Stöcker W, Otte M, Ulrich S, Normann D, Stöcker K, Jantschek G
Dtsch Med Wochenschr. 1984 Dec 21;109(51-52):1963-9. doi: 10.1055/s-2008-1069485.
It was demonstrated by indirect immunofluorescence that Crohn's disease and ulcerative colitis are serologically distinct. In 59 patients with Crohn's disease, confirmed by endoscopy and histology, 23 (39%) had serum autoantibodies against exocrine pancreas; in 17 (29%) the titre was 1 : 100 or higher. In 46 patients with confirmed ulcerative colitis pancreas antibodies were demonstrated only twice, in 100 healthy control subjects only 3 times, with titres less than 1 : 100. Pancreas antibodies do not occur in high concentrations in pancreatitis; titres higher than 1 : 100 therefore suggest Crohn's disease. The pancreas antibodies of patients with Crohn's disease were predominantly immunoglobulins IgA and IgG, twice they were IgD and once IgM, never IgE. In 6 patients the pancreas antibodies fixed complement. Autoantibodies against intestinal goblet cells were found only in patients with ulcerative colitis (13 of 46 = 28%). The titres range was from 1 : 10 to 1 : 1000. The goblet-cell antibodies consisted only of IgA and IgG, never reacting with complement. These results indicate that determining pancreas and goblet-cell antibodies alone will make it possible to diagnose either Crohn's disease or ulcerative colitis in more than a quarter of patients with chronic inflammatory intestinal disease.
间接免疫荧光法证明，克罗恩病和溃疡性结肠炎在血清学上是不同的。59例经内镜检查和组织学确诊为克罗恩病的患者中，23例（39%）血清中有抗外分泌胰腺的自身抗体；17例（29%）抗体滴度为1:100或更高。46例确诊为溃疡性结肠炎的患者中仅2次检测到胰腺抗体，100名健康对照者中仅3次检测到，且滴度均低于1:100。胰腺炎患者中胰腺抗体不会高浓度出现；因此，滴度高于1:100提示克罗恩病。克罗恩病患者的胰腺抗体主要为免疫球蛋白IgA和IgG，2次为IgD，1次为IgM，从未检测到IgE。6例患者的胰腺抗体可固定补体。仅在溃疡性结肠炎患者中发现抗肠杯状细胞的自身抗体（46例中有13例，占28%）。滴度范围为1:10至1:1000。杯状细胞抗体仅由IgA和IgG组成，从不与补体发生反应。这些结果表明，仅检测胰腺和杯状细胞抗体就可以在超过四分之一的慢性炎症性肠病患者中诊断出克罗恩病或溃疡性结肠炎。
