麻风病体液免疫反应的特异性和非特异性方面

Specific and nonspecific aspects of humoral immune response in leprosy.

Kirsztajn G M, Nishida S K, Silva M S, Lombardi C, Ajzen H, Pereira A B

Departamento de Medicina, Escola Paulista de Medicina, São Paulo, Brasil.

Braz J Med Biol Res. 1994 Jan;27(1):43-54.

Abstract

We have studied some generic and specific aspects of the humoral immune response in 96 patients with leprosy (29 paucibacillary and 67 multibacillary individuals). We determined serum immunoglobulins (IgM, IgG and IgA), CH50, C1q, C3 and C4, circulating immune complexes (CIC), C-reactive protein (CRP), rheumatoid factor (RF) and antinuclear antibodies. No specific pattern of general humoral immune changes could be observed. 2. The specific immune response was studied by the detection of specific IgM anti-M. leprae antibodies. An immunoradiometric assay (IRMA) and an ELISA were compared for clinical effectiveness. IRMA showed greater sensitivity for the serodiagnosis of leprosy as compared to ELISA (88.1% vs 58.2% for multibacillary patients and 20.7% vs 10.3% for paucibacillary leprosy patients). Specificity was 96% for IRMA and 97% for ELISA. 3. Our results indicate that nonspecific changes in the humoral immune response are of little value in assessing leprosy patients and that immune assays for the detection of specific anti-M. leprae antibodies may be of value in the diagnosis, study and follow-up of these patients.

摘要

我们研究了96例麻风病患者（29例少菌型和67例多菌型个体）体液免疫反应的一些一般和特定方面。我们测定了血清免疫球蛋白（IgM、IgG和IgA）、CH50、C1q、C3和C4、循环免疫复合物（CIC）、C反应蛋白（CRP）、类风湿因子（RF）和抗核抗体。未观察到一般体液免疫变化的特定模式。2. 通过检测特异性抗麻风杆菌IgM抗体研究特异性免疫反应。比较了免疫放射分析（IRMA）和酶联免疫吸附测定（ELISA）的临床有效性。与ELISA相比，IRMA对麻风病的血清诊断显示出更高的敏感性（多菌型患者分别为88.1%对58.2%，少菌型麻风病患者分别为20.7%对10.3%）。IRMA的特异性为96%，ELISA的特异性为97%。3. 我们的结果表明，体液免疫反应的非特异性变化在评估麻风病患者方面价值不大，而检测特异性抗麻风杆菌抗体的免疫测定在这些患者的诊断、研究和随访中可能具有价值。