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针对保护性分子——C1q、C反应蛋白、血清淀粉样蛋白P、甘露糖结合凝集素和载脂蛋白A1的自身抗体:在系统性红斑狼疮中的患病率

Autoantibodies against protective molecules--C1q, C-reactive protein, serum amyloid P, mannose-binding lectin, and apolipoprotein A1: prevalence in systemic lupus erythematosus.

作者信息

Shoenfeld Yehuda, Szyper-Kravitz Martine, Witte Torsten, Doria Andrea, Tsutsumi Akito, Tatsuya Abe, Dayer Jean-Michel, Roux-Lombard Pascale, Fontao Lionel, Kallenberg Cees G M, Bijl Marc, Matthias Torsten, Fraser Abigail, Zandman-Goddard Gisele, Blank Miri, Gilburd Boris, Meroni Pier Luigi

机构信息

Center for Autoimmune Diseases and Department of Medicine B, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

Ann N Y Acad Sci. 2007 Jun;1108:227-39. doi: 10.1196/annals.1422.025.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of several autoantibodies. Among the multiple factors involved in SLE development, apoptotic defects and impaired clearance of cellular debris have gained considerable interest, as they contribute to autoantigen overload. Several molecules of the innate immunity, also participate in the removal of damaged and apoptotic cells. Among them are C1q, C-reactive protein (CRP), serum amyloid P protein (SAP), mannose-binding lectin (MBL), and apolipoprotein A1 (APO A1). To evaluate the prevalence of autoantibodies against CRP, SAP, MBL, APO A1, and C1q among SLE patients, and their relationship with disease activity, a total of 150 SLE patients were screened for the presence of elevated antibody titers against C1q, CRP, SAP, MBL, and APO A1, utilizing the enzyme-linked immunosorbent assay (ELISA) method. Disease activity was assessed using the ECLAM or SLEDAI scores. The study population comprised two groups of patients: 100 patients with quiescent disease (median ECLAM score 2) comprised the first group, and 50 patients with active disease (median SLEDAI score 16) comprised group 2. Elevated titers of anti-CRP antibodies were significantly elevated only in group 1 (10% versus 4% of controls). Antibodies against SAP were evaluated only among patients in group 1, and were found at a significant high prevalence (20%). Elevated titers of anti-MBL antibodies were significantly elevated only in group 1 (15% versus 3.6%); and antibodies directed against APO A1 were significantly elevated in 21% of group 1, and 50% of group 2 patients. Elevated titers of anti-C1q were evaluated only in group 2, and were found at a significant prevalence of 66%. Significant correlation with disease activity was found only for anti-APO A1 antibodies, and only in group 1. Several patients harbored more than one of the autoantibodies tested. In patients with SLE, autoantibodies directed against protective molecules, that is, acute-phase proteins involved in the disposal of cellular and nuclear debris, can be detected. These autoantibodies may play a pathogenic role in the development or perpetuation of autoimmunity in SLE.

摘要

系统性红斑狼疮(SLE)是一种自身免疫性疾病,其特征是产生多种自身抗体。在参与SLE发病的多种因素中,凋亡缺陷和细胞碎片清除受损引起了广泛关注,因为它们会导致自身抗原过载。一些固有免疫分子也参与受损细胞和凋亡细胞的清除。其中包括C1q、C反应蛋白(CRP)、血清淀粉样蛋白P(SAP)、甘露糖结合凝集素(MBL)和载脂蛋白A1(APO A1)。为了评估SLE患者中抗CRP、SAP、MBL、APO A1和C1q自身抗体的患病率及其与疾病活动的关系,采用酶联免疫吸附测定(ELISA)方法对150例SLE患者进行筛查,以检测其抗C1q、CRP、SAP、MBL和APO A1抗体滴度是否升高。使用欧洲狼疮活动度量表(ECLAM)或系统性红斑狼疮疾病活动指数(SLEDAI)评分评估疾病活动度。研究人群包括两组患者:第一组为100例病情静止的患者(ECLAM评分中位数为2),第二组为50例病情活动的患者(SLEDAI评分中位数为16)。仅在第一组中,抗CRP抗体滴度显著升高(10%,而对照组为4%)。仅在第一组患者中检测了抗SAP抗体,发现其患病率显著较高(20%)。仅在第一组中,抗MBL抗体滴度显著升高(15%,而对照组为3.6%);第一组中21%的患者和第二组中50%的患者抗APO A1抗体显著升高。仅在第二组中检测了抗C1q抗体滴度,发现其患病率显著为66%。仅在第一组中,发现抗APO A1抗体与疾病活动度存在显著相关性。一些患者携带不止一种检测的自身抗体。在SLE患者中,可以检测到针对保护性分子的自身抗体,即参与处理细胞和核碎片的急性期蛋白。这些自身抗体可能在SLE自身免疫的发生或持续中起致病作用。

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