Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Thorax. 2011 Feb;66(2):101-7. doi: 10.1136/thx.2009.134171. Epub 2010 Nov 3.
Chronic obstructive pulmonary disease (COPD) is associated with a higher prevalence of antinuclear autoantibodies (ANAs). However, a significant subgroup of patients is ANA negative. It remains to be determined which patient groups carry autoantibodies.
The association of smoking behaviour, disease status, gender, age and body mass index (BMI) with the presence of autoantibodies in the serum was determined in 124 patients with COPD and 108 non-COPD control subjects. In addition, the role of B cells in autoantibody generation in COPD was investigated by sequencing the antibody repertoire of B cells in the lungs of patients with COPD and of ex-smoking and never-smoking control subjects.
Patients with COPD had a significantly higher risk of being serum positive for ANAs (OR 3.12, 95% CI 1.68 to 5.76, p<0.001). ANAs were not significantly associated with age, smoking status, gender or pack-years of smoking. Within the COPD population, subjects with BMI <22 kg/m2 had a significantly higher risk of ANAs (OR 4.93, 95% CI 1.50 to 16.50, p=0.009) than those with normal or high BMI. The antibody repertoire of B cells in the lungs of patients with COPD had a high frequency of positively charged CDR3 residues, a feature which is associated with self-reactive antibodies.
The results show that COPD is a heterogeneous disease with respect to the prevalence of ANAs. ANAs are primarily associated with the presence of COPD and with low BMI, but not with smoking and forced expiratory volume in 1 s.
慢性阻塞性肺疾病（COPD）与抗核抗体（ANA）的阳性率较高有关。然而，相当一部分患者的 ANA 为阴性。目前尚不清楚哪些患者群体携带自身抗体。
本研究在 124 例 COPD 患者和 108 例非 COPD 对照受试者中，确定了吸烟行为、疾病状态、性别、年龄和体重指数（BMI）与血清中自身抗体存在的相关性。此外，通过对 COPD 患者和曾吸烟及从不吸烟对照受试者肺部 B 细胞的抗体库进行测序，研究了 B 细胞在 COPD 中产生自身抗体的作用。
COPD 患者血清 ANA 阳性的风险显著升高（OR 3.12，95%CI 1.68 至 5.76，p<0.001）。ANA 与年龄、吸烟状况、性别或吸烟包年数无显著相关性。在 COPD 人群中，BMI<22 kg/m2 的受试者 ANA 阳性的风险显著升高（OR 4.93，95%CI 1.50 至 16.50，p=0.009），而 BMI 正常或较高者则无此风险。COPD 患者肺部 B 细胞的抗体库中，带正电荷的 CDR3 残基的频率较高，这一特征与自身反应性抗体有关。
研究结果表明，COPD 是一种异质性疾病，ANA 的阳性率存在差异。ANA 主要与 COPD 及 BMI 较低有关，而与吸烟和 1 秒用力呼气量（FEV1）无关。
