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抗线粒体IgA和IgG在原发性胆汁性肝硬化诊断中的意义

[The significance of antimitochondrial IgA and IgG in the diagnosis of primary biliary cirrhosis].

作者信息

Lu Jian-xi, Qian Shi-yu, Shu Xin, Li Gang

机构信息

Vaccine Research Institute, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2009 Dec;17(12):905-9.

Abstract

OBJECTIVE

To evaluate the sensitivity and the specificity of Anti-M2-3E ELISA for the detection of IgG- and IgA-specific isotypes of antimitochondrial antibody (AMA), and to investigate the significance of antimitochondrial IgA and IgG in the diagnosis of primary biliary cirrhosis (PBC).

METHODS

Sera were collected from 107 PBC patients, 87 disease controls and 26 healthy controls, and the antimitochondrial antibodies (IgG and IgA) were detected using indirect immunofluorescence (IFL), Anti-PDC ELISA and Anti-M2-3E ELISA.

RESULTS

The AMA IgG positive rate in PBC patients was 90.6% detected by Anti-M2-3E ELISA, which is significantly higher than that (81.3%) detected by IFL(t = 4.32, P < 0.05) and that (72.9%) detected by Anti- PDC ELISA (t = 6.03, P < 0.05). The AMA IgA was positive in 59 of the 107 PBC patients, and 99 of the 107 patients were positive for AMA IgG or/and IgA. 9 of the 20 IFL-negative patients were positive for AMA IgG as indicated by Anti-M2-3E ELISA, 11 of the 20 IFL-negative patients were positive for AMA IgG or/and IgA as indicated Anti-M2-3E ELISA. Compared to patients negative for IgG AMA, patients positive for IgG AMA had more severe histopathology and higher levels of ALP, IgG, and IgM.

CONCLUSION

The IgG and IgA Anti- M2-3E ELISAs are more sensitive for the AMA detection than IFN and the Anti-PDC ELISA. The presence of AMA IgG is the characteristics of severe PBC.

摘要

目的

评估抗M2-3E ELISA检测抗线粒体抗体(AMA)IgG和IgA特异性亚型的敏感性和特异性,并探讨抗线粒体IgA和IgG在原发性胆汁性肝硬化(PBC)诊断中的意义。

方法

收集107例PBC患者、87例疾病对照者和26例健康对照者的血清,采用间接免疫荧光法(IFL)、抗丙酮酸脱氢酶ELISA和抗M2-3E ELISA检测抗线粒体抗体(IgG和IgA)。

结果

抗M2-3E ELISA检测PBC患者中AMA IgG阳性率为90.6%,显著高于IFL检测的阳性率(81.3%)(t = 4.32,P < 0.05)和抗PDC ELISA检测的阳性率(72.9%)(t = 6.03,P < 0.05)。107例PBC患者中有59例AMA IgA阳性,107例患者中有99例AMA IgG或/和IgA阳性。抗M2-3E ELISA显示,20例IFL阴性患者中有9例AMA IgG阳性,20例IFL阴性患者中有11例AMA IgG或/和IgA阳性。与IgG AMA阴性患者相比,IgG AMA阳性患者的组织病理学更严重,碱性磷酸酶、IgG和IgM水平更高。

结论

IgG和IgA抗M2-3E ELISA检测AMA比IFN和抗PDC ELISA更敏感。AMA IgG的存在是重度PBC的特征。

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