Yahya T M, Benedict S, Shalabi A, Bayoumi R
Department of Internal Medicine, Faculty of Medicine & Health Sciences, UAE University, Al Ain, United Arab Emirates.
Clin Exp Immunol. 1997 Oct;110(1):41-4. doi: 10.1046/j.1365-2249.1997.4981395.x.
Autoantibodies of diverse specificities are detected in sera of patients with acute malaria. The clinical relevance of these autoantibodies is not clear, though there are reports associating some autoantibodies with specific disease manifestations. We have investigated the occurrence of ANCA in the sera of 93 patients during episodes of acute malaria. Sera were tested by indirect immunofluorescence (IIF) and by ELISA for antibodies to neutrophil cytoplasmic components proteinase 3 (PR3), myeloperoxidase (MPO), cathepsin G (CG), human leucocyte elastase (HLE), and lactoferrin (LF). Forty-seven sera samples (50.5%) were positive by IIF, all except one with the atypical ANCA pattern (a-ANCA). When screened by ELISA, anti-CG antibodies were detected in 52 samples (56%), while anti-PR3 and anti-MPO antibodies were detected in three and one samples, respectively. Antibody binding to HLE and LF was not significant. Anti-CG antibodies were detected in 93% of the IIF-positive sera. A combination of anti-CG and anti-PR3 antibodies was noted in three samples. Our study demonstrates the presence of ANCA in sera from patients with acute malaria, almost all with the a-ANCA pattern on IIF. The antibody specificity, noted for the first time in our study, appears to be predominantly directed against CG. The significance of CG and CG-ANCA in the pathogenesis and clinical manifestations of malaria has yet to be elucidated.
在急性疟疾患者的血清中可检测到多种特异性自身抗体。尽管有报道称某些自身抗体与特定疾病表现相关，但这些自身抗体的临床相关性尚不清楚。我们调查了93例急性疟疾发作期患者血清中抗中性粒细胞胞浆抗体（ANCA）的出现情况。通过间接免疫荧光法（IIF）和酶联免疫吸附测定（ELISA）检测血清中针对中性粒细胞胞浆成分蛋白酶3（PR3）、髓过氧化物酶（MPO）、组织蛋白酶G（CG）、人白细胞弹性蛋白酶（HLE）和乳铁蛋白（LF）的抗体。47份血清样本（50.5%）通过IIF检测呈阳性，除一份外均为非典型ANCA模式（a-ANCA）。通过ELISA筛查时，在52份样本（56%）中检测到抗CG抗体，而分别在3份和1份样本中检测到抗PR3和抗MPO抗体。抗体与HLE和LF的结合不显著。在93%的IIF阳性血清中检测到抗CG抗体。在3份样本中发现了抗CG和抗PR3抗体的组合。我们的研究表明，急性疟疾患者血清中存在ANCA，几乎所有患者在IIF上呈a-ANCA模式。我们的研究首次发现的抗体特异性似乎主要针对CG。CG和CG-ANCA在疟疾发病机制和临床表现中的意义尚待阐明。
