Lai K N, Jayne D R, Brownlee A, Lockwood C M
Department of Medicine, University of Cambridge, England.
Clin Exp Immunol. 1990 Nov;82(2):233-7. doi: 10.1111/j.1365-2249.1990.tb05432.x.
Autoantibodies to neutrophil cytoplasmic antigens are found in patients with small or medium-size vessel systemic vasculitis such as Wegener's granulomatosis and microscopic polyarteritis. We studied the specificity of anti-neutrophil cytoplasm autoantibodies (ANCA) by examining the binding of sera from patients with different forms of systemic vasculitis, to neutrophil extract size-fractionated by gel filtration for high performance liquid chromatography. Sequential fractions were collected for solid-phase radioimmunoassay. Patients with Wegener's granulomatosis showed two peaks of activity over fractions of 12 and 2 kD. Patients with microscopic polyarteritis had two different peaks of activity over fractions of 100 and 25 kD. Patients with Takayasu's arteritis and dermal lymphocytic vasculitis were studied as controls (all were ANCA negative by indirect immunofluorescence studies and solid-phase radioimmunoassay). However, the patient with lymphocytic vasculitis showed a distinct peak of activity over 22 kD and patients with Takayasu's arteritis had a single peak of activity over 200 kD. These results suggest the binding pattern of sera to fractionated neutrophil extract could be useful in differentiating between different diseases within the spectrum of systemic vasculitis. Cryptic antigen recognition in certain vasculitides may only be revealed by this procedure. We conclude that the association of ANCA and systemic vasculitis may not be limited to diseases of small or medium-size vessels, but could also include large vessel disease such as Takayasu's arteritis.
在患有小或中等大小血管系统性血管炎（如韦格纳肉芽肿病和显微镜下多动脉炎）的患者中发现了抗中性粒细胞胞浆抗原自身抗体。我们通过检测不同形式系统性血管炎患者血清与经高效液相色谱凝胶过滤按大小分级的中性粒细胞提取物的结合，研究了抗中性粒细胞胞浆自身抗体（ANCA）的特异性。收集连续的级分用于固相放射免疫测定。韦格纳肉芽肿病患者在12和2kD的级分上显示出两个活性峰。显微镜下多动脉炎患者在100和25kD的级分上有两个不同的活性峰。将高安动脉炎和皮肤淋巴细胞性血管炎患者作为对照进行研究（通过间接免疫荧光研究和固相放射免疫测定，所有患者ANCA均为阴性）。然而，淋巴细胞性血管炎患者在22kD以上显示出一个明显的活性峰，高安动脉炎患者在200kD以上有一个单一的活性峰。这些结果表明，血清与分级中性粒细胞提取物的结合模式可能有助于区分系统性血管炎谱内的不同疾病。某些血管炎中的隐匿抗原识别可能仅通过此程序才能揭示。我们得出结论，ANCA与系统性血管炎的关联可能不仅限于小或中等大小血管的疾病，还可能包括大动脉疾病，如高安动脉炎。
