Cambridge G, Rampton D S, Stevens T R, McCarthy D A, Kamm M, Leaker B
Department of Renal Medicine, University College and Middlesex School of Medicine, London.
Gut. 1992 May;33(5):668-74. doi: 10.1136/gut.33.5.668.
Anti-neutrophil antibodies have been shown in sera from patients with a variety of inflammatory diseases. Those reacting with components of neutrophil cytoplasm are associated with systemic vasculitis. Both nuclear and perinuclear staining patterns on human neutrophils have been reported using sera from patients with inflammatory bowel disease. We have evaluated the reactivity against human neutrophils of sera from 100 patients with inflammatory bowel disease, 14 disease controls, and 20 normal volunteers. Altogether 27/50 (54%) sera from patients with ulcerative colitis contained antibodies that reacted with cytospun ethanol fixed neutrophils compared with 5/50 (10%) from Crohn's disease (p less than 0.001) and 0/34 control sera (p less than 0.001). All seven sera from patients with proctitis alone were negative (p less than 0.01). There was no correlation between presence or titre of anti-neutrophil antibodies and either disease activity or treatment. Positive sera gave three different staining patterns on human neutrophils. The predominant pattern was perinuclear (17/32); 12 sera gave a cytoplasmic and three a homogeneous nuclear staining pattern. None of the patients or the controls had antibodies to myeloperoxidase, elastase, or serine proteinase 3, all of which are recognised by anti-neutrophil cytoplasmic antibodies. Only 2/27 sera positive by indirect immunofluorescence reacted with an extract of neutrophil primary granules. In conclusion, anti-neutrophil antibodies occur more commonly in ulcerative colitis than in Crohn's disease or control subjects and the anti-neutrophil antibodies found in inflammatory bowel disease are different from those associated with vasculitis.
在患有各种炎症性疾病患者的血清中已发现抗中性粒细胞抗体。那些与中性粒细胞胞质成分发生反应的抗体与系统性血管炎有关。据报道，使用炎症性肠病患者的血清对人类中性粒细胞进行染色时会出现核染色和核周染色模式。我们评估了100例炎症性肠病患者、14例疾病对照者和20名正常志愿者血清对人类中性粒细胞的反应性。溃疡性结肠炎患者的50份血清中有27份（54%）含有与细胞涂片乙醇固定中性粒细胞发生反应的抗体，相比之下，克罗恩病患者的50份血清中有5份（10%）（p<0.001），34份对照血清中无阳性（p<0.001）。仅患有直肠炎的所有7份血清均为阴性（p<0.01）。抗中性粒细胞抗体的存在或滴度与疾病活动度或治疗均无相关性。阳性血清对人类中性粒细胞呈现三种不同的染色模式。主要模式是核周染色（17/32）；12份血清呈现胞质染色，3份呈现均匀核染色模式。患者和对照者均无针对髓过氧化物酶、弹性蛋白酶或丝氨酸蛋白酶3的抗体，而这些抗体均可被抗中性粒细胞胞质抗体识别。通过间接免疫荧光检测呈阳性的27份血清中只有2份与中性粒细胞初级颗粒提取物发生反应。总之，抗中性粒细胞抗体在溃疡性结肠炎中比在克罗恩病或对照受试者中更常见，且在炎症性肠病中发现的抗中性粒细胞抗体与血管炎相关的抗体不同。
