自身免疫性肺泡蛋白沉积症患者血清抗 GM-CSF 自身抗体水平的临床意义。
Clinical significance of serum anti-GM-CSF autoantibody levels in autoimmune pulmonary alveolar proteinosis.
机构信息
Division of Respiratory Medicine & Allergology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.
Department of Infection Control & Prevention, Aichi Medical University Hospital, Aichi, Japan.
出版信息
Biomark Med. 2018 Feb;12(2):151-159. doi: 10.2217/bmm-2017-0362. Epub 2017 Dec 5.
AIM
Precise clinical significance of antigranulocyte-macrophage colony stimulating factor (GM-CSF) autoantibody levels in autoimmune pulmonary alveolar proteinosis (aPAP) has not been well studied.
METHODS
We obtained sera from 50 healthy controls, 46 aPAP patients, 50 with sarcoidosis, 52 with idiopathic interstitial pneumonia and 75 with pneumoconiosis. The clinical course of aPAP patients was assessed by scoring computed tomography images in 19 patients.
RESULTS
The cut-off level of anti-GM-CSF IgG for discrimination between aPAP and other diffuse lung diseases was 2.8 μg/ml with 100% sensitivity and 98% specificity. Antibody levels at baseline were significantly lower in the improved group than in the unimproved group (p = 0.008).
CONCLUSION
Our results indicate the existence of threshold levels of serum anti-GM-CSF IgG for the development and persistence of aPAP.
目的
抗粒细胞-巨噬细胞集落刺激因子（GM-CSF）自身抗体水平在自身免疫性肺泡蛋白沉积症（aPAP）中的精确临床意义尚未得到很好的研究。
方法
我们从 50 名健康对照者、46 名 aPAP 患者、50 名结节病患者、52 名特发性间质性肺炎患者和 75 名尘肺患者中获得了血清。对 19 名 aPAP 患者的计算机断层扫描图像进行评分，评估 aPAP 患者的临床病程。
结果
区分 aPAP 和其他弥漫性肺疾病的抗 GM-CSF IgG 截断值为 2.8μg/ml，具有 100%的敏感性和 98%的特异性。在改善组中，基线时的抗体水平明显低于未改善组（p=0.008）。
结论
我们的结果表明，血清抗 GM-CSF IgG 的存在存在一个阈值水平，与 aPAP 的发生和持续存在相关。
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