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[结缔组织病自身抗体检测的研究进展]

[Progress of Autoantibody Examinations for Connective Tissue Diseases].

作者信息

Akashi Kengo, Saegusa Jun, Morinobu Akio

出版信息

Rinsho Byori. 2015 May;63(5):562-9.

Abstract

Connective tissue diseases are chronic inflammatory diseases that can affect multiple organs and, thus, have a broad spectrum of clinical presentations. Various autoantibodies are detected in patients with connective tissue diseases, represented by anti-nuclear antibody for systemic lupus erythematosus (SLE), systemic sclerosis (SSc), polymyositis/dermatomyositis (PM/DM), Sjögren's syndrome, and mixed connective tissue disease. Assessment of the autoantibody profile is fundamental for the clinical management of patients with connective tissue diseases, providing important data for the diagnosis, clinical characterization, and disease activity evaluation. Anti-ribosomal P antibody and anti-NMDA receptor antibody are associated with neuropsychiatric SLE. Anti-synthetase syndrome comprises the association of myositis (PM/DM), interstitial lung disease, fever, Raynaud's phenomenon, mechanic's hands, and anti-aminoacyl tRNA synthetase antibodies. Anti-MDA5 antibody is detected in patients with clinically amyopathic DM, often complicated by rapidly progressive interstitial lung disease. Between 50 and 75% of malignancy-associated DM patients are positive for anti-TIF1-γ antibody. Anti-RNA polymerase III antibody is associated with diffuse cutaneous SSc and renal crisis. This review focuses on the importance and usefulness of these autoantibodies for the diagnosis and management of patients with connective tissue diseases in clinical practice.

摘要

结缔组织病是一类慢性炎症性疾病,可累及多个器官,因此具有广泛的临床表现。结缔组织病患者可检测到多种自身抗体,以系统性红斑狼疮(SLE)、系统性硬化症(SSc)、多发性肌炎/皮肌炎(PM/DM)、干燥综合征和混合性结缔组织病中的抗核抗体为代表。自身抗体谱的评估是结缔组织病患者临床管理的基础,可为诊断、临床特征描述和疾病活动度评估提供重要数据。抗核糖体P抗体和抗NMDA受体抗体与神经精神性SLE相关。抗合成酶综合征包括肌炎(PM/DM)、间质性肺病、发热、雷诺现象、技工手和抗氨酰tRNA合成酶抗体。临床上无肌病性皮肌炎患者可检测到抗MDA5抗体,常并发快速进展性间质性肺病。50%至75%的恶性肿瘤相关性皮肌炎患者抗TIF1-γ抗体呈阳性。抗RNA聚合酶III抗体与弥漫性皮肤型SSc和肾危象相关。本综述重点关注这些自身抗体在临床实践中对结缔组织病患者诊断和管理的重要性及实用性。

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