Nomura M, Douchin M, Tokuda A, Sato F, Ito S, Kohli Y, Fujiki N
Second Department of Internal Medicine, Fukui Medical School, Japan.
Am J Gastroenterol. 1988 Dec;83(12):1390-4.
Serum immunoglobulin A (IgA) hepatitis B core antibody (anti-HBc) was measured by a solid-phase enzyme immunoassay using monoclonal antibodies in sera from chronic carriers of hepatitis B surface antigen (HBsAg). To reinforce the clinical significance of IgA anti-HBc, levels of IgA subclasses and molecular characterization of IgA anti-HBc in sera of 13 patients in the acute exacerbation phase and the remission phase were compared. IgA anti-HBc was significantly higher in sera in the acute exacerbation phase than in the remission phase (p less than 0.025); in particular, more significant changes were observed in IgA2 anti-HBc (p less than 0.0025) and in secretory IgA anti-HBc (p less than 0.001). Analysis of molecular size distribution of IgA anti-HBc by high performance liquid chromatography showed that the elevation of polymeric IgA anti-HBc was significantly greater than that of monomeric IgA anti-HBc in the acute exacerbation phase (p less than 0.05), although there was an increase in both monomeric and polymeric IgA anti-HBc. Thus, the elevation of polymeric IgA anti-HBc suggests that the focal immune response against HBcAg in the liver and secretory IgA anti-HBc is an important marker of acute exacerbation in patients with HBsAg-positive chronic liver disease.
采用固相酶免疫测定法，利用单克隆抗体检测乙型肝炎表面抗原（HBsAg）慢性携带者血清中的血清免疫球蛋白A（IgA）乙肝核心抗体（抗-HBc）。为强化IgA抗-HBc的临床意义，比较了13例处于急性加重期和缓解期患者血清中IgA亚类水平及IgA抗-HBc的分子特征。急性加重期血清中的IgA抗-HBc显著高于缓解期（p<0.025）；尤其是，IgA2抗-HBc（p<0.0025）和分泌型IgA抗-HBc（p<0.001）出现更显著变化。通过高效液相色谱分析IgA抗-HBc的分子大小分布显示，尽管单体和多聚体IgA抗-HBc均有所增加，但急性加重期多聚体IgA抗-HBc的升高显著大于单体IgA抗-HBc（p<0.05）。因此，多聚体IgA抗-HBc升高提示肝脏中针对HBcAg的局灶性免疫反应以及分泌型IgA抗-HBc是HBsAg阳性慢性肝病患者急性加重的重要标志物。
