Krause I, Monselise Y, Milo G, Weinberger A
Department of Medicine E, Rabin Medical Center, Petah-Tiqva, Israel.
Clin Exp Rheumatol. 2002 Jul-Aug;20(4 Suppl 26):S21-4.
To evaluate the prevalence and clinical correlations of antibodies against Saccharomyces cerevisiae (ASCA) among patients with BD.
Twenty-seven BD patients were studied. Data from medical files and from patients' interviews was collected, regarding the entire spectrum of disease manifestations, and a severity score was calculated for each patient. IgA- and IgG-ASCA levels, determined by ELISA, were studied in all BD patients and in three control groups: patients with recurrent aphthous stomatitis (RAS), systemic lupus erythematosus (SLE) and healthy volunteers.
Thirteen BD patients (48.1%) were ASCA-positive, compared to one patient in each control group (10%, p = 0.01). The mean value of IgG-ASCA in the BD patients was 20.7 +/- 12.3 units, significantly higher than in patients with RAS (10.0 +/- 5.5, p < 0.001), SLE (11.8 +/- 9.3, p < 0.03) or healthy volunteers (10.8 +/- 9.8, p < 0.02). Mean IgA-ASCA level was 16.8 +/- 8.8 units in the BD patients, significantly higher compared to healthy volunteers (11.0 +/- 5.0, p = 0.02) but similar to patients with RAS (17.0 +/- 5.3). No correlation was found between ASCA and any BD-associated clinical manifestation nor the presence of HLA-B5. No difference was found in the rate of major oral ulcers nor in the systemic disease severity score between positive- and negative-ASCA patients (27.3% vs. 30.8%, and 7.31 +/- 1.80 vs. 7.28 +/- 2.27 respectively, NS).
The results of our study associate, for the first time, the presence of a distinct antibody, i.e. ASCA, with BD. ASCA were not linked to a specific clinical manifestation of the disease and probably do not pose an increased risk for a more severe disease course.
评估白塞病（BD）患者中抗酿酒酵母抗体（ASCA）的患病率及其临床相关性。
对27例BD患者进行研究。收集患者病历及访谈数据，涵盖疾病表现的全谱，并为每位患者计算严重程度评分。采用酶联免疫吸附测定法（ELISA）检测所有BD患者以及三个对照组（复发性阿弗他口炎患者、系统性红斑狼疮患者和健康志愿者）的IgA-ASCA和IgG-ASCA水平。
13例BD患者（48.1%）ASCA呈阳性，而每个对照组各有1例患者呈阳性（10%，p = 0.01）。BD患者中IgG-ASCA的平均值为20.7±12.3单位，显著高于复发性阿弗他口炎患者（10.0±5.5，p < 0.001）、系统性红斑狼疮患者（11.8±9.3，p < 0.03）或健康志愿者（10.8±9.8，p < 0.02）。BD患者中IgA-ASCA的平均水平为16.8±8.8单位，与健康志愿者相比显著更高（11.0±5.0，p = 0.02），但与复发性阿弗他口炎患者相似（17.0±5.3）。未发现ASCA与任何BD相关临床表现或HLA-B5的存在之间存在相关性。ASCA阳性和阴性患者之间在主要口腔溃疡发生率或全身疾病严重程度评分方面均未发现差异（分别为27.3%对30.8%，以及7.31±1.80对7.28±2.27，无统计学意义）。
我们的研究结果首次将一种独特抗体即ASCA的存在与BD联系起来。ASCA与该病的特定临床表现无关，可能也不会增加疾病更严重病程的风险。
