[抗着丝点抗体和抗CENP - B抗体在原发性胆汁性肝硬化患者血清中的临床意义]

[Clinical significance of anti-centromere antibody and anti-CENP-B antibody in sera of patients with primary biliary cirrhosis].

作者信息

Onozuka Y, Shibata M, Yonezawa H, Terauti K, Miyachi K, Ueno Y

机构信息

Department of Clinical Laboratories, Kawasaki Central Hospital.

出版信息

Rinsho Byori. 1996 Sep;44(9):877-82.

PMID:8911074

Abstract

Anti-centromere antibody (ACA) have been recognized in sera of patients with primary biliary cirrhosis (PBC) and CREST syndrome. The major reactive antigen of ACA have been identified as CENP-B (80kDa). Using an indirect immunofluorescence (IIF) method and ELISA method, we detected ACA and anti-CENP-B antibody in patients with PBC and various liver diseases and collagen diseases. We tested sera of 44 patients with PBC, 8 patients with autoimmune hepatitis (AIH), 51 patients with chronic hepatitis B (CH-B), 312 patients with chronic hepatitis C(CH-C), 12 patients with progressive systemic sclerosis (PSS), 10 patients with systemic lupus erythematosus (SLE), 10 patients with rheumatoid arthritis (RA), and 30 with healthy subjects (HS). ACA was detected by IIF technique, using HEp-2 cell and fluoro-CENTRO slides (MBL) as substrates. Anti-CENP-B antibody was detected by ELISA method using recombinant CENP-B (MBL) as the antigen. ACA was detected in sera of 12 (27%) patients with PBC, two (25%) patients with AIH, five (2%) patients with CH-C, nine (75%) patients with PSS, and one (10%) patients with RA. ACA was not detected in sera of patients with CH-B and SLE and in HS. The results of IIF test for ACA, using HEp -2 cells and fluoro-CENTRO slides, were completely agreed. Anti-CENP-B antibody was detected in 28(97%) out of 29 patients sera positive for ACA. The titers of ACA and anti-CENP-B antibody did not show a correlation (r = 0.24). Out of 12 sera, in which, the titers of anti-CENP-B antibody was over 400. Among them, eight were patients with PBC and four were PSS. Later, out of four patients with PSS, three (75%) were found to be positive for anti-mitochondrial antibody. Out of five patients, in which the titer of anti-CENP-B antibody showed over 800, all were patients with PBC. The titers of ACA have no relationship with PBC. However, the titers of anti-CENP-B antibody have closed relationship with PBC. The reason why the titers of ACA and anti-CENP-B antibody were not correlated is unknown. We consider anti-CENP-B antibody is a new marker of a subset of PBC, because almost all the patients were PBC when this antibody showed over 400.

摘要

抗着丝点抗体（ACA）已在原发性胆汁性肝硬化（PBC）和CREST综合征患者的血清中被识别。ACA的主要反应性抗原已被鉴定为CENP - B（80kDa）。我们采用间接免疫荧光（IIF）法和酶联免疫吸附测定（ELISA）法，检测了PBC患者以及各种肝脏疾病和胶原病患者的ACA和抗CENP - B抗体。我们检测了44例PBC患者、8例自身免疫性肝炎（AIH）患者、51例慢性乙型肝炎（CH - B）患者、312例慢性丙型肝炎（CH - C）患者、12例进行性系统性硬化症（PSS）患者、10例系统性红斑狼疮（SLE）患者、10例类风湿关节炎（RA）患者以及30例健康对照者（HS）的血清。采用IIF技术，以人喉表皮样癌细胞（HEp - 2细胞）和荧光着丝点玻片（MBL）为底物检测ACA。采用ELISA法，以重组CENP - B（MBL）为抗原检测抗CENP - B抗体。在12例（27%）PBC患者、2例（25%）AIH患者、5例（2%）CH - C患者、9例（75%）PSS患者以及1例（10%）RA患者的血清中检测到了ACA。在CH - B患者、SLE患者的血清以及健康对照者中未检测到ACA。使用HEp - 2细胞和荧光着丝点玻片进行的ACA的IIF检测结果完全一致。在29例ACA阳性患者血清中，28例（97%）检测到抗CENP - B抗体。ACA和抗CENP - B抗体的滴度无相关性（r = 0.24）。在12份抗CENP - B抗体滴度超过400的血清中，其中8例为PBC患者，4例为PSS患者。之后，在4例PSS患者中，3例（75%）抗线粒体抗体呈阳性。在5例抗CENP - B抗体滴度超过800的患者中，均为PBC患者。ACA的滴度与PBC无关。然而，抗CENP - B抗体的滴度与PBC密切相关。ACA和抗CENP - B抗体滴度不相关的原因尚不清楚。我们认为抗CENP - B抗体是PBC一个亚组的新标志物，因为当该抗体滴度超过400时，几乎所有患者均为PBC患者。