Kaya Selçuk, Demirci Mustafa, Sesli Cetin Emel, Cicioğlu Aridoğan Buket, Sahin Mehmet, Taş Tekin, Korkmaz Metin
Süleyman Demirel Universitesi Tip Fakültesi, Tibbi Mikrobiyoloji Anabilim Dali, Isparta.
Mikrobiyol Bul. 2009 Oct;43(4):661-6.
Immunopathologic reactions may occur during toxocariasis due to tissue invasion and destruction by the secretions of larvae containing various enzymes with broad spectrum. The aim of this study was to search for autoantibodies such as anti-nuclear (ANA), anti-mitochondrial (AMA), anti-smooth muscle (ASMA), anti-neutrophil cytoplasmic (ANCA), anti-myeloperoxidase (MPO) and liver-kidney microsomal type 1 (LKM-1) antibodies in patients with toxocariasis, in order to investigate the role of toxocariasis as a trigger factor for autoimmune reactions. Forty patients (22 were male; mean age: 35.6 +/- 10.7 years) diagnosed as toxocariasis by clinical findings (abdominal pain, allergic symptoms and/or eosinophilia, without detection of any other causative agents, and without liver dysfunction, diabetes mellitus, cardiac or renal failure, and autoimmune disease) and in-house ELISA positivity and 32 healthy controls (16 were male; mean age: 40.7 +/- 11.2 years) were included to the study. ANA (screen), dsDNA, SS-A, SS-B, Scl-70, LKM-1, MPO and M2 autoantibodies have been investigated by ELISA (Euroimmun, Germany), while ANCA, AMA and ASMA antibodies by indirect immunofluorescence (IMMCO, NY) methods. Autoantibody positivity was detected in 18 (45%) patients of whom 11 yielded a single type, and 7 yielded > or = 2 types of autoantibodies. This rate was 12.5% for control group (two subjects were positive for ANA-Screen, one for anti-M2 and one for anti-LKM-1). The difference between the total positivity rates in patient and control groups was found statistically significant (chi2 = 5.72, p = 0.004). The most frequent autoantibody type among patients were ASMA (n = 6), followed by anti-dsDNA (n = 5), anti-M2 (n = 5), anti-SS-B (n = 4), anti-LKM-1 (n = 3), anti-SS-A (n = 2), ANCA (n = 2) and anti-MPO (n = 1). Positivity rate for ASMA was found statistically significant in patients' group compared to controls (chi2 = 12.24, p = 0.03), while there was no significant difference between the groups in terms of other autoantibody rates (p> 0.05). These data could be related to the possible release of autoantigens following muscle tissue injury during toxocariasis and/or antigenic mimicry of parasitic products during the infection in which muscle invasion is frequently seen. In conclusion, since autoantibodies are frequently detected in toxocariasis, this situation should be taken into consideration in the presence of autoantibodies.
由于含有多种具有广泛作用谱酶的幼虫分泌物对组织的侵袭和破坏,弓蛔虫病期间可能会发生免疫病理反应。本研究的目的是在弓蛔虫病患者中寻找自身抗体,如抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(ASMA)、抗中性粒细胞胞浆抗体(ANCA)、抗髓过氧化物酶抗体(MPO)和1型肝肾微粒体抗体(LKM-1),以研究弓蛔虫病作为自身免疫反应触发因素的作用。40例患者(22例男性;平均年龄:35.6±10.7岁)通过临床表现(腹痛、过敏症状和/或嗜酸性粒细胞增多,未检测到任何其他病原体,且无肝功能障碍、糖尿病、心脏或肾衰竭以及自身免疫性疾病)、内部酶联免疫吸附测定(ELISA)阳性确诊为弓蛔虫病,32例健康对照者(16例男性;平均年龄:40.7±11.2岁)纳入本研究。采用ELISA法(德国欧蒙公司)检测ANA(筛查)、双链DNA、SS-A、SS-B、Scl-70、LKM-1、MPO和M2自身抗体,采用间接免疫荧光法(纽约免疫公司)检测ANCA、AMA和ASMA抗体。在18例(45%)患者中检测到自身抗体阳性,其中11例为单一类型,7例为≥2种类型的自身抗体。对照组的这一比例为12.5%(2例ANA筛查阳性,1例抗M2阳性,1例抗LKM-1阳性)。患者组和对照组的总阳性率差异有统计学意义(χ2 = 5.72,p = 0.004)。患者中最常见的自身抗体类型是ASMA(n = 6),其次是抗双链DNA(n = 5)、抗M2(n = 5)、抗SS-B(n = 4)、抗LKM-1(n = 3)、抗SS-A(n = 2)、ANCA(n = 2)和抗MPO(n = 1)。与对照组相比,患者组ASMA的阳性率差异有统计学意义(χ2 = 12.24,p = 0.03),而其他自身抗体率在两组之间无显著差异(p>0.05)。这些数据可能与弓蛔虫病期间肌肉组织损伤后自身抗原的可能释放和/或感染期间寄生虫产物的抗原模拟有关,在感染中经常可见肌肉侵袭。总之,由于在弓蛔虫病中经常检测到自身抗体,在存在自身抗体的情况下应考虑这种情况。