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抗组氨酰-tRNA合成酶(Jo1)自身抗体的临床意义

Clinical significance of anti-histidyl-tRNA synthetase (Jo1) autoantibodies.

作者信息

Gomard-Mennesson Emeline, Fabien Nicole, Cordier Jean-Francois, Ninet Jacques, Tebib Jacques, Rousset Hugues

机构信息

Department of Internal Medicine, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, Franc.

出版信息

Ann N Y Acad Sci. 2007 Aug;1109:414-20. doi: 10.1196/annals.1398.047.

Abstract

The clinical significance of a discovery of anti-histidyl-tRNA synthetase (Jo1) autoantibodies patients was established in the early diagnosis of antisynthetase syndrome (ASS) as the common form of this pathology is characterized by interstitial lung disease (ILD), inflammatory muscle disease, and production of anti-Jo1 autoantibodies. However, the specificity of such autoantibodies has to be evaluated in daily clinical practice. In this study, the clinical and prognostic profiles of 45 patients displaying anti-Jo1 autoantibodies were determined. Among 36 patients with a titer of anti-Jo1 autoantibodies above the cutoff value suggested by the manufacturer (40 AU/mL), three different groups were identified. The first group (n = 26) suffered from a complete or incomplete ASS and showed anti-Jo1 autoantibodies mostly above 60 AU/mL. A second group (n = 7) suffered from another autoimmune disease, that is, a systemic lupus erythematosus, cutaneous lupus and rheumatoid arthritis, and Crohn's disease with anti-Jo1 autoantibodies mostly below 60 AU/mL. The third group (n = 3) did not suffer from any autoimmune disease and presented anti-Jo1 autoantibodies below 60 AU/mL. The nine doubtful cases (titer of anti-Jo1 autoantibodies of 30-39 AU/mL) were from patients with no ASS nor myositis. Only 27 out of 45 patients showed antinuclear antibodies with 15 sera showing a pattern characteristic of anti-Jo1 autoantibodies by indirect immunofluorescence on HEp2 cells. In conclusion, this study underlines the need to search for anti-Jo1 autoantibodies even if antinuclear antibodies are negative by indirect immunofluorescence and underlines the usefulness of anti-Jo1 antibodies of titer above 60 AU/mL in the diagnosis of complete or incomplete ASS.

摘要

抗组氨酰 - tRNA合成酶(Jo1)自身抗体的发现对患者的临床意义在于其在抗合成酶综合征(ASS)早期诊断中的作用,因为这种病理状态的常见形式具有间质性肺病(ILD)、炎性肌病以及抗Jo1自身抗体产生的特征。然而,在日常临床实践中必须评估此类自身抗体的特异性。在本研究中,确定了45例显示抗Jo1自身抗体患者的临床和预后情况。在36例抗Jo1自身抗体滴度高于制造商建议的临界值(40 AU/mL)的患者中,识别出三个不同的组。第一组(n = 26)患有完全或不完全的ASS,且抗Jo1自身抗体大多高于60 AU/mL。第二组(n = 7)患有另一种自身免疫性疾病,即系统性红斑狼疮、皮肤狼疮、类风湿关节炎以及克罗恩病,其抗Jo1自身抗体大多低于60 AU/mL。第三组(n = 3)未患任何自身免疫性疾病,其抗Jo1自身抗体低于60 AU/mL。9例可疑病例(抗Jo1自身抗体滴度为30 - 39 AU/mL)来自既无ASS也无肌炎的患者。45例患者中只有27例显示抗核抗体,其中15份血清在HEp2细胞上通过间接免疫荧光显示出抗Jo1自身抗体的特征性模式。总之,本研究强调即使间接免疫荧光显示抗核抗体为阴性,也需要检测抗Jo1自身抗体,并强调滴度高于60 AU/mL的抗Jo1抗体在诊断完全或不完全ASS中的有用性。

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