Komazaki Yoshitoshi, Miyazaki Yasunari, Fujie Toshihide, Sakashita Hiroyuki, Tsuchiya Kimitake, Tamaoka Meiyo, Sumi Yuki, Maruyama Yuichiro, Nanki Toshihiro, Inase Naohiko
Department of Integrated Pulmonology, Tokyo Medical and Dental University, Tokyo, Japan.
Respiration. 2014;87(2):129-35. doi: 10.1159/000354791. Epub 2013 Dec 4.
Mycobacterium avium complex (MAC) pulmonary disease (PD) is often difficult and complicated to diagnose or to discriminate from follicular bronchitis, bronchiectasis, or other conditions associated with rheumatoid arthritis (RA) lung in the clinical setting.
We investigated whether a serologic test for anti-glycopeptidolipid (GPL) antibody was useful for distinguishing MAC-PD from RA lung in diagnosis.
Serum IgA antibody to MAC-specific GPL core antigen was measured by an enzyme immunoassay. Antibody levels were measured in sera from 14 RA patients with MAC-PD (RA + MAC), 20 RA patients with bronchial or bronchiolar lesions without MAC-PD (RA w/o MAC), 20 RA patients without pulmonary lesions (RA only), and 25 healthy volunteers (HV).
The levels of serum anti-GPL antibodies were higher in the RA + MAC group than in the RA w/o MAC, RA-only, and HV groups (2.87 ± 2.83 vs. 0.50 ± 0.45, 0.31 ± 0.24, and 0.38 ± 0.10 U/ml, respectively; p < 0.001). With the cutoff point in receiver-operating characteristic analysis set at 0.7 U/ml, the serologic test differentiated RA + MAC from RA w/o MAC with a sensitivity of 100% and specificity of 90%.
This serologic test for anti-GPL antibody is useful for diagnosing MAC-PD in RA.
在临床环境中，鸟分枝杆菌复合群（MAC）肺部疾病（PD）的诊断往往困难且复杂，难以与滤泡性支气管炎、支气管扩张或其他与类风湿性关节炎（RA）肺部相关的疾病相鉴别。
我们研究了抗糖脂肽（GPL）抗体的血清学检测在诊断中区分MAC-PD与RA肺部疾病方面是否有用。
采用酶免疫测定法检测血清中针对MAC特异性GPL核心抗原的IgA抗体。检测了14例合并MAC-PD的RA患者（RA+MAC）、20例有支气管或细支气管病变但无MAC-PD的RA患者（无MAC的RA）、20例无肺部病变的RA患者（仅RA）以及25名健康志愿者（HV）血清中的抗体水平。
RA+MAC组的血清抗GPL抗体水平高于无MAC的RA组、仅RA组和HV组（分别为2.87±2.83 vs. 0.50±0.45、0.31±0.24和0.38±0.10 U/ml；p<0.001）。在受试者工作特征分析中，将临界值设定为0.7 U/ml时，该血清学检测区分RA+MAC与无MAC的RA的灵敏度为100%，特异性为90%。
这种抗GPL抗体的血清学检测在诊断RA合并MAC-PD方面是有用的。
