Zumla A, Williams W, Mudd D, Locniskar M, Behrens R, Isenberg D, McAdam K P
Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, England.
Clin Exp Immunol. 1991 Jun;84(3):522-6.
The sera of 187 patients from across the leprosy spectrum were screened for the expression of the PR4 idiotype, which was first identified on a human hybridoma-derived monoclonal antibody from a patient with leprosy and found to react with the Mycobacterium leprae phenolic glycolipid and a variety of polynucleotides. Sixty per cent (51 out of 85) of patients with lepromatous leprosy (LL), 66% (33 out of 49) with borderline lepromatous (BL) disease, 47% (14 out of 30) with borderline tuberculoid (BT) leprosy, and 56% (13 out of 23) of tuberculoid (TT) patients were found to have significantly elevated titres of the PR4 idiotype in their sera compared with endemic controls, irrespective of the presence or absence of endemic malaria. Sera from 52 patients with tuberculosis were also screened as a control for mycobacterial infection. The PR4 idiotype was significantly elevated in 37% (19 out of 52) of these patients. No correlation between idiotype and serum immunoglobulins IgG and IgM was found, indicating that the concentrations of idiotype levels in sera were not merely a reflection of changes in serum immunoglobulin levels. It is hypothesized that the expression of the PR4 idiotype is due to certain germline genes preferentially expressed rather than being the result of polyclonal B cell activation.
对来自麻风病谱系各型的187例患者的血清进行了PR4独特型表达的筛查，该独特型最初在一名麻风病患者的人杂交瘤衍生单克隆抗体上被鉴定出来，发现其可与麻风分枝杆菌酚糖脂和多种多核苷酸发生反应。发现瘤型麻风（LL）患者中有60%（85例中的51例）、界线类偏瘤型（BL）患者中有66%（49例中的33例）、界线类偏结核型（BT）患者中有47%（30例中的14例）以及结核型（TT）患者中有56%（23例中的13例），与地方性对照相比，其血清中PR4独特型的滴度显著升高，无论是否存在地方性疟疾。还对52例结核病患者的血清进行了筛查，作为分枝杆菌感染的对照。这些患者中有37%（52例中的19例）PR4独特型显著升高。未发现独特型与血清免疫球蛋白IgG和IgM之间存在相关性，这表明血清中独特型水平的浓度并非仅仅是血清免疫球蛋白水平变化的反映。据推测，PR4独特型的表达是由于某些种系基因的优先表达，而不是多克隆B细胞活化的结果。
