Günther C, Hertl M, Meurer M
Klinik und Poliklinik für Dermatologie am Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
Hautarzt. 2007 Dec;58(12):1063-74; quiz 1075. doi: 10.1007/s00105-007-1432-8.
In the field of dermatology, autoantibody diagnostics are relevant in bullous autoimmune and connective tissue diseases and in certain forms of systemic vasculopathy and psoriatic arthritis. Autoantibody diagnosis of bullous autoimmune skin diseases is an area of dermatology, while serodiagnosis of the other diseases is also performed in rheumatology or in large laboratory centers. Antibody diagnosis of bullous skin diseases is more targeted, as the localization, molecular structures, and function of the relevant epidermal or dermal autoantigens are now known to a large extent, and there are sound experimental indications of the pathogenetic role of these autoantibodies. In practical terms, it is important that some of these antibodies are not only used for the initial diagnosis but also to evaluate the course of the disease and the success of treatment. The autoantibody profile in patients with connective tissue disease may also be disease specific, whereas the pathogenetic significance of these autoantibodies, which are usually directed against nuclear and cytoplasmic components or membrane receptors, is still largely unknown. Autoantibody diagnosis is also important in practice in certain vascular diseases. The future will show whether the determination of antibodies against cyclic citrullinated peptides will become more important in diagnosing and following the course of psoriatic arthritis in practice.
在皮肤病学领域,自身抗体诊断在大疱性自身免疫性疾病、结缔组织病以及某些形式的系统性血管病和银屑病关节炎中具有重要意义。大疱性自身免疫性皮肤病的自身抗体诊断属于皮肤病学范畴,而其他疾病的血清学诊断也可在风湿病学领域或大型实验室中心进行。大疱性皮肤病的抗体诊断更具针对性,因为相关表皮或真皮自身抗原的定位、分子结构和功能目前在很大程度上已为人所知,并且有充分的实验证据表明这些自身抗体的致病作用。实际上,重要的是其中一些抗体不仅用于初始诊断,还用于评估疾病进程和治疗效果。结缔组织病患者的自身抗体谱也可能具有疾病特异性,然而这些通常针对核和细胞质成分或膜受体的自身抗体的致病意义在很大程度上仍不明确。自身抗体诊断在某些血管疾病的实际应用中也很重要。未来将表明,抗环瓜氨酸肽抗体的检测在银屑病关节炎的实际诊断和病程监测中是否会变得更加重要。