Procaccia S, Bianchi Porro G, Colucci A, Villa P, Blasio R, Ardizzone S, Bonacina C A, Zanussi C
Istituto di Clinica Medica I, University of Milan, Italy.
Boll Ist Sieroter Milan. 1990 Jun;69(2):413-21.
The behaviour of some serological aspects of autoimmunity was studied in patients with inflammatory bowel disease (IBD) by determining the incidence and levels of serum IgM, IgG and IgA rheumatoid factors (RF) and of circulating immune-complexes (IC) in 67 patients suffering from ulcerative colitis (UC) and 53 from Crohn's disease (CD). Sera from 40 young healthy subjects were included as controls. RF were detected by an enzyme linked immuno-assay (ELISA) and IC by the CIC-conglutinin and the CIC-C1q assays. ELISA detected a higher incidence of IgM RF in both UC and CD groups than the routine agglutination tests, although the mean levels were non significantly higher than in controls. Mean IgG RF levels were significantly above normal in UC and CD patients, the latter showing a greater incidence of elevated values and higher mean levels. IgA RF were significantly elevated only in CD patients; mean values for the UC group were within the normal range. The CIC-conglutinin test did not detect a significant incidence or high mean levels of IC and the CIC-C1q assay turned up a sizeable number of positive samples only in the CD group. Although still only preliminary, these overall findings suggest that RF activity is somehow present in patients with IBD. The greater prevalence of IC in CD patients, together with the patterns of IgG and IgA RF support the concept that this disease possibly involves autoimmune phenomena more than ulcerative colitis.
通过测定67例溃疡性结肠炎（UC）患者和53例克罗恩病（CD）患者血清IgM、IgG和IgA类风湿因子（RF）的发生率及水平，以及循环免疫复合物（IC）的情况，研究了炎症性肠病（IBD）患者自身免疫某些血清学方面的表现。纳入40名年轻健康受试者的血清作为对照。采用酶联免疫吸附测定法（ELISA）检测RF，采用CIC-胶固素和CIC-C1q测定法检测IC。ELISA检测发现，UC组和CD组中IgM RF的发生率均高于常规凝集试验，尽管其平均水平仅略高于对照组。UC和CD患者的平均IgG RF水平显著高于正常，CD患者中升高值的发生率更高，平均水平也更高。仅CD患者的IgA RF显著升高；UC组的平均值在正常范围内。CIC-胶固素试验未检测到IC的显著发生率或高平均水平，而CIC-C1q测定法仅在CD组发现大量阳性样本。尽管这些总体发现仍只是初步的，但提示IBD患者存在某种程度的RF活性。CD患者中IC的较高患病率，以及IgG和IgA RF的模式支持了这一观点，即与溃疡性结肠炎相比，该疾病可能更多地涉及自身免疫现象。
