Díez A, Quiroga J A, Melero M, Moraleda G, Castillo I, Porres J C, Carreño V
Department of Gastroenterology, Fundación Jiménez Díaz, Madrid, Spain.
Digestion. 1991;49(3):125-33. doi: 10.1159/000200711.
We have analyzed the presence of IgG and IgM anti-calmodulin antibodies (anti-CaM) by ELISA in patients with chronic hepatitis due to B, delta and C viruses as well as in patients with other liver diseases. The specificity of the assay was demonstrated by preadsorption of positive serum with calmodulin (CaM) but not with myosin light chain. Among 164 patients with chronic viral hepatitis (B, delta and C) and 50 with non-viral hepatitis, 27 and 26%, respectively, had auto antibodies against CaM. There was a significantly increased frequency (37%) of these auto-antibodies in chronic delta infection as compared to that (21%) of patients with chronic B hepatitis (p less than 0.05). An intermediate incidence of anti-CaM, (24%) was found in chronic C infection. The frequency of anti-CaM was not related to the level of hepatitis B virus (HBV) or hepatitis delta virus (HDV) replication. A high occurrence of anti-CaM in the presence of liver membrane antibody (p less than 0.03) was observed. During follow-up of patients with chronic delta-hepatitis, the presence of anti-CaM was consistently observed, when the isotype was IgM, but transiently when it was IgG. The occurrence of anti-CaM correlated neither with ALT levels nor with histological diagnosis. Antibodies to CaM, are present in liver diseases especially in chronic delta-hepatitis, and do not play a pathogenic role on hepatocellular damage.
我们通过酶联免疫吸附测定法(ELISA)分析了乙型、丁型和丙型病毒所致慢性肝炎患者以及其他肝病患者中IgG和IgM抗钙调蛋白抗体(抗CaM)的存在情况。用钙调蛋白(CaM)而非肌球蛋白轻链预吸附阳性血清,证明了该检测方法的特异性。在164例慢性病毒性肝炎(乙型、丁型和丙型)患者和50例非病毒性肝炎患者中,分别有27%和26%的患者存在抗CaM自身抗体。与慢性乙型肝炎患者(21%)相比,慢性丁型感染患者中这些自身抗体的频率显著增加(37%)(p<0.05)。在慢性丙型感染中发现抗CaM的发生率处于中等水平(24%)。抗CaM的频率与乙型肝炎病毒(HBV)或丁型肝炎病毒(HDV)的复制水平无关。在存在肝细胞膜抗体的情况下,抗CaM的发生率较高(p<0.03)。在慢性丁型肝炎患者的随访过程中,当同种型为IgM时,持续观察到抗CaM的存在,而当为IgG时则为短暂存在。抗CaM的出现与丙氨酸氨基转移酶(ALT)水平和组织学诊断均无相关性。抗CaM抗体存在于肝病中,尤其是慢性丁型肝炎,但对肝细胞损伤不发挥致病作用。