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炎症性肠病中一组五种抗体的血清学检测:诊断价值及与疾病表型的相关性

Serologic testing of a panel of five antibodies in inflammatory bowel diseases: Diagnostic value and correlation with disease phenotype.

作者信息

Wang Zhi-Zhi, Shi Ke, Peng Jie

机构信息

Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.

Laboratory of the Department of Gerontology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.

出版信息

Biomed Rep. 2017 Apr;6(4):401-410. doi: 10.3892/br.2017.860. Epub 2017 Feb 17.

Abstract

The aim of the present study was to evaluate the diagnostic value of five serological antibodies, perinuclear antineutrophil cytoplasmic antibody (pANCA), anti- antibodies [ASCA; ASCA-immunoglobulin (IgG)and ASCA-IgA], outer membrane porin C antibody (anti-OmpC) and CBir1 flagellin antibody for detection in inflammatory bowel diseases. Whether the antibody status correlated with the disease phenotype was also evaluated. Sera from 71 patients with Crohn's disease (CD), 41 patients with ulcerative colitis (UC), 78 patients with other gastrointestinal diseases and 31 healthy control subjects were investigated. Clinical data were gathered at the time of serum sampling and enzyme-linked immunosorbent assay was used to determine titers of the above mentioned five antibodies. The pANCA test exhibited a sensitivity of 53.7% for UC and the ASCA test had a sensitivity of 66.2% for CD. The prevalence of anti-OmpC was significantly higher in CD than in intestinal tuberculosis (TB), indicating that anti-OmpC may be a serologic marker distinguishing CD from TB. The pANCA/ASCA- exhibited the best specificity for differentiating between CD and UC. In UC, the presence of pANCA was greater in the patients with moderate to severe activity than in those with mild activity. ASCA was more positive in ileal CD. Furthermore, positive ASCA-IgG or anti-OmpC implied that complicated CD and pANCA was associated with colonic CD. Seropositivity of anti-CBir1 was lowest in colonic CD.

摘要

本研究的目的是评估五种血清学抗体,即核周抗中性粒细胞胞浆抗体(pANCA)、抗酿酒酵母抗体[ASCA;ASCA-免疫球蛋白(IgG)和ASCA-IgA]、外膜孔蛋白C抗体(抗OmpC)和CBir1鞭毛蛋白抗体在炎症性肠病检测中的诊断价值。还评估了抗体状态与疾病表型是否相关。对71例克罗恩病(CD)患者、41例溃疡性结肠炎(UC)患者、78例其他胃肠道疾病患者和31例健康对照者的血清进行了研究。在采集血清时收集临床数据,并采用酶联免疫吸附测定法测定上述五种抗体的滴度。pANCA检测对UC的敏感性为53.7%,ASCA检测对CD的敏感性为66.2%。CD患者中抗OmpC的患病率显著高于肠结核(TB)患者,这表明抗OmpC可能是区分CD与TB的血清学标志物。pANCA/ASCA-在区分CD和UC方面表现出最佳特异性。在UC中,中度至重度活动患者中pANCA的阳性率高于轻度活动患者。ASCA在回肠CD中更呈阳性。此外,ASCA-IgG或抗OmpC阳性意味着存在复杂性CD,而pANCA与结肠CD相关。抗CBir1的血清阳性率在结肠CD中最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/655f/5374894/cccebc5ea9ff/br-06-04-0401-g00.jpg

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