Subair H, Tiwana H, Fielder M, Binder A, Cunningham K, Ebringer A, Wilson C, Hudson M J
King Edward VII Memorial Hospital, Hamilton, Bermuda.
J Rheumatol. 1995 Oct;22(10):1825-8.
To determine whether patients with rheumatoid arthritis (RA) from Bermuda and England have an increased anti-Proteus antibody titer when compared to healthy Bermudian and English controls, and to ascertain whether any increase in antibody titer is specific by testing 4 other microbes, Escherichia coli and 3 normal anaerobic bowel bacteria.
Antibody titers were measured by ELISA and indirect immunofluorescence (IIFA) under coded conditions.
Elevated titers of anti-Proteus antibodies were demonstrated in 34 patients with active RA from Bermuda when compared to 33 healthy Bermudian controls by ELISA (p < 0.001) and IIFA (p < 0.001). An elevation of anti-Proteus antibodies was also observed in 34 patients with RA from England when compared to 30 healthy English controls again by ELISA (p < 0.001). A similar antibody elevation in 31 patients with RA from England was observed when compared to 30 healthy controls when measured by IIFA (p < 0.001). However, there was no significant elevation in antibody titers against E. coli or the 3 normal bowel flora isolates in the patients with RA from both countries compared to their respective controls, when measured by ELISA.
A specific elevation in the immune response to Proteus mirabilis has been demonstrated in patients with RA from both Bermuda and England. However, this study cannot distinguish between antibody association with disease per se and association with disease activity. The role of Proteus in RA and the effect of anti-Proteus therapy in patients with RA merits further study.
确定来自百慕大群岛和英国的类风湿性关节炎（RA）患者与健康的百慕大群岛和英国对照者相比，抗变形杆菌抗体滴度是否增加，并通过检测其他4种微生物（大肠杆菌和3种正常肠道厌氧菌）来确定抗体滴度的任何增加是否具有特异性。
在编码条件下通过酶联免疫吸附测定（ELISA）和间接免疫荧光法（IIFA）测量抗体滴度。
通过ELISA（p < 0.001）和IIFA（p < 0.001）检测发现，与33名健康的百慕大群岛对照者相比，34名来自百慕大群岛的活动性RA患者的抗变形杆菌抗体滴度升高。同样通过ELISA检测，与30名健康的英国对照者相比，34名来自英国的RA患者的抗变形杆菌抗体也升高（p < 0.001）。通过IIFA检测，与30名健康对照者相比，31名来自英国的RA患者也观察到类似的抗体升高（p < 0.001）。然而，通过ELISA检测，与各自的对照者相比，来自这两个国家的RA患者针对大肠杆菌或3种正常肠道菌群分离株的抗体滴度没有显著升高。
已证实在来自百慕大群岛和英国的RA患者中，对奇异变形杆菌的免疫反应有特异性升高。然而，本研究无法区分抗体与疾病本身的关联以及与疾病活动的关联。变形杆菌在RA中的作用以及抗变形杆菌治疗对RA患者的影响值得进一步研究。
