Dreisin R B, Schwarz M I, Theofilopoulos A N, Stanford R E
N Engl J Med. 1978 Feb 16;298(7):353-7. doi: 10.1056/NEJM197802162980701.
We determined circulating immune complex levels and their correlation with pulmonary histopathology, immunofluorescence and steroid responsiveness in 24 patients with idiopathic interstitial pneumonias. Levels were elevated in all but three of 16 patients with cellular disease, but in none of eight with diffuse fibrosis (P less than 0.001). Granular deposition of IgG, usually with elevated levels, but in only 11 per cent of those with normal levels (P less than 0.001). The radiographic and physiologic response to corticosteroid therapy was better in patients with initially elevated levels than in those with normal levels (P less than 0.03). Circulating immune complexex are present in patients with cellular idiopathic interstitial pneumonias, have a pathogentic role in this disease and may identify a patient population that is potentially steroid responsive.
我们测定了24例特发性间质性肺炎患者的循环免疫复合物水平及其与肺组织病理学、免疫荧光和类固醇反应性的相关性。在16例细胞性疾病患者中，除3例之外，其余患者的循环免疫复合物水平均升高，但8例弥漫性纤维化患者的循环免疫复合物水平均未升高（P<0.001）。IgG呈颗粒状沉积，通常水平升高，但在循环免疫复合物水平正常的患者中仅占11%（P<0.001）。初始循环免疫复合物水平升高的患者对皮质类固醇治疗的影像学和生理学反应优于水平正常的患者（P<0.03）。细胞性特发性间质性肺炎患者存在循环免疫复合物，其在该疾病中具有致病作用，并且可能识别出潜在对类固醇有反应的患者群体。
