Rambukkana A, Das P K, Witkamp L, Yong S, Meinardi M M, Bos J D
Department of Dermatology, University of Amsterdam, The Netherlands.
J Invest Dermatol. 1993 Jan;100(1):87-92. doi: 10.1111/1523-1747.ep12354979.
An association of microbial agents and autoimmunity has been suggested for the pathogenesis of psoriasis. Mycobacteria are common environmental microbes and their antigens, especially the highly conserved mycobacterial 65-kDa heat shock protein (hps65), have been implicated in the pathogenesis of autoimmune arthritis and other idiopathic diseases. In this context, we investigated a possible mycobacterium-induced humoral immune response in psoriasis. Sera from 17 patients with chronic plaque-type psoriasis were studied by immunoblotting using the whole sonicate of Mycobacterium tuberculosis and purified recombinant mycobacterial hsp65. Immunoblot analysis demonstrated that 58% of the psoriasis patients compared to patients with acne and DLE, and normal controls showed strong antibody activity to 65-kDa and 48/45 doublet antigens from M. tuberculosis sonicate, whereas 47% of the patients showed antibody activity to mycobacterial hsp65. Only 10-20% of the patients had an antibody response to 16-kDa and 80-kDa antigens. Similar antibody activity to 65 kDa and 48/45 kDa was also found consistently with eight different sonicated mycobacterial species by immunoblotting, indicating that these seroreactive antigens are crossreactive and are present in common environmental mycobacteria. Antibody activities to both mycobacterial 65-kDa and hsp65 showed a positive correlation (r = 0.76) with the psoriasis disease activity, whereas antibodies to 48/45-kDa doublet antigens showed a weak correlation (r = 0.54). By enzyme-linked immunosorbent assay (ELISA), 47% of the psoriasis patients showed significantly elevated antibody titers to hsp65 (p < 0.003) as compared to control groups, and the antibody response by ELISA also showed a significant positive correlation (r = 0.76) with disease activity. Anti-mycobacterial antibody activity may be related to severity of disease and may be useful in monitoring disease activity in psoriasis.
微生物因子与自身免疫的关联已被认为与银屑病的发病机制有关。分枝杆菌是常见的环境微生物，其抗原，尤其是高度保守的分枝杆菌65 kDa热休克蛋白（hsp65），已被认为与自身免疫性关节炎和其他特发性疾病的发病机制有关。在此背景下，我们研究了银屑病中可能由分枝杆菌诱导的体液免疫反应。使用结核分枝杆菌的全超声裂解物和纯化的重组分枝杆菌hsp65，通过免疫印迹法研究了17例慢性斑块型银屑病患者的血清。免疫印迹分析表明，与痤疮患者、盘状红斑狼疮患者和正常对照组相比，58%的银屑病患者对结核分枝杆菌超声裂解物中的65 kDa和48/45双联体抗原有较强的抗体活性，而47%的患者对分枝杆菌hsp65有抗体活性。只有10 - 20%的患者对16 kDa和80 kDa抗原有抗体反应。通过免疫印迹法，还始终在八种不同的超声裂解分枝杆菌菌株中发现了与65 kDa和48/45 kDa相似的抗体活性，表明这些血清反应性抗原具有交叉反应性，且存在于常见的环境分枝杆菌中。对分枝杆菌65 kDa和hsp65的抗体活性与银屑病疾病活动呈正相关（r = 0.76），而对48/45 kDa双联体抗原的抗体呈弱相关（r = 0.54）。通过酶联免疫吸附测定（ELISA），与对照组相比，47%的银屑病患者对hsp65的抗体滴度显著升高（p < 0.003），ELISA检测的抗体反应也与疾病活动呈显著正相关（r = 0.76）。抗分枝杆菌抗体活性可能与疾病严重程度相关，可能有助于监测银屑病的疾病活动。
