Saxon A, Shanahan F, Landers C, Ganz T, Targan S
Hart and Louise Lyon Immunology Laboratory, University of California-Los Angeles/Harbor Inflammatory Bowel Disease Center.
J Allergy Clin Immunol. 1990 Aug;86(2):202-10. doi: 10.1016/s0091-6749(05)80067-3.
Antineutrophil cytoplasmic antibodies (ANCAs) have recently been demonstrated to be of importance in Wegener's granulomatosis and certain other forms of vasculitis associated with glomerulonephritis. With a fixed-cell ELISA, we demonstrated that ANCAs occur in the serum of patients with inflammatory bowel disease (IBD) involving the colon. In a blinded study, sera from 21 of 25 patients with ulcerative colitis (UC) and five of 25 patients with Crohn's disease had binding in the fixed-cell ELISA. The five reactive sera from patients with Crohn's disease were associated with the presence of clear colonic involvement. The presence of ANCA in patients with UC was not influenced by disease distribution or activity. Indeed, such antibodies were present in four subjects with UC more than 5 years after colectomy. The IBD-associated ANCAs were distinct from ANCAs reported in patients with Wegener's granulomatosis since the pattern of staining on indirect immunofluorescence exhibited a nongranular perinuclear distribution (P-ANCA). The P-ANCA observed in IBD did not react with myeloperoxidase and thus was distinct from the P-ANCA observed in vasculitis with cresentric glomerulonephritis. IBD and, in particular, UC, is associated with a distinct subset of P-ANCA, which may have important diagnostic and potential pathophysiologic implications.
抗中性粒细胞胞浆抗体（ANCA）最近被证明在韦格纳肉芽肿病和某些其他与肾小球肾炎相关的血管炎中具有重要意义。通过固定细胞酶联免疫吸附测定（ELISA），我们证明ANCA存在于累及结肠的炎症性肠病（IBD）患者的血清中。在一项盲法研究中，25例溃疡性结肠炎（UC）患者中有21例以及25例克罗恩病患者中有5例的血清在固定细胞ELISA中出现结合。来自克罗恩病患者的5份反应性血清与结肠明显受累有关。UC患者中ANCA的存在不受疾病分布或活动的影响。事实上，在4例接受结肠切除术后5年以上的UC患者中也存在此类抗体。IBD相关的ANCA与韦格纳肉芽肿病患者中报道的ANCA不同，因为间接免疫荧光染色模式显示为非颗粒状核周分布（P-ANCA）。在IBD中观察到的P-ANCA与髓过氧化物酶不反应，因此与伴有新月体性肾小球肾炎的血管炎中观察到的P-ANCA不同。IBD，尤其是UC，与一种独特的P-ANCA亚群相关，这可能具有重要的诊断和潜在病理生理学意义。
