Sachar D B
Mount Sinai Hospital, New York, NY 10029.
J Clin Gastroenterol. 1989 Dec;11(6):613-4.
Over the past 10 years, Kiron Das and his associates have developed an animal model for the study of a putative Crohn's disease (CD)-specific antigen. Athymic T-cell deficient nu/nu mice inoculated with intestinal and lymph node tissue filtrates from patients with CD sometimes develop lymphomas and/or lymph node plasma cell hyperplasia. Patients with CD often have an antibody that reacts with an antigen contained in these murine lymphomas and hyperplastic lymph nodes. This antibody is found in the sera of about one-third to one-half of CD patients, but it is rarely found in ulcerative colitis (UC) patients and almost never in other controls. This issue of the Journal of Clinical Gastro-enterology contains Das's most recent clinical study on the subject, indicating that this serum antibody was present in 11 of 29 CD patients (38%), in only 4 of 25 UC patients (16%), and in almost no disease controls or normal subjects. Das's immunofluorescent assay is not yet sufficiently sensitive, specific, or convenient to be widely applicable as a routine serodiagnostic tool in clinical practice, but it could be enormously important if it proved in fact to be a marker for a CD-specific antigen. Other laboratories, however, have sharply questioned the specificity of this antigen, whose pathogenetic significance therefore remains controversial.
在过去10年里，基隆·达斯及其同事开发了一种动物模型，用于研究一种假定的克罗恩病（CD）特异性抗原。给无胸腺T细胞缺陷的裸鼠接种来自CD患者的肠道和淋巴结组织滤液后，这些裸鼠有时会发生淋巴瘤和/或淋巴结浆细胞增生。CD患者通常有一种抗体，能与这些鼠类淋巴瘤和增生性淋巴结中所含的一种抗原发生反应。约三分之一至二分之一的CD患者血清中可发现这种抗体，但在溃疡性结肠炎（UC）患者中很少发现，在其他对照人群中几乎从未发现。本期《临床胃肠病学杂志》刊载了达斯关于该主题的最新临床研究，结果显示，29例CD患者中有11例（38%）存在这种血清抗体，25例UC患者中只有4例（16%）存在，而在疾病对照人群或正常受试者中几乎没有。达斯的免疫荧光检测在敏感性、特异性或便利性方面还不足以作为临床实践中的常规血清诊断工具广泛应用，但如果它最终被证明是CD特异性抗原的标志物，可能会具有极其重要的意义。然而，其他实验室对这种抗原的特异性提出了尖锐质疑，因此其致病意义仍存在争议。
