Castellino F, Rosina F, Bansi D S, Bauducci M, Touscoz G A, Giorda L, Borghesio E, Bessone M P, Astegiano M, Musso A
Department of Gastroenterology, Ospedale Molinette, Torino, Italy.
Eur J Gastroenterol Hepatol. 1995 Sep;7(9):859-64.
To evaluate the prevalence of anti-neutrophil cytoplasmic antibodies in a series of patients with inflammatory bowel disease, the discriminatory value of these antibodies in differentiating between ulcerative colitis and Crohn's disease, their antigen specificity and their correlation with epidemiological and clinical variables.
Serum anti-neutrophil cytoplasmic antibodies were evaluated by indirect immunofluorescence and immunoblotting using neutrophils isolated from peripheral blood and by enzyme-linked immunosorbent assays (ELISAs) using proteinase 3 and myeloperoxidase as antigens.
Anti-neutrophil cytoplasmic antibodies were detected by immunofluorescence in 43 (39.8%) of 108 patients with ulcerative colitis, in 11 (11.9%) of 92 patients with Crohn's disease (P < 0.001) and 5 (6.8%) of 73 control patients. The predominant pattern was perinuclear staining around neutrophil nuclei (44 of 59, 75%); a homogeneous cytoplasmic staining was present in 15 (25%) of 59 sera, mainly among Crohn's disease and control patients. The ELISAs gave no positive results. Recognition of proteins of relative molecular masses 27,000 and 49,000 at immunoblotting was common to ulcerative colitis, Crohn's disease and control sera. The proteins of relative molecular masses 32,000 and 106,000 were recognized exclusively by 11% of anti-neutrophil-positive ulcerative colitis sera. No significant correlation was found between the presence of anti-neutrophil cytoplasmic antibodies and the demographic and clinical characteristics of the patients.
Anti-neutrophil cytoplasmic antibodies are detectable in a large proportion of patients with ulcerative colitis, but their prevalence in a limited proportion of patients with Crohn's disease reduces their discriminatory capability. The persistence of anti-neutrophil cytoplasmic antibodies after total colectomy and the absence of a correlation between the activity of the disease and the presence or titre of these antibodies support the hypothesis that anti-neutrophil cytoplasmic antibodies are not simply an epiphenomenon of colonic inflammation.
评估一系列炎症性肠病患者中抗中性粒细胞胞浆抗体的患病率、这些抗体在区分溃疡性结肠炎和克罗恩病方面的鉴别价值、其抗原特异性以及它们与流行病学和临床变量的相关性。
采用间接免疫荧光法和免疫印迹法，利用从外周血分离的中性粒细胞评估血清抗中性粒细胞胞浆抗体，并采用以蛋白酶3和髓过氧化物酶为抗原的酶联免疫吸附测定（ELISA）法。
108例溃疡性结肠炎患者中有43例（39.8%）通过免疫荧光检测到抗中性粒细胞胞浆抗体，92例克罗恩病患者中有11例（11.9%）（P<0.001），73例对照患者中有5例（6.8%）。主要模式是中性粒细胞核周围的核周染色（59例中的44例，75%）；59份血清中有15份（25%）呈现均匀的胞浆染色，主要见于克罗恩病患者和对照患者。ELISA检测未得出阳性结果。在溃疡性结肠炎、克罗恩病和对照血清中，免疫印迹时相对分子质量为27,000和49,000的蛋白质的识别较为常见。相对分子质量为32,000和106,000的蛋白质仅被11%的抗中性粒细胞阳性溃疡性结肠炎血清识别。抗中性粒细胞胞浆抗体的存在与患者的人口统计学和临床特征之间未发现显著相关性。
在大部分溃疡性结肠炎患者中可检测到抗中性粒细胞胞浆抗体，但在少数克罗恩病患者中的患病率降低了其鉴别能力。全结肠切除术后抗中性粒细胞胞浆抗体仍持续存在，且疾病活动与这些抗体的存在或滴度之间缺乏相关性，这支持了抗中性粒细胞胞浆抗体并非简单的结肠炎症附带现象这一假说。
