Schoenfeld N, Schmolke B, Schmitt M, Remy N, Ellensohn P, Wahn U, Loddenkemper R
Lungenklinik Heckeshorn, Berlin, Germany.
Thorax. 1994 Jul;49(7):688-91. doi: 10.1136/thx.49.7.688.
Circulating immune complexes can be elevated in serum samples of patients with sarcoidosis and are associated with disease activity, but their diagnostic significance is not understood.
The different classes of circulating immune complexes containing immunoglobulin A, G, or M, and the content of complement in circulating immune complexes (polyethylene glycol precipitation) as well as levels of complement binding circulating immune complexes (complement binding assay) were determined in 19 patients with active, untreated pulmonary sarcoidosis. The results were compared with other parameters in the serum (soluble interleukin 2 receptor, angiotensin converting enzyme, immunoglobulin A, G, and M) and the bronchoalveolar lavage fluid (lymphocytes, helper cells, suppressor cells, activated T cells), and with radiological stage and functional parameters (FEV1, vital capacity, total lung capacity, transfer coefficient (KCO), and the alveolar-arterial oxygen difference during exercise).
In all patients circulating immune complexes could be detected by polyethylene glycol precipitation and were similar to control subjects. The content of C1q in circulating immune complexes was higher than in controls, yet in all but one of the cases was still within normal limits. In contrast, elevated levels of complement binding circulating immune complexes were found in 67% of the patients. No correlation was seen between circulating immune complexes and any of the other parameters in the serum, bronchoalveolar lavage fluid, or lung function values. No differences were found between radiological type I and II presentations of sarcoidosis.
The complement binding assay showed a much higher sensitivity for the detection of circulating immune complexes in active pulmonary sarcoidosis than the polyethylene glycol precipitation method. As there was no correlation between levels of circulating immune complexes and other parameters of the disease they are probably not useful for the assessment of disease activity.
结节病患者血清样本中循环免疫复合物水平可能升高，且与疾病活动相关，但其诊断意义尚不清楚。
对19例未经治疗的活动性肺结节病患者，测定含免疫球蛋白A、G或M的不同类型循环免疫复合物、循环免疫复合物中的补体含量（聚乙二醇沉淀法）以及补体结合循环免疫复合物水平（补体结合试验）。将结果与血清中的其他参数（可溶性白细胞介素2受体、血管紧张素转换酶、免疫球蛋白A、G和M）、支气管肺泡灌洗液（淋巴细胞、辅助细胞、抑制细胞、活化T细胞）以及放射学分期和功能参数（第1秒用力呼气容积、肺活量、肺总量、转移系数（KCO）以及运动时肺泡 - 动脉氧分压差）进行比较。
所有患者均可通过聚乙二醇沉淀法检测到循环免疫复合物，其水平与对照组相似。循环免疫复合物中C1q的含量高于对照组，但除1例患者外，其余患者的C1q含量仍在正常范围内。相比之下，67%的患者补体结合循环免疫复合物水平升高。循环免疫复合物与血清、支气管肺泡灌洗液中的任何其他参数或肺功能值之间均无相关性。结节病放射学I型和II型表现之间未发现差异。
补体结合试验对检测活动性肺结节病患者循环免疫复合物的敏感性远高于聚乙二醇沉淀法。由于循环免疫复合物水平与疾病的其他参数之间无相关性，它们可能对评估疾病活动无用。
