阿尔茨海默病和血管性痴呆患者以及非痴呆对照受试者的血清自身抗体。

Serum autoantibodies in patients with Alzheimer's disease and vascular dementia and in nondemented control subjects.

作者信息

Lopez O L, Rabin B S, Huff F J, Rezek D, Reinmuth O M

机构信息

Alzheimer's Disease Research Center, University of Pittsburgh, School of Medicine, Pa.

出版信息

Stroke. 1992 Aug;23(8):1078-83. doi: 10.1161/01.str.23.8.1078.

DOI:10.1161/01.str.23.8.1078

PMID:1636181

Abstract

BACKGROUND AND PURPOSE

In this study we sought to evaluate the clinical significance of serum autoantibodies to dementing processes.

METHODS

We assessed 40 age-matched subjects: 10 patients with probable Alzheimer's disease, 10 with possible Alzheimer's disease with cerebrovascular disease, 10 with vascular dementia, and 10 nondemented control subjects. Serum from each subject was tested for the presence of antithyroglobulin antibody, thyroid antimicrosomal antibody, gastric anti-parietal cell antibody, anti-smooth muscle antibody, antinuclear antibody, rheumatoid factor, antineuronal antibody, and anticardiolipin antibody. In addition, we investigated the sera of these patients for the presence of an antivascular antibody directed against the vascular basement membrane proteoglycan antigen and for circulating immune complexes.

RESULTS

Autoantibodies were present in 100% of the patients with possible Alzheimer's disease with cerebrovascular disease, 80% of those with vascular dementia, 40% of those with probable Alzheimer's disease, and 30% of the nondemented control subjects. The highest number of autoantibodies was observed in patients with vascular dementia and possible Alzheimer's disease with cerebrovascular disease. Antinuclear antibody was present in 60% of vascular dementia patients and antineuronal antibody in 50% of these patients. However, no individual autoantibody could differentiate Alzheimer's disease from cerebrovascular disorders. Immune complexes were detected in the serum of 20-30% of each patient group. Neither the patient nor the control sera was found to contain antiendothelial antibody.

CONCLUSIONS

Despite the relatively small number of individuals examined in each category, the elevated number of autoantibodies associated with possible Alzheimer's disease with cerebrovascular disease and vascular dementia indicates a possible link between the presence of autoantibodies and cerebrovascular disorders in dementia.

摘要

背景与目的

在本研究中，我们试图评估血清中针对痴呆相关过程的自身抗体的临床意义。

方法

我们评估了40名年龄匹配的受试者：10名可能患有阿尔茨海默病的患者，10名可能患有阿尔茨海默病合并脑血管疾病的患者，10名血管性痴呆患者，以及10名非痴呆对照受试者。检测了每个受试者血清中抗甲状腺球蛋白抗体、甲状腺微粒体抗体、胃壁细胞抗体、抗平滑肌抗体、抗核抗体、类风湿因子、抗神经元抗体和抗心磷脂抗体的存在情况。此外，我们还研究了这些患者血清中针对血管基底膜蛋白聚糖抗原的抗血管抗体以及循环免疫复合物的存在情况。

结果

在可能患有阿尔茨海默病合并脑血管疾病的患者中，100%存在自身抗体；血管性痴呆患者中，80%存在自身抗体；可能患有阿尔茨海默病的患者中，40%存在自身抗体；非痴呆对照受试者中，30%存在自身抗体。在血管性痴呆患者以及可能患有阿尔茨海默病合并脑血管疾病的患者中观察到的自身抗体数量最多。60%的血管性痴呆患者存在抗核抗体，其中50%存在抗神经元抗体。然而，没有单一的自身抗体能够区分阿尔茨海默病和脑血管疾病。在每个患者组中，20% - 30%的血清中检测到免疫复合物。在患者血清和对照血清中均未发现抗内皮抗体。