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狼疮性肾炎患者的抗磷脂抗体

Antiphospholipid antibodies in patients with lupus nephritis.

作者信息

Fialová Lenka, Zima Tomás, Tesar Vladimír, Mikulíková Ludmila, Malbohan Ivan M, Merta Miroslav, Certíková Vĕra

机构信息

Institute for Medical Biochemistry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

Ren Fail. 2003 Sep;25(5):747-58. doi: 10.1081/jdi-120024290.

Abstract

The aim of this study was to compare the prevalence of anticardiolipin antibodies with other types of antiphospholipid antibodies (aPL) (antiphosphatidylserine--aPS, antiphosphatidylinositol--aPI, antiphosphatidylethanolamine--aPE) in patients with lupus nephritis and to find if the examination of a panel of various aPL is valuable for further diagnosis of patients. Additionally we determined the levels of autoantibodies against beta2-glycoprotein I (beta2GPI) and oxidized low-density lipoprotein (anti-oxLDL) and also investigated the relationship between antibodies against beta2GPI and oxLDL, which were assessed by ELISA methods. Twenty-two patients with lupus nephritis were studied. The control group consisted of 62 healthy blood donors. A statistically significant higher occurrence of all aPLs in the patients with lupus nephritis in comparison to the control group was found. The prevalence of polyspecific antibodies, which reacted with at least two various phospholipids, was 82% in the group of SLE patients. Significantly higher levels of IgG anti-beta2GPI in the sera of SLE patients (p = 0.0003) was detected. The levels of anti-oxLDL in the sera of the patients group did not differ significantly from the control one. Some positive samples for anti-beta2GPI and negative for aCL or anti-oxLDL and vice versa were found. It ca be concluded that the production of aPL including anti-beta2GPI and anti-oxLDL in the lupus nephritis patients is higher in comparison with healthy blood donors. We assume that the estimation of various types of aPL may be important in the selection of the group patients with renal diseases. The synthesis of aPL can reflect the spreading of the autoimmune response for several antigens modified on the vessel wall.

摘要

本研究旨在比较狼疮性肾炎患者中抗心磷脂抗体与其他类型抗磷脂抗体(aPL)(抗磷脂酰丝氨酸—aPS、抗磷脂酰肌醇—aPI、抗磷脂酰乙醇胺—aPE)的患病率,并探讨检测一组不同的aPL对患者进一步诊断是否有价值。此外,我们还测定了抗β2糖蛋白I(β2GPI)和氧化型低密度脂蛋白(抗oxLDL)自身抗体的水平,并通过ELISA方法研究了抗β2GPI抗体与oxLDL抗体之间的关系。对22例狼疮性肾炎患者进行了研究。对照组由62名健康献血者组成。结果发现,与对照组相比,狼疮性肾炎患者中所有aPL的发生率在统计学上显著更高。在系统性红斑狼疮(SLE)患者组中,与至少两种不同磷脂发生反应的多特异性抗体的患病率为82%。检测到SLE患者血清中IgG抗β2GPI水平显著更高(p = 0.0003)。患者组血清中的抗oxLDL水平与对照组无显著差异。发现一些抗β2GPI阳性而抗心磷脂(aCL)或抗oxLDL阴性的样本,反之亦然。可以得出结论,与健康献血者相比,狼疮性肾炎患者中包括抗β2GPI和抗oxLDL在内的aPL产生更高。我们认为,评估各种类型的aPL在肾病患者的分组选择中可能很重要。aPL的合成可以反映针对血管壁上多种修饰抗原的自身免疫反应的扩散情况。

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