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自身免疫性胰腺炎中 B 细胞激活因子的临床意义。

Clinical significance of B cell-activating factor in autoimmune pancreatitis.

机构信息

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.

出版信息

Pancreas. 2011 Aug;40(6):840-5. doi: 10.1097/MPA.0b013e3182143b10.

Abstract

OBJECTIVES

Overexpression of B Cell-activating factor (BAFF) is involved in autoimmunity, but little is known about its role in autoimmune pancreatitis (AIP). The aim of this study was to investigate the role of BAFF in the diagnosis and pathogenesis of AIP.

METHODS

Patients with AIP (n = 19) were compared with 2 disease control groups (chronic pancreatitis [n = 17] and pancreatic cancer [n = 15]) and a healthy subject group (n = 19). Serum BAFF levels were assessed using an enzyme-linked immunosorbent assay. The expressions of BAFF and BAFF receptor in the pancreatic tissue of patients with AIP were estimated using immunohistochemistry.

RESULTS

Mean serum BAFF levels were higher in the patients with AIP than in the patients with chronic pancreatitis, the patients with pancreatic cancer, and the healthy subjects (P < 0.0001 for all groups). Using the cutoff value of 1389 pg/mL, the sensitivity and specificity to differentiate AIP from disease and healthy controls were 89.5% and 92.2%, respectively. Glucocorticoid therapy decreased serum BAFF levels below 1389 pg/mL in all patients with AIP (P < 0.0001). B Cell-activating factor and BAFF receptor were expressed on cells infiltrating the pancreas of patients with AIP.

CONCLUSIONS

B Cell-activating factor could be a novel marker for diagnosis and treatment response in AIP and may contribute to its pathogenesis.

摘要

目的

B 细胞激活因子(BAFF)的过表达与自身免疫有关,但对其在自身免疫性胰腺炎(AIP)中的作用知之甚少。本研究旨在探讨 BAFF 在 AIP 的诊断和发病机制中的作用。

方法

将 19 例 AIP 患者与 2 个疾病对照组(慢性胰腺炎[17 例]和胰腺癌[15 例])和 19 例健康对照组进行比较。采用酶联免疫吸附试验检测血清 BAFF 水平。采用免疫组织化学法检测 AIP 患者胰腺组织中 BAFF 和 BAFF 受体的表达。

结果

与慢性胰腺炎、胰腺癌和健康对照组相比,AIP 患者的血清 BAFF 水平更高(所有组 P<0.0001)。采用 1389pg/ml 的截断值,区分 AIP 与疾病和健康对照组的敏感性和特异性分别为 89.5%和 92.2%。糖皮质激素治疗使所有 AIP 患者的血清 BAFF 水平降至 1389pg/ml 以下(P<0.0001)。B 细胞激活因子和 BAFF 受体在 AIP 患者胰腺浸润细胞上表达。

结论

BAFF 可能是 AIP 诊断和治疗反应的新标志物,并可能有助于其发病机制。

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