Hayashi S, Kiyokawa T, Aochi H, Nagamine K, Oshida M, Tomiyama Y, Kurata Y
Department of Blood Transfusion, Osaka University Hospital, Suita, Japan.
Autoimmunity. 1997;26(3):195-203. doi: 10.3109/08916939708994741.
Neutropenia is frequently observed in a variety of autoimmune disorders. As the mechanism of neutropenia in these disorders, the destruction of neutrophils by anti-neutrophil autoantibodies has been believed since elevated levels of neutrophil-associated IgG (NAIgG) have been described. However, no data exists to characterize the nature of NAIgG and show NAIgG is an anti-neutrophil autoantibodies. We investigated whether the elevated NAIgG in these patients consists of anti-neutrophil autoantibodies. The NAIgGs of 91 patients with autoimmune disorders including 50 patients with idiopathic thrombocytopenic purpura, 13 patients with systemic lupus erythematosus, 11 patients with Hashimoto's thyroiditis and 10 patients with Graves' disease were analyzed. The level of NAIgG was high in 36 of 91 patients. Elution studies were performed to determine whether NAIgG has a nature of autoantibodies. In model experiments, the ether eluate from neutrophils sensitized with neutrophil-specific alloantibody (anti-NA2) reacted with donor neutrophils, whereas the eluates from those with model immune complexes (ICs) failed. These data indicated that the ether elution technique is useful to determine whether NAIgG consists of anti-neutrophil autoantibodies. The NAIgG on patient's neutrophils was eluted with ether and the reactivity of the eluate with normal neutrophils was investigated. The eluates from 34 of 36 patients with various autoimmune disorders with elevated NAIgG level failed to react with donor neutrophils. These data indicated that the elevated NAIgG in the majority of these patients did not consist of anti-neutrophil autoantibodies, but possibly of ICs.
中性粒细胞减少症在多种自身免疫性疾病中经常出现。作为这些疾病中中性粒细胞减少症的机制，自描述了中性粒细胞相关IgG（NAIgG）水平升高以来，人们一直认为抗中性粒细胞自身抗体可破坏中性粒细胞。然而，目前尚无数据可表征NAIgG的性质并证明NAIgG是抗中性粒细胞自身抗体。我们研究了这些患者中升高的NAIgG是否由抗中性粒细胞自身抗体组成。分析了91例自身免疫性疾病患者的NAIgG，其中包括50例特发性血小板减少性紫癜患者、13例系统性红斑狼疮患者、11例桥本甲状腺炎患者和10例格雷夫斯病患者。91例患者中有36例NAIgG水平较高。进行洗脱研究以确定NAIgG是否具有自身抗体的性质。在模型实验中，用中性粒细胞特异性同种抗体（抗NA2）致敏的中性粒细胞的乙醚洗脱液与供体中性粒细胞发生反应，而来自具有模型免疫复合物（ICs）的中性粒细胞的洗脱液则无此反应。这些数据表明，乙醚洗脱技术有助于确定NAIgG是否由抗中性粒细胞自身抗体组成。用乙醚洗脱患者中性粒细胞上的NAIgG，并研究洗脱液与正常中性粒细胞的反应性。36例NAIgG水平升高的各种自身免疫性疾病患者中，有34例的洗脱液未能与供体中性粒细胞发生反应。这些数据表明，这些患者中的大多数NAIgG升高并非由抗中性粒细胞自身抗体组成，而可能由免疫复合物组成。
