是正确了解肝移植受者术后状况最有用的指标,其检测对患者的长期随访可能有用。

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