溃疡性结肠炎中特异性未明的抗中性粒细胞胞浆抗体：与疾病活动度及治疗的相关性

p-ANCA of undefined specificity in ulcerative colitis: correlation to disease activity and therapy.

作者信息

Rump J A, Wörner I, Roth M, Schölmerich J, Hänsch M, Peter H H

机构信息

Abt. Rheumatologie, Med. Univ. Klinik, Freiburg, Germany.

出版信息

Adv Exp Med Biol. 1993;336:507-13. doi: 10.1007/978-1-4757-9182-2_92.

DOI:10.1007/978-1-4757-9182-2_92

PMID:8296665

Abstract

Sera of 108 patients with chronic inflammatory bowel disease (IBD) and 13 sera from patients with other gastrointestinal diseases were screened for antibodies against neutrophil cytoplasmic antigens (ANCA) by an indirect immunofluorescence test. 37 out of 64 sera (58%) from patients with ulcerative colitis (UC) produced a fine granular and perinuclear ANCA staining pattern ("snowdrift-like" p-ANCA) clearly different from the cytoplasmic ANCA fluorescence (c-ANCA) seen in active Wegener's granulomatosis (WG) and the typical p-ANCA pattern produced by anti-myeloperoxidase (MPO) autoantibodies. Only 1 of 44 sera from patients with Crohn's disease (CD) and none of the control sera showed positive "snowdrift-like" p- ANCA reactions. 31 out of the 37 p-ANCA positive sera (84%) were obtained from patients with high disease activity with and without longterm high dose steroids. p-ANCA titers became negative after longterm steroid therapy and following complete colectomy.

摘要

通过间接免疫荧光试验，对108例慢性炎症性肠病（IBD）患者的血清以及13例其他胃肠道疾病患者的血清进行抗中性粒细胞胞浆抗原（ANCA）抗体筛查。64例溃疡性结肠炎（UC）患者血清中的37例（58%）呈现出细小颗粒状和核周型ANCA染色模式（“雪堆样”p-ANCA），这与在活动性韦格纳肉芽肿（WG）中见到的胞浆型ANCA荧光（c-ANCA）以及抗髓过氧化物酶（MPO）自身抗体产生的典型p-ANCA模式明显不同。克罗恩病（CD）患者的44例血清中仅有1例，对照血清中则无一例呈现阳性“雪堆样”p-ANCA反应。37例p-ANCA阳性血清中的31例（84%）来自疾病活动度高的患者，这些患者有的使用了长期大剂量类固醇，有的未使用。长期类固醇治疗后以及全结肠切除术后，p-ANCA滴度变为阴性。