de Aizpurua H J, Ungar B, Toh B H
N Engl J Med. 1985 Aug 22;313(8):479-83. doi: 10.1056/NEJM198508223130805.
We examined serum IgG fractions from 20 patients with pernicious anemia and 25 control subjects for their capacity to inhibit binding of [125I]15-leu human gastrin-17 to parietal-cell-enriched gastric mucosal cells. IgG fractions from six patients reduced gastrin binding by 45.6 +/- 12.2 per cent, as compared with a reduction of 1.8 +/- 0.7 per cent by fractions from the 25 controls. The fractions from these six patients also reduced gastrin-stimulated [14C]aminopyrine uptake by gastric cells (an index of gastric acid secretory activity in vitro) by 50.2 +/- 8.4 per cent (mean +/- S.D.), as compared with 9.2 +/- 4.1 per cent for the controls. IgG fractions from six other patients that did not reduce gastrin binding also inhibited gastrin-stimulated [14C]aminopyrine uptake, by 48.1 +/- 9.1 per cent. These reductions in gastrin binding and aminopyrine uptake were abolished by absorption of the IgG fractions with suspensions of viable gastric mucosal cells but not by absorption with liver or kidney cells. The IgG fractions did not inhibit [3H]histamine binding or histamine-stimulated [14C]aminopyrine uptake. These results suggest that serum IgG from some patients with pernicious anemia contains autoantibodies to the gastrin receptor.
我们检测了20例恶性贫血患者和25例对照者的血清IgG组分,观察其抑制[125I]15-亮氨酸人胃泌素-17与富含壁细胞的胃黏膜细胞结合的能力。6例患者的IgG组分使胃泌素结合减少了45.6±12.2%,而25例对照者的IgG组分使胃泌素结合减少了1.8±0.7%。这6例患者的IgG组分还使胃细胞受胃泌素刺激的[14C]氨基比林摄取(体外胃酸分泌活性指标)减少了50.2±8.4%(均值±标准差),而对照者为9.2±4.1%。另外6例未减少胃泌素结合的患者的IgG组分也抑制了胃泌素刺激的[14C]氨基比林摄取,减少了48.1±9.1%。胃泌素结合和氨基比林摄取的这些减少通过用活的胃黏膜细胞悬液吸收IgG组分而消除,但用肝细胞或肾细胞吸收则不能消除。这些IgG组分不抑制[3H]组胺结合或组胺刺激的[14C]氨基比林摄取。这些结果提示,一些恶性贫血患者的血清IgG含有胃泌素受体自身抗体。