Lieberman J, Schwartzman M N
Department of Medicine, Veterans Administration Medical Center, Sepulveda, California 91343.
Am J Med Sci. 1990 Feb;299(2):103-6. doi: 10.1097/00000441-199002000-00005.
Analysis of urine samples for a lectin-like factor in patients with a diagnosis of cystic fibrosis (CF) revealed that the low molecular weight (MW) factor is present in urine only from such patients and not from heterozygous carriers of the CF gene or from normal controls. The urine fraction containing the factor must be separated from whole urine by a gel filtration column (TSK-20) for the activity to appear. The assay requires addition of an aliquot of normal serum to provide the necessary IgM to which the CF-factor binds, resulting in the lectin-like activity that causes agglutination of mouse erythrocytes. All 22 CF patients tested, who were not receiving intravenous (IV) antibiotics had positive CF-lectin urinary activity, whereas five others receiving IV aminoglycosides were negative. Four patients with a clinical diagnosis of CF, but with normal sweat tests (35-54 mEq/L), all had positive urinary CF-lectin tests. A blind study in which urine samples were shipped from Miami, FL to Sepulveda, CA was completely successful in correctly identifying 11 samples from CF patients as compared with ten from non-CF patients. It was concluded that an assay for urinary CF-lectin factor is specific and reliable for confirming a diagnosis of CF when the sweat test is indeterminate, and when patients have not received recent IV aminoglycosides.
对确诊为囊性纤维化（CF）患者的尿液样本进行一种类凝集素因子分析发现，低分子量（MW）因子仅存在于此类患者的尿液中，而不存在于CF基因杂合携带者或正常对照者的尿液中。含有该因子的尿液组分必须通过凝胶过滤柱（TSK - 20）从全尿中分离出来，活性才会显现。该检测需要加入一份正常血清以提供CF因子结合所需的必要IgM，从而产生导致小鼠红细胞凝集的类凝集素活性。所有接受检测的22例未接受静脉（IV）抗生素治疗的CF患者，其尿液CF凝集素活性均为阳性，而另外5例接受IV氨基糖苷类药物治疗的患者则为阴性。4例临床诊断为CF但汗液检测正常（35 - 54 mEq/L）的患者，其尿液CF凝集素检测均为阳性。一项盲法研究中，尿液样本从佛罗里达州迈阿密运至加利福尼亚州塞普尔韦达，成功地将11份CF患者的样本与10份非CF患者的样本正确区分开来。得出的结论是，当汗液检测结果不确定且患者近期未接受IV氨基糖苷类药物治疗时，尿液CF凝集素因子检测对于确诊CF具有特异性和可靠性。
