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[消化系统器官疾病中的自身免疫反应]

[Autoimmune reactions in diseases of the digestive system organs].

作者信息

Tsaregorodtseva T M, Serova T I, Vinnitskaia E V, Sabel'nikova E A, Berezina O V

出版信息

Ter Arkh. 2009;81(2):68-71.

Abstract

AIM

To examine content, diagnostic and prognostic role of autologous antibodies in gastrointestinal diseases (GID).

MATERIAL AND METHODS

Enzyme immunoassay was used to measure content of autologous antibodies to N+/K+ ATPase (Aab) of gastric parietal cells, mitochondria, microsomes, tissue transglutaminase in blood serum of 196 patients with gastric, gallbladder, small and large intestinal diseases. Aab relations with heterologous antibodies were studied with kits provided by Bektor-Best (Novosibirsk), DRG-Diagnostics, Orgentec (Germany) and others.

RESULTS

In GID high circulation of Aab to parietal cells (Ab-PC) was detected in 42% cases, mean content being 217 +/- 32.4 U/ml, 10 U/ml in the control. Maximal concentration (180 = 340 U/ml) occurred in hepatic cirrhosis, celiac disease, atrophic gastritis. In exacerbations of pancreatitis, colelithiasis and duodenal ulcer ab-PC concentration was 190-210 U/ml, in remission--6-12 U/ml. Minimal concentration (8-38 U/ml) was seen in polyps, gastric cancer, nonspecific ulcerative colitis. For primary biliary cirrhosis more typical was high A/ab concentration to mitochondria (in 83%; 200 U.ml), for autoimmune hepatitis--Aab to microsomes (in 81%; 170 U/ml), in celial disease--Aab to tissue transglutaminase (93%, 75 U/ml). High autoantibodies concentration in GID is accompanied with overcirculation of heteroantibodies to infectious-toxic agents confirming their role in development of autoimmune processes.

CONCLUSION

GID are associated with high circulation of autologous antibodies--markers of systemic humoral autoimmune reactions differing in duration, severity, site of lesion, form, stage, disease duration. Maximal detection rate and concentration of serum autologous antibodies were observed in hepatic cirrhosis, active hepatitis, celiac disease, atrophic gastritis, exacerbations of cholelithiasis, ulcer, pancreatitis. Estimation of Aab concentration is essential for diagnosis, prognosis of autoimmune diseases, it reflects intensity and duration of autoimmune reactions in GID.

摘要

目的

研究自身抗体在胃肠道疾病(GID)中的含量、诊断及预后作用。

材料与方法

采用酶免疫测定法检测196例胃、胆囊、小肠及大肠疾病患者血清中胃壁细胞、线粒体、微粒体的N+/K+ ATP酶自身抗体(Aab)以及组织转谷氨酰胺酶的含量。使用Bektor-Best(新西伯利亚)、DRG-Diagnostics、Orgentec(德国)等公司提供的试剂盒研究Aab与异源抗体的关系。

结果

在胃肠道疾病中,42%的病例检测到壁细胞自身抗体(Ab-PC)高循环,平均含量为217±32.4 U/ml,对照组为10 U/ml。最高浓度(180 = 340 U/ml)出现在肝硬化、乳糜泻、萎缩性胃炎中。胰腺炎、胆石症和十二指肠溃疡发作时,Ab-PC浓度为190 - 210 U/ml,缓解期为6 - 12 U/ml。息肉、胃癌、非特异性溃疡性结肠炎中浓度最低(8 - 38 U/ml)。原发性胆汁性肝硬化中,线粒体A/ab浓度高更为典型(83%;200 U/ml),自身免疫性肝炎中为微粒体Aab(81%;170 U/ml),乳糜泻中为组织转谷氨酰胺酶Aab(93%,75 U/ml)。胃肠道疾病中自身抗体浓度高伴随着对感染 - 毒性因子的异源抗体过度循环,证实了它们在自身免疫过程发展中的作用。

结论

胃肠道疾病与自身抗体高循环有关,自身抗体是系统性体液自身免疫反应的标志物,在持续时间、严重程度、病变部位、形式、阶段、病程方面存在差异。在肝硬化、活动性肝炎、乳糜泻、萎缩性胃炎、胆石症发作、溃疡、胰腺炎中观察到血清自身抗体的最高检出率和浓度。Aab浓度的评估对自身免疫性疾病的诊断、预后至关重要,它反映了胃肠道疾病中自身免疫反应的强度和持续时间。

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