Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Vascular and Endovascular Surgery Research Center, Alavi Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Turk Kardiyol Dern Ars. 2021 Sep;49(6):439-447. doi: 10.5543/tkda.2021.19014.
The treatment of Buerger's disease (BD) presents a medical problem as its etiology is still unclear. In this study, our objective was to evaluate the serum levels of autoimmune markers in patients with different clinical features of BD.
In this study, 80 BD patients were categorized in three groups using a cross-sectional design: migratory thrombophlebitis, cold sensitivity, and skin discoloration (mild symptoms); chronic ulcers, claudication, and burning pain of the feet at night (moderate symptoms); pain at rest and spontaneous gangrene (severe symptoms). Enzyme-linked immunosorbent assay was performed to measure antibodies against immunoglobulin M rheumatoid factor (IgM RF), anti-nuclear antibodies (ANA), antibodies against cyclic citrullinated peptide (anti-CCP), antiphospholipid antibodies (APA), anti-cardiolipin antibodies (ACLA), anti-double stranded DNA (anti-dsDNA), and extractable nuclear antigen (ENA) profile.
Patients with severe symptoms showed the lowest age (p=0.031), ESR (p<0.001), and highest prevalence of ischemia (p<0.001). In all the patients, the serum levels of ANA and IgM RF were higher than 1 U and 15 IU/mL, respectively. However, the progression of the disease from mild to moderate did not affect these markers significantly (p>0.05). Other markers were negative in patients with BD.
The findings of this study indicate that BD may closely be correlated to transient autoimmune phenomena, despite the fact that further research is required to investigate how transient unspecific autoimmune reactions contribute to the BD pathogenesis.
布厄勒氏病(BD)的治疗存在医学问题,因为其病因仍不清楚。本研究旨在评估不同临床特征的 BD 患者的自身免疫标志物的血清水平。
本研究采用横断面设计,将 80 例 BD 患者分为三组:迁移性血栓性静脉炎、冷敏感性和皮肤变色(轻度症状);慢性溃疡、跛行和夜间脚部灼痛(中度症状);休息时疼痛和自发性坏疽(重度症状)。采用酶联免疫吸附试验检测免疫球蛋白 M 类风湿因子(IgM RF)、抗核抗体(ANA)、抗环瓜氨酸肽抗体(抗-CCP)、抗磷脂抗体(APA)、抗心磷脂抗体(ACLA)、抗双链 DNA(抗-dsDNA)和可提取核抗原(ENA)谱的抗体。
重度症状组患者的年龄最小(p=0.031)、红细胞沉降率(ESR)最高(p<0.001)、缺血发生率最高(p<0.001)。所有患者的 ANA 和 IgM RF 血清水平均高于 1 U 和 15 IU/mL。然而,疾病从轻度到中度的进展并没有显著影响这些标志物(p>0.05)。BD 患者的其他标志物均为阴性。
本研究结果表明,BD 可能与短暂的自身免疫现象密切相关,尽管需要进一步研究来探讨短暂的非特异性自身免疫反应如何导致 BD 的发病机制。