Adoue D, Vernier I, Oksman F
Centre de Médecine Interne et de Gériatrie, CHU Toulouse-Purpan.
Ann Med Interne (Paris). 1989;140(6):435-9.
The demonstration of antibodies directed against granulocyte cytoplasm in Wegener's disease and in the microscopic forms of polyarteritis nodosa led to the proposal that these antibodies could be used as a diagnostic tool and a means to monitor the evolution of these diseases. However, the presence of these antibodies in different pathological situations and, in particular, in syndromes not related to vasculitides, poses the question as to their specificity. In addition, the observation of dissociated reactions between the methods available for the detection of these antibodies (indirect immunofluorescence, radioimmunological assay), like the existence of different morphological aspects seen in immunofluorescence, favor the hypothesis of different antigenic determinants, whose recognition could contribute to the nosology and pathophysiology of these diseases. We performed a retrospective study based on 42 positive results (paired execution of both detection techniques), in order to characterize the corresponding anatomic and clinical states. We confirmed the classical positivity in Wegener's disease and microscopic forms of polyarteritis nodosa, justified the paired running of both detection assays because of dissociated results and false positives found by immunofluorescence, corroborated the presence of antibodies in conditions apparently unrelated to vasculitides, and specified the different aspects observable by immunofluorescence, thus demonstrating the reality of different antigenic determinants.
在韦格纳肉芽肿病和显微镜下型结节性多动脉炎中针对粒细胞胞浆的抗体的证实,引发了这样的提议,即这些抗体可用作诊断工具以及监测这些疾病进展的手段。然而,这些抗体在不同病理情况下的存在,特别是在与血管炎无关的综合征中的存在,引发了关于其特异性的问题。此外,可用于检测这些抗体的方法(间接免疫荧光法、放射免疫测定法)之间出现的分离反应,以及免疫荧光中所见的不同形态学表现的存在,支持了存在不同抗原决定簇的假说,对这些抗原决定簇的识别可能有助于这些疾病的分类学和病理生理学研究。我们基于42例阳性结果(两种检测技术的配对实施)进行了一项回顾性研究,以描述相应的解剖学和临床状态。我们证实了韦格纳肉芽肿病和显微镜下型结节性多动脉炎中的典型阳性情况,由于免疫荧光法出现的分离结果和假阳性,证明了两种检测方法配对实施的合理性,证实了在明显与血管炎无关的情况下抗体的存在,并明确了免疫荧光可观察到的不同表现,从而证明了不同抗原决定簇的存在。