Abuaf N, Barthet C
Service d'Immunologie et d'Hématologie Biologique, Hôpital Rothschild, Paris.
J Mal Vasc. 1994;19(1):1-6.
Vascular abnormalities are frequent in connective tissue disease. In this kind of patients a lot of autoantibodies are observed. To screen them a strategy must be selected according to the connective tissue disease that is suspected. When the diagnosis is unknown the tests must screen a great number of autoantibodies and this is the case for indirect immunofluorescence assays, at the opposite when the diagnosis is known antibodies specific for the disease should be screened. Some antibodies are specific for a disease this is the case for antibodies directed against double stranded DNA, centromere, extractable nuclear antigens Sm, RNP, Scl-70, Pm-Scl, Jo1, neutrophil cytoplasmic antigen proteinase 3, and beta 2-glycoprotein I the cofactor of anti-cardiolipin antibodies. Anti-SS-A(Ro) antibodies are very frequent in autoimmune diseases and they are not specific for anyone of them. Some autoantibodies are frequent in autoimmune and also in non autoimmune diseases and this is the case for antibodies directed against phospholipids, single stranded DNA, histones, rheumatoid factor. The detection of antibodies depends on the assays used for screening, that is why results should mention the assay used for their detection. The standardization of the detection of the autoantibodies especially when quantitative results are requested, is not yet performed enough. So to obtain reproducible results when monitoring a patient the screening must be done by the same assay in the same laboratory.
血管异常在结缔组织病中很常见。在这类患者中可观察到许多自身抗体。为了筛查这些自身抗体,必须根据怀疑的结缔组织病选择一种策略。当诊断不明时,检测必须筛查大量自身抗体,间接免疫荧光测定就是这种情况,相反,当诊断已知时,应筛查针对该疾病的特异性抗体。有些抗体对某种疾病具有特异性,例如针对双链DNA、着丝粒、可提取核抗原Sm、RNP、Scl-70、Pm-Scl、Jo1、中性粒细胞胞浆抗原蛋白酶3以及抗心磷脂抗体的辅助因子β2-糖蛋白I的抗体。抗SS-A(Ro)抗体在自身免疫性疾病中非常常见,且对其中任何一种疾病都不具有特异性。有些自身抗体在自身免疫性疾病和非自身免疫性疾病中都很常见,例如针对磷脂、单链DNA、组蛋白、类风湿因子的抗体。抗体的检测取决于用于筛查的检测方法,这就是为什么结果应提及用于检测的检测方法。自身抗体检测的标准化,尤其是在需要定量结果时,目前还做得不够。因此,为了在监测患者时获得可重复的结果,筛查必须在同一实验室使用相同的检测方法进行。