Dall'Aglio P P, Pesci A, Bertorelli G, Brianti E, Scarpa S
Istituto di Semeiotica Medica, Università degli Studi di Parma, Italia.
Respiration. 1988;54 Suppl 1:36-41. doi: 10.1159/000195495.
Immune complexes (IC) were investigated in the bronchoalveolar lavage fluid (BAL) of 5 patients with hypersensitivity pneumonitis (HP), 11 with idiopathic pulmonary fibrosis (IPF) and 16 with sarcoidosis (S) by three different methods: C1Q-BA, KgB, AKgB-MA. Using AKgB-MA, it is possible to identify the class of antibodies forming the IC. IC were present in all cases of HP, in 8/11 (73%) of IPF and in 10/16 (62%) of S. However, the three tests showed discordant results for the three different diseases: C1Q-BA and KgB-SP were both positive in 40%, AKgB-MA in 80% of HP cases; C1Q-BA in 73%, KgB-SP in 9% and AKgB-MA in 46% of IPF cases; C1Q-BA in 31%, KgB-SP in 12% and AKgB-MA in 31% of S cases. In all of the diseases, the IC were mostly composed of IgG; moreover, in HP IgA was also frequently present. The determination of IC in different fractions obtained from BAL ultracentrifugation, confirmed the simultaneous presence of IC of different molecular weights and antibody composition. Lung transbronchial biopsy with immunofluorescence showed immunoglobulin, prevalently IgG, and C, in all HP cases, the majority of IPF cases and 50% of S cases. This confirms the importance of IC in the pathogenesis and/or evolution of some pulmonary diseases.
采用三种不同方法（C1Q - BA、KgB、AKgB - MA）对5例过敏性肺炎（HP）患者、11例特发性肺纤维化（IPF）患者和16例结节病（S）患者的支气管肺泡灌洗液（BAL）中的免疫复合物（IC）进行了研究。使用AKgB - MA可以鉴定形成IC的抗体类别。IC存在于所有HP病例、8/11（73%）的IPF病例和10/16（62%）的S病例中。然而，这三种检测方法对这三种不同疾病的检测结果不一致：在HP病例中，C1Q - BA和KgB - SP均为阳性的占40%，AKgB - MA为阳性的占80%；在IPF病例中，C1Q - BA为阳性的占73%，KgB - SP为阳性的占9%，AKgB - MA为阳性的占46%；在S病例中，C1Q - BA为阳性的占31%，KgB - SP为阳性的占12%，AKgB - MA为阳性的占31%。在所有疾病中，IC大多由IgG组成；此外，在HP中IgA也经常出现。对BAL超速离心得到的不同组分中的IC进行测定，证实了不同分子量和抗体组成的IC同时存在。经免疫荧光检测的肺经支气管活检显示，在所有HP病例、大多数IPF病例和50%的S病例中均有免疫球蛋白，主要为IgG和补体C。这证实了IC在某些肺部疾病的发病机制和/或演变中的重要性。
