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在原发性干燥综合征中使用纯化重组蛋白检测抗Ro/SS-A和抗La/SS-B自身抗体的临床意义。

The clinical significance of the detection of anti-Ro/SS-A and anti-La/SS-B autoantibodies using purified recombinant proteins in primary Sjögren's syndrome.

作者信息

Markusse H M, Veldhoven C H, Swaak A J, Smeenk R T

机构信息

Department of Rheumatology, Dr. Daniel den Hoed Clinic, Rotterdam, The Netherlands.

出版信息

Rheumatol Int. 1993;13(4):147-50. doi: 10.1007/BF00301261.

Abstract

Recently, an enzyme-linked immunosorbent assay (ELISA), using purified recombinant non-fusion proteins, has been introduced to detect and quantify Ro/SS-A and La/SS-B autoantibodies. We compared this method with anti-Ro/SS-A and anti-La/SS-B detection by means of counterimmunoelectrophoresis and immunoblotting in patients with primary Sjögren's syndrome (SS), patients suspected of the syndrome and controls. The sensitivity and specificity of the newly developed ELISA for anti-Ro/SS-A were 53% and 100%, respectively, and for anti-La/SS-B, 40% and 98%, respectively. No significant difference was found between these results and those obtained from both other assays. Titres of Ro/SS-A and La/SS-B autoantibodies correlated with the presence of an abnormal parotid gland sialogram and hypergammaglobulinaemia. We concluded that the new ELISA did not enhance the diagnostic yield in cases of suspicion of primary Sjögren's syndrome. Longitudinal studies of large groups of patients with primary Sjögren's syndrome are necessary to demonstrate whether following the course of the titres of these autoantibodies would be of value for prediction of disease exacerbations.

摘要

最近,一种使用纯化重组非融合蛋白的酶联免疫吸附测定(ELISA)已被用于检测和定量Ro/SS-A和La/SS-B自身抗体。我们将该方法与原发性干燥综合征(SS)患者、疑似该综合征的患者及对照者中通过对流免疫电泳和免疫印迹法检测抗Ro/SS-A和抗La/SS-B进行了比较。新开发的ELISA检测抗Ro/SS-A的敏感性和特异性分别为53%和100%,检测抗La/SS-B的敏感性和特异性分别为40%和98%。这些结果与通过其他两种检测方法获得的结果之间未发现显著差异。Ro/SS-A和La/SS-B自身抗体的滴度与腮腺唾液造影异常和高球蛋白血症的存在相关。我们得出结论,新的ELISA在疑似原发性干燥综合征的病例中并未提高诊断率。有必要对大量原发性干燥综合征患者进行纵向研究,以证明跟踪这些自身抗体滴度的变化过程是否对预测疾病加重有价值。

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