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[自身抗体]

[Autoantibodies].

作者信息

Ishihara Yasushi

机构信息

Technical Service Department, Medical and Biological Laboratories Co., ltd. Ina 396-0002.

出版信息

Rinsho Byori. 2005 Jun;53(6):562-9.

Abstract

The autoantibody test gives significant information for diagnosis of autoimmune diseases. Since the finding of the LE-cell in 1948, dozens of autoantibodies have been found. Anti nuclear antibody (ANA) is the essential test for the screening of autoantibodies. Indirect immunofluorescence (IIF) is the conventional method for the detection of ANA. IIF can detect a wide spectrum of ANA and gives abundant information obtained from a staining pattern. However under the recent circumstances of using advanced fluorescent microscopes and reagents we often have difficulty interpreting positive results seen in normal individuals and in detailed staining patterns. ELISA (enzyme-linked immunosorbent assay), detecting disease specific autoantibodies alone, is one solution. Some antibodies such as anti-DNA or anti-ENA (extractable nuclear antigen) have a strong relation to specific diseases. These autoantibodies have been detected by IIF, RIA (radioimmunoassay) or DID (double immune diffusion). With the progress of molecular biology many autoantigens have been characterized. Now ELISA is a typical way to detect autoantibodies because purified or recombinant antigens are easily available. Though RF (rheumatoid factor) is the historical autoantibody detected in RA patients, the specificity to RA is low. The new anti-CCP is promising from its high specificity and sensitivity. Now we can choose various kind of autoantibody tests, not only conventional ones but also newly developed ones. For diagnosis and treatment of autoimmune diseases, understanding of both clinical significance and methodology is important.

摘要

自身抗体检测为自身免疫性疾病的诊断提供了重要信息。自1948年发现狼疮细胞以来,已发现了数十种自身抗体。抗核抗体(ANA)检测是自身抗体筛查的基本检测项目。间接免疫荧光法(IIF)是检测ANA的传统方法。IIF能够检测多种ANA,并能从染色模式中获得丰富信息。然而,在使用先进荧光显微镜和试剂的当下,我们常常难以解读正常个体出现的阳性结果以及详细的染色模式。酶联免疫吸附测定法(ELISA)仅检测疾病特异性自身抗体,是一种解决方法。某些抗体,如抗DNA或抗可提取核抗原(ENA),与特定疾病密切相关。这些自身抗体已通过IIF、放射免疫测定法(RIA)或双向免疫扩散法(DID)检测。随着分子生物学的发展,许多自身抗原已得到鉴定。如今,ELISA是检测自身抗体的典型方法,因为纯化或重组抗原易于获取。尽管类风湿因子(RF)是在类风湿关节炎(RA)患者中检测到的传统自身抗体,但其对RA的特异性较低。新型抗环瓜氨酸肽(CCP)抗体因其高特异性和敏感性而颇具前景。现在我们可以选择各种自身抗体检测方法,不仅有传统方法,还有新开发的方法。对于自身免疫性疾病的诊断和治疗,了解临床意义和检测方法都很重要。

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