Samuel A M, Ashtekar M D, Ganatra R D
Clin Exp Immunol. 1984 Nov;58(2):317-24.
In the present study we have tried to demonstrate circulating immune complexes (CIC) in sera from patients with pulmonary tuberculosis (TB) by three techniques; latex agglutination; 3.5% PEG precipitation and determination of optical density at 280 nm and RIA of CIC using bovine spermatozoa. About 40 normal control sera and 100 TB patients sera were investigated for the presence of CIC. Seventeen per cent cases of pulmonary TB were positive by latex agglutination while none of the control was positive. Levels of CIC as detected by PEG precipitation and RIA were significantly elevated in patients as compared to normal controls. While IgG, IgA and IgM were elevated in the CIC of patients, IgM immunoglobulins were detected only in patients and not in controls. Detection of CIC may at times be useful in diagnosis, prognosis and therapeutic monitoring of disease processes, but it is the characterization of immune complexes (IC) and identification of the specific components of these complexes which holds the greatest potential for better understanding of disease mechanisms. CIC were precipitated using 3.5% PEG from sera of patients suffering from TB. The specific anti-TB antibody component of complex was determined using S. aureus protein A as a solid phase, Anti-BCG antibody and 125I-labelled TB antigen. The specific TB antigen component of the IC was dissociated thermally from TB antibody and assayed by a radioimmunoassay technique developed in our laboratory. Patients were classified into two groups. Those those sputum was positive for Mycobacterium tuberculosis by smear and/or culture and those whose sputum was negative. The TB antigen concentrations of CIC was higher 19.1 +/- 2.3 ng/ml (mean +s.e.) in sputum positive cases, and 9.9 +/- 1.9 ng/ml in sputum negative cases as compared to 2.2 +/- 0.3 ng/ml in controls. Patient groups were significantly different from controls as well as from each other (P less than 0.001). Anti-TB antibody ratios were 11.7 +/- 1.48, 5.1 +/- 1.5 and 0.6 +/- 0.1 in sputum positive, sputum negative and controls. The significance of differences between the groups was P less than 0.001. The effect of treatment administered over a period of 12 weeks or more was evaluated. It was observed that in patients with persistent demonstration of M. tuberculosis in the sputum, the TB antigen and TB antibody levels of CIC were consistently high. In patients who responded to anti-tubercular drugs the TB antigen levels decreased progressively while TB antibody levels remained high.(ABSTRACT TRUNCATED AT 400 WORDS)
在本研究中，我们试图通过三种技术来检测肺结核（TB）患者血清中的循环免疫复合物（CIC）；乳胶凝集试验；3.5%聚乙二醇（PEG）沉淀法以及在280nm处测定光密度并使用牛精子进行CIC的放射免疫分析（RIA）。我们对约40份正常对照血清和100份肺结核患者血清进行了CIC检测。17%的肺结核病例通过乳胶凝集试验呈阳性，而对照组均为阴性。与正常对照组相比，通过PEG沉淀法和RIA检测到的患者CIC水平显著升高。患者CIC中的IgG、IgA和IgM升高，而仅在患者中检测到IgM免疫球蛋白，对照组未检测到。检测CIC有时可能对疾病过程的诊断、预后和治疗监测有用，但免疫复合物（IC）的特性以及这些复合物特定成分的鉴定对于更好地理解疾病机制具有最大潜力。使用3.5% PEG从肺结核患者血清中沉淀CIC。使用金黄色葡萄球菌蛋白A作为固相、抗卡介苗抗体和125I标记的结核抗原测定复合物中特异性抗结核抗体成分。IC中的特异性结核抗原成分通过热解离从结核抗体中分离出来，并通过我们实验室开发的放射免疫分析技术进行检测。患者分为两组。一组痰涂片和/或培养结核分枝杆菌呈阳性，另一组痰涂片阴性。与对照组的2.2±0.3 ng/ml相比，痰涂片阳性病例CIC的结核抗原浓度较高，为19.1±2.3 ng/ml（平均值±标准误），痰涂片阴性病例为9.9±1.9 ng/ml。患者组与对照组以及彼此之间均有显著差异（P<0.001）。痰涂片阳性、痰涂片阴性和对照组的抗结核抗体比率分别为11.7±1.48、5.1±1.5和0.6±0.1。各组之间差异的显著性为P<0.001。评估了为期12周或更长时间的治疗效果。观察到痰中持续检出结核分枝杆菌的患者，CIC的结核抗原和结核抗体水平一直很高。对抗结核药物有反应的患者，结核抗原水平逐渐下降，而结核抗体水平仍很高。（摘要截断于400字）
