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冷球蛋白与感染性疾病

Cryoglobulins and infectious diseases.

作者信息

Galli M, Invernizzi F, Chemotti M, Monti G, Gasparro M G, Caredda F, Negri C, Moroni M

出版信息

Ric Clin Lab. 1986 Apr-Jun;16(2):301-13. doi: 10.1007/BF02909354.

Abstract

The relationship between infectious diseases due to various pathogenetic factors and cryoglobulin production mechanisms has been investigated. Cryoglobulins have been evidenced in infections caused by very heterogeneous pathogens, i.e. leptospirosis, psittacosis, Mediterranean tick typhus, brucellosis, gram-negative bacterial septicemias, in which they had never been previously reported. In type A hepatitis a high cryoglobulin prevalence (91%) has been confirmed during the acute phase, with a rapid decrease both in prevalence and concentration in the subsequent stages of the disease. Cryoglobulins were all of type III and were mainly represented by IgM; anti-HAV-IgM antibodies have been evidenced in all but one cryoprecipitates. In non-A, non-B hepatitis a lower cryoglobulin prevalence (44.7%) was shown during the acute phase and the same fast decrease has been noted in the subsequent stages. Cryoglobulins were all of type III and in some cases polyclonal IgG was the only Ig class present in cryoprecipitates. The cryoglobulin prevalence in the acute phase of HBsAg-positive hepatitis amounted to 73.4%; all the cryoprecipitates were of type III. No correlation between the presence of cryoglobulins and HBeAg positivity or between cryoglobulins and delta agent infections was found. In all the cases studied the presence of cryoglobulins was related to the persistence of liver damage. Cryoglobulins were not found in HBsAg chronic carriers, while they have been evidenced, by a preliminary study, in 41.6% of HTLV-III antibody-positive subjects complaining of a persistent generalized lymphadenopathy without clinical or laboratory signs of liver impairment. No HTLV-III antibodies were found by ELISA method in the type III cryoprecipitates.

摘要

已对各种致病因素引起的传染病与冷球蛋白产生机制之间的关系进行了研究。在由非常不同的病原体引起的感染中,即钩端螺旋体病、鹦鹉热、地中海蜱传斑疹伤寒、布鲁氏菌病、革兰氏阴性菌败血症中,已证实存在冷球蛋白,而此前从未有过相关报道。在甲型肝炎急性期,冷球蛋白患病率很高(91%),在疾病的后续阶段,患病率和浓度均迅速下降。冷球蛋白均为III型,主要由IgM代表;除一份冷沉淀物外,所有冷沉淀物中均检测到抗甲型肝炎病毒IgM抗体。在非甲非乙型肝炎急性期,冷球蛋白患病率较低(44.7%),在后续阶段也观察到同样快速的下降。冷球蛋白均为III型,在某些情况下,多克隆IgG是冷沉淀物中唯一存在的免疫球蛋白类别。HBsAg阳性肝炎急性期冷球蛋白患病率为73.4%;所有冷沉淀物均为III型。未发现冷球蛋白的存在与HBeAg阳性之间或冷球蛋白与丁型肝炎病毒感染之间存在相关性。在所有研究的病例中,冷球蛋白的存在与肝损伤的持续存在有关。在HBsAg慢性携带者中未发现冷球蛋白,而一项初步研究表明,在41.6%抱怨持续性全身淋巴结肿大且无肝脏损害临床或实验室体征的HTLV-III抗体阳性受试者中发现了冷球蛋白。通过ELISA方法在III型冷沉淀物中未发现HTLV-III抗体。

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