Hosoda Hideo, Okawa-Takatsuji Masako, Shinmura Wahei, Hasimoto Naoaki, Ozaki Yukio, Ikeda Yusei
Department of Clinical Laboratory Medicine, Tokyo-Kosei-Nenkin Hospital, Tokyo, Japan.
Pancreas. 2008 Jul;37(1):e1-7. doi: 10.1097/MPA.0b013e318162cb3a.
Pancreatic ductal epithelia contain an abundance of carbonic anhydrase (CA), and the presence of antibodies to this enzyme has been described in autoimmune disorders. We previously found a small amount of an immunoglobulin G-like material in purchased CAII reagents, which led to pseudopositive reactions.
We determined the optimum measurement conditions for detecting anti-CAII antibody using an enzyme-linked immunosorbent assay and sera from 140 patients with pancreatic diseases.
Compared with the prevalence of anti-CAII antibody in healthy subjects, a significantly higher seroprevalence of the antibody was detected in patients with autoimmune pancreatitis (AIP) (88.9%, P < 0.02), Sjögren syndrome (67.6%, P < 0.01), and alcoholic chronic pancreatitis (45.8%, P < 0.01). No positive results were obtained among patients with pancreatic cancer. Moreover, the antibody value obtained in the pancreatic cancer patients was actually lower than that obtained in healthy subjects.
The anti-CAII antibody is probably not a specific marker of AIP because it was present at a higher frequency in the sera of patients with other pancreatic diseases. Nevertheless, the anti-CAII antibody may be a useful tool for the differential diagnosis of AIP and pancreatic cancer.
胰腺导管上皮含有大量碳酸酐酶（CA），在自身免疫性疾病中已发现针对该酶的抗体。我们之前在购买的CAII试剂中发现少量免疫球蛋白G样物质，这导致了假阳性反应。
我们使用酶联免疫吸附测定法和140例胰腺疾病患者的血清，确定检测抗CAII抗体的最佳测量条件。
与健康受试者中抗CAII抗体的患病率相比，自身免疫性胰腺炎（AIP）患者（88.9%，P<0.02）、干燥综合征患者（67.6%，P<0.01）和酒精性慢性胰腺炎患者（45.8%，P<0.01）中该抗体的血清阳性率显著更高。胰腺癌患者中未获得阳性结果。此外，胰腺癌患者获得的抗体值实际上低于健康受试者。
抗CAII抗体可能不是AIP的特异性标志物，因为它在其他胰腺疾病患者的血清中出现频率更高。然而，抗CAII抗体可能是AIP和胰腺癌鉴别诊断的有用工具。
