Monselise A, Weinberger A, Monselise Y, Fraser A, Sulkes J, Krause I
Department of Medicine B, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Clin Exp Rheumatol. 2006 Sep-Oct;24(5 Suppl 42):S87-90.
To evaluate the rate and clinical correlations of antibodies against saccharomyces cerevisiae (ASCA) among healthy family members of patients with Behçet's disease (BD).
Twenty-one BD patients and 52 healthy family members (HFM) were studied. Data from medical files and from patients' interviews was collected, regarding the entire spectrum of disease manifestations. Each family member was personally interviewed and a questionnaire composed of BD symptoms and their temporal relation was compiled. IgA- and IgG-ASCA levels, determined by ELISA, were studied in all BD patients and their family members, the results were compared to a group of 23 healthy controls (HC).
Eight (38.1%) BD patients were ASCA positive, compared to five among HFM (9.6%) and none among healthy unrelated controls (p=0.001). Mean IgG and IgA-ASCA levels were significantly higher in BD patients compared with HFM and HC groups (p = 0.002 and p = 0.03, respectively). No correlation was found between positive ASCA tests and any of BD-related manifestations. Mean IgG-ASCA levels were significantly lower in HFM compared to BD patients (p = 0.03), yet IgA-ASCA levels were similar in HFM and BD. Mean IgG and IgA-ASCA levels were higher in HFM compared with healthy unrelated controls (p=0.09 and p=0.03). No difference was found in ASCA rates between relatives of BD patients who had positive or negative ASCA tests, or between spouses of BD patients and genetically related relatives. In HFM with recurrent oral ulcers there was a positive correlation between titers of IgA-ASCA and the yearly number of oral ulcers episodes (p = 0.01), and mean ulcers healing time (p = 0.01). IgG-ASCA titers correlated with yearly number of aphtae episodes (p = 0.03).
The results of this study confirm our previous observation on a high prevalence of ASCA in BD. ASCA levels are also increased in healthy family members of BD patients, and are probably influenced by genetic as well as environmental factors. ASCA in HFM were significantly associated with a more severe oral ulcer disease. The role of ASCA as a marker for predisposition to develop future BD remains to be evaluated.
评估白塞病（BD）患者健康家庭成员中抗酿酒酵母抗体（ASCA）的发生率及其临床相关性。
研究了21例BD患者和52名健康家庭成员（HFM）。收集了来自病历和患者访谈的数据，涉及疾病表现的整个范围。对每个家庭成员进行了个人访谈，并编制了一份由BD症状及其时间关系组成的问卷。通过酶联免疫吸附测定（ELISA）测定所有BD患者及其家庭成员的IgA-和IgG-ASCA水平，将结果与一组23名健康对照者（HC）进行比较。
8例（38.1%）BD患者ASCA呈阳性，相比之下，HFM中有5例（9.6%）呈阳性，健康非亲属对照者中无一例阳性（p=0.001）。与HFM和HC组相比，BD患者的平均IgG和IgA-ASCA水平显著更高（分别为p = 0.002和p = 0.03）。ASCA检测阳性与任何BD相关表现之间均未发现相关性。与BD患者相比，HFM中的平均IgG-ASCA水平显著更低（p = 0.03），然而HFM和BD患者的IgA-ASCA水平相似。与健康非亲属对照者相比，HFM中的平均IgG和IgA-ASCA水平更高（p=0.09和p=0.03）。BD患者ASCA检测呈阳性或阴性的亲属之间，或BD患者的配偶与遗传相关亲属之间，ASCA发生率无差异。在患有复发性口腔溃疡的HFM中，IgA-ASCA滴度与每年口腔溃疡发作次数（p = 0.01）以及平均溃疡愈合时间（p = 0.01）之间存在正相关。IgG-ASCA滴度与每年口疮发作次数相关（p = 0.03）。
本研究结果证实了我们之前关于BD中ASCA高患病率的观察结果。BD患者的健康家庭成员中ASCA水平也有所升高，并且可能受到遗传以及环境因素的影响。HFM中的ASCA与更严重的口腔溃疡疾病显著相关。ASCA作为未来发生BD易感性标志物的作用仍有待评估。
