Belizna C, Tervaert J W
Department of Internal Medicine, University Hospital Groningen, The Netherlands.
Semin Arthritis Rheum. 1997 Oct;27(2):98-109. doi: 10.1016/s0049-0172(97)80010-8.
To characterize the putative target antigens for antiendothelial cell antibodies (AECA), the possible pathophysiological role of AECA, and the clinical value of these antibodies as markers of disease activity.
A structured literature search was done using Medline in combination with a manual search. Two physicians reviewed all articles of special interest.
AECA are a heterogenous group of antibodies directed against a variety of antigen determinants on endothelial cells (EC). The EC antigens can be constitutively expressed, constitutively expressed and modulated by cytokines, or cryptic. In addition, antigen determinants for AECA may also be molecules that adhere to EC ("planted" antigens). However, many AECA antigens are currently not well characterized. AECA are detected in a wide variety of inflammatory disorders. Although probably of limited value in disease diagnosis, the detection of these antibodies may be valuable in following disease activity. In several diseases such as systemic lupus erythematosus and systemic vasculitis, high AECA titers are found during active disease whereas lower titers or disappearence of AECA have been reported during remission. The correlation between changes in AECA titers and disease activity suggests an important role for AECA in processes in which vessel wall damage occurs, although it does not exclude the possibility that AECA are an epiphenomenon of vascular injury. Several recent in vitro studies support a role of AECA in the pathophysiology of these inflammatory disorders. AECA may play a role in the pathophysiology by inducing activation of EC resulting in upregulation in the expression of endothelial adhesion molecules and/or secretion of chemoattractants and cytokines. An alternative mechanism by which AECA could be a trigger in the pathogenesis of some diseases is complement dependent cytotoxicity (CDC) and/or antibody dependent cellular cytotoxicity (ADCC). In experimental animal models, antibodies to antigenic determinants expressed on EC were capable of inducing vascular injury.
AECA represent a heterogenous group of antibodies directed against a variety of antigenic determinants on EC. They are present in a variety of inflammatory disorders. The detection of these antibodies may be valuable in following disease activity. Further characterization of putative antigens is needed to better understand their pathophysiological role.
明确抗内皮细胞抗体（AECA）的假定靶抗原、AECA可能的病理生理作用以及这些抗体作为疾病活动标志物的临床价值。
使用Medline并结合手工检索进行结构化文献搜索。两名医生查阅了所有特别感兴趣的文章。
AECA是一类异质性抗体，针对内皮细胞（EC）上的多种抗原决定簇。EC抗原可以是组成性表达的、由细胞因子组成性表达并调节的或隐蔽的。此外，AECA的抗原决定簇也可能是附着于EC的分子（“植入”抗原）。然而，目前许多AECA抗原尚未得到充分表征。在多种炎症性疾病中可检测到AECA。虽然这些抗体在疾病诊断中可能价值有限，但检测它们在跟踪疾病活动方面可能有价值。在系统性红斑狼疮和系统性血管炎等几种疾病中，疾病活动期可发现高AECA滴度，而缓解期则报告AECA滴度降低或消失。AECA滴度变化与疾病活动之间的相关性表明AECA在血管壁损伤发生的过程中起重要作用，尽管这并不排除AECA是血管损伤的一种附带现象的可能性。最近几项体外研究支持AECA在这些炎症性疾病的病理生理中起作用。AECA可能通过诱导EC活化导致内皮黏附分子表达上调和/或趋化因子及细胞因子分泌，从而在病理生理中发挥作用。AECA可能成为某些疾病发病机制触发因素的另一种机制是补体依赖性细胞毒性（CDC）和/或抗体依赖性细胞毒性（ADCC）。在实验动物模型中，针对EC上表达的抗原决定簇的抗体能够诱导血管损伤。
AECA代表一类针对EC上多种抗原决定簇的异质性抗体。它们存在于多种炎症性疾病中。检测这些抗体在跟踪疾病活动方面可能有价值。需要进一步表征假定抗原，以更好地理解它们的病理生理作用。
