Autoimmunity laboratory, Centre for Inflammatory Diseases, Department of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
Autoimmunity. 2012 Nov;45(7):527-32. doi: 10.3109/08916934.2012.702813. Epub 2012 Aug 21.
Parietal cell antibody is a marker for autoimmune gastritis. With identification of gastric H/K ATPase as its molecular target, ELISAs have been introduced. We compared performance of ELISA with immunofluorescence in a retrospective and prospective sera set and correlated the results with intrinsic factor antibody. In 138 retrospective sera selected for positivity or negativity for intrinsic factor antibody, 87 reacted with gastric H/K ATPase by Euroimm ELISA but only 62 reacted by immunofluorescencence.. Similar results were obtained with Inova ELISA with 78 positives that were also positive by Euroimm ELISA. In 161 prospective sera, 29 sera tested positive by ELISA compared to 24 by immunofluorescence. ELISA positive but immunofluoresnce negative sera are bona fide positives because a representative set of 16 sera reacted with both 95kD α and 60-90kDβ subunits of gastric H/K ATPase. ELISA values rose with age regardless of whether immunofluorescence tests were positive or negative. Of 53 sera containing antibody to intrinsic factor, 46/53 (87%) reacted to gastric H/K ATPase by ELISA. Taken together, the data indicates an enhanced detection rate by ELISA over immunofluorescence and validates it as a robust diagnostic assay for parietal cell antibody. As parietal cell antibody marks asymptomatic autoimmune gastritis that may progress to end stage gastric atrophy and haematological complications, and as autoimmune gastritis is associated with autoimmune thyroiditic and type 1 diabetes mellitus, early detection of parietal cell antibody by a sensitive ELISA will enable early follow-up of at risk subjects.
壁细胞抗体是自身免疫性胃炎的标志物。随着胃 H/K ATP 酶作为其分子靶标的鉴定，已经引入了 ELISA。我们比较了 ELISA 与免疫荧光法在回顾性和前瞻性血清中的性能，并将结果与内因子抗体相关联。在为内因子抗体阳性或阴性选择的 138 份回顾性血清中，87 份与 Euroimm ELISA 中的胃 H/K ATP 酶反应，但只有 62 份与免疫荧光反应。用 Inova ELISA 也得到了类似的结果，其中 78 份阳性与 Euroimm ELISA 也阳性。在 161 份前瞻性血清中，有 29 份 ELISA 阳性，而免疫荧光法阳性的有 24 份。ELISA 阳性但免疫荧光阴性的血清是真正的阳性，因为一组有代表性的 16 份血清与胃 H/K ATP 酶的 95kDα和 60-90kDβ亚单位均有反应。无论免疫荧光试验阳性还是阴性，ELISA 值都随年龄增长而升高。在含有内因子抗体的 53 份血清中，46/53（87%）通过 ELISA 与胃 H/K ATP 酶反应。总之，数据表明 ELISA 比免疫荧光法检测率更高，并验证了其作为壁细胞抗体的可靠诊断检测方法。由于壁细胞抗体标记可能进展为终末期胃萎缩和血液学并发症的无症状自身免疫性胃炎，并且自身免疫性胃炎与自身免疫性甲状腺炎和 1 型糖尿病相关，因此通过敏感的 ELISA 早期检测壁细胞抗体将能够对高危人群进行早期随访。
