Nozicka Z
Katedra patologické anatomie a soudního lékarství Lékarské fakulty Univerzity Karlovy v Hradci Králové.
Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove Suppl. 1991;34(1):1-169.
Results of twenty years experience with identification of anti organ autoantibodies occurring mainly during autoimmune diseases are presented. Cryostat sections from human cadaver tissue and albino-rat kidneys were used for the detection of the above mentioned antibodies, by method of two-step (indirect) immunofluorescence. The study describes working schedule of a newly established subspeciality of pathological anatomy--the "histoserology". The main aim of the study was investigate the occurrence of autoantibodies and to asses the correlation between these findings and health condition of patients. The following antibodies were evaluated: antibodies against epithelia and colloid of thyroid gland, the antibody against parietal cells of stomach mucosa, antibodies against striated ducts of salivary gland and basal elements in its excretory ducts, the antibody against suprarenal cortical elements, the antibody against parathyreoidea, the antibody against smooth muscle cells, anti brush-border antibody, and the anti-nuclear factor as well as the antibodies against intercellular substance and basement membrane of epidermis. Antibody against thyroid gland coloid appears to be of diagnostic value for recognizing of Hashimoto and focal thyroiditis. The finding of antibody against parietal cells indicates the probability of pernicious trait in diagnostically unclear anaemias. On the other hand the finding of such antibody is not very useful in classification of gastritis and its subtyping. The appearance of the phenomenon of "shaggy rim" during the assay for antinuclear factor seems to be very reliable for verification of systemic lupus. The antibody against salivary gland striated ducts does not give fundamental support for diagnosis of Sjögren's disease. Very interesting immunopathological phenomenon is an occurrence of antibody binding to basal cells of salivary gland excretory ducts. To our knowledge, this phenomenon is rather typical for the antibody against cytokeratin polypeptide No 13 and 16. The finding of the antibody against suprarenal gland cortical elements seems to be essential for diagnosis of chronic nonspecific epinephritis since its appearance is mostly without false positivities. Also the antibodies against epidermal intercellular and basement membrane show similar high specificity. Both these antibodies unfortunately often fail and for their high number of false negative results are solely of affirmative importance, since their lack is evidently unwarranted for exclusion of considered disease. Both the findings of antibody against smooth muscle cells and against mitochondria are usefull for the diagnosis of liver lesions especially those of primary biliary cirrhosis. Anti brush-border antibody essentially assists the diagnosis of Crohn's disease and works to differentiate it from ulcerative colitis. Antireticulin antibodies counts frequently for the diagnosis of celiakia.(ABSTRACT TRUNCATED AT 400 WORDS)
本文介绍了二十年来主要在自身免疫性疾病中鉴定抗器官自身抗体的经验结果。通过两步(间接)免疫荧光法,利用人尸体组织和白化大鼠肾脏的低温切片来检测上述抗体。该研究描述了病理解剖学一个新设立的亚专业——“组织血清学”的工作流程。该研究的主要目的是调查自身抗体的出现情况,并评估这些发现与患者健康状况之间的相关性。评估了以下抗体:抗甲状腺上皮和胶质的抗体、抗胃黏膜壁细胞的抗体、抗唾液腺纹状管及其排泄管基底成分的抗体、抗肾上腺皮质成分的抗体、抗甲状旁腺的抗体、抗平滑肌细胞的抗体、抗刷状缘抗体、抗核因子以及抗表皮细胞间物质和基底膜的抗体。抗甲状腺胶质抗体似乎对诊断桥本甲状腺炎和局灶性甲状腺炎具有诊断价值。抗壁细胞抗体的发现表明在诊断不明确的贫血中存在恶性特征的可能性。另一方面,这种抗体的发现对胃炎的分类及其亚型划分并不是很有用。在抗核因子检测过程中出现的“毛糙边缘”现象似乎对系统性红斑狼疮的确诊非常可靠。抗唾液腺纹状管抗体对干燥综合征的诊断没有提供根本性的支持。一个非常有趣的免疫病理现象是抗唾液腺排泄管基底细胞的抗体结合现象。据我们所知,这种现象对于抗细胞角蛋白多肽13和16的抗体来说相当典型。抗肾上腺皮质成分抗体的发现似乎对慢性非特异性肾上腺炎的诊断至关重要,因为其出现大多没有假阳性。抗表皮细胞间和基底膜的抗体也显示出类似的高特异性。不幸的是,这两种抗体经常出现漏诊情况,并且由于它们有大量假阴性结果,所以仅具有肯定性意义,因为它们的缺乏显然不能作为排除所考虑疾病的依据。抗平滑肌细胞抗体和抗线粒体抗体的发现对肝脏病变尤其是原发性胆汁性肝硬化的诊断都很有用。抗刷状缘抗体对克罗恩病的诊断有重要辅助作用,并有助于将其与溃疡性结肠炎区分开来。抗网硬蛋白抗体在乳糜泻的诊断中经常具有重要意义。(摘要截选至400字)