Atta M S, Lim K L, Ala'deen D A, Powell R J, Todd I
Department of Immunology, University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.
Ann Rheum Dis. 1995 Feb;54(2):117-24. doi: 10.1136/ard.54.2.117.
To assess the prevalence of antibodies to human fibronectin (anti-Fn) in sera of patients with certain connective tissue diseases and to determine their association with disease activity and the pattern of organ involvement in patients with systemic lupus erythematosus (SLE).
A capture enzyme linked immunosorbent assay (ELISA) was developed to quantify anti-Fn antibodies in serum samples from 65 patients with well characterised SLE, 50 with rheumatoid arthritis (RA), 15 with Behçet's disease (BD), 15 with systemic vasculitis and 36 healthy subjects. An anti-Fn antibody titre greater than mean + 3SD of the healthy control log values after back transformation to the normal scale was considered positive. Disease activity in SLE patients was scored using the British Isles Lupus Assessment Group (BILAG) Index. Erythrocyte sedimentation rate (ESR), concentrations of anti-dsDNA antibody, soluble interleukin-2 receptors (sIL-2R), C3, C4, C3 degradation products (C3dg) and immunoglobulin, and antinuclear antibody (ANA) titres were measured in blood samples from SLE patients; neopterin concentration was measured in corresponding urine samples.
Anti-Fn antibodies were found in 22 of 65 SLE patients (33.8%), seven of 50 with RA (14%), one of 15 with BD (6.6%) and none of the 15 subjects with vasculitis. Thirty SLE patients had active disease and 35 had inactive disease; their median anti-Fn concentrations were 117 u/ml (range 47-450) and 68 u/ml (range 17-334), respectively (p = 0.0001). The presence of anti-Fn did not correlate with immunoglobulin concentrations or ANA titres in these sera. No significant difference was found between SLE patients with disease activity in one major organ system compared with multiple organ involvement, as defined by BILAG (p = 0.19). However, patients with musculoskeletal manifestations had consistently greater anti-Fn concentrations compared with patients with other clinical manifestations. There were significant correlations between amounts of anti-Fn in SLE sera and ESR (rs = 0.25, p = 0.045), sIL-2R (rs = 0.28, p = 0.024) and urine neopterin (rs = 0.3, p = 0.016) but not with serum anti-dsDNA antibody titres, plasma C3, C3dg or C4. However multiple regression analysis showed a low significant correlation only with sIL-2R and BILAG score (p = 0.047 and 0.042, respectively).
Anti-Fn antibodies were detected in 34% of SLE patients and in small proportions of RA and BD patients. An association between serum anti-Fn and disease activity in SLE has been identified and most SLE patients with musculoskeletal involvement had increased anti-Fn antibody concentrations.
评估某些结缔组织病患者血清中抗人纤连蛋白抗体（抗Fn）的流行情况，并确定其与系统性红斑狼疮（SLE）患者疾病活动度及器官受累模式的关联。
开发了一种捕获酶联免疫吸附测定（ELISA）法，以定量检测65例特征明确的SLE患者、50例类风湿关节炎（RA）患者、15例白塞病（BD）患者、15例系统性血管炎患者及36名健康受试者血清样本中的抗Fn抗体。经逆变换回到正常尺度后，抗Fn抗体滴度大于健康对照对数均值+3标准差被视为阳性。SLE患者的疾病活动度采用英伦三岛狼疮评估组（BILAG）指数进行评分。检测SLE患者血样中的红细胞沉降率（ESR）、抗双链DNA抗体浓度、可溶性白细胞介素-2受体（sIL-2R）、C3、C4、C3降解产物（C3dg）和免疫球蛋白以及抗核抗体（ANA）滴度；检测相应尿样中的新蝶呤浓度。
65例SLE患者中有22例（33.8%）检测到抗Fn抗体，50例RA患者中有7例（14%），15例BD患者中有1例（6.6%），而15例血管炎患者均未检测到。30例SLE患者疾病活动，35例疾病不活动；其抗Fn浓度中位数分别为117 u/ml（范围47 - 450）和68 u/ml（范围17 - 334）（p = 0.0001）。这些血清中抗Fn的存在与免疫球蛋白浓度或ANA滴度无相关性。根据BILAG定义，单一大器官系统疾病活动的SLE患者与多器官受累患者之间未发现显著差异（p = 0.19）。然而，与其他临床表现的患者相比，有肌肉骨骼表现的患者抗Fn浓度始终更高。SLE血清中抗Fn量与ESR（rs = 0.25，p = 0.045）、sIL-2R（rs = 0.28，p = 0.024）和尿新蝶呤（rs = 0.3，p = 0.016）之间存在显著相关性，但与血清抗双链DNA抗体滴度、血浆C3、C3dg或C4无相关性。然而，多元回归分析显示仅与sIL-2R和BILAG评分存在低显著相关性（分别为p = 0.047和0.042）。
34%的SLE患者、小比例的RA和BD患者检测到抗Fn抗体。已确定SLE患者血清抗Fn与疾病活动度之间存在关联，大多数有肌肉骨骼受累的SLE患者抗Fn抗体浓度升高。
