Esteve M, Mallolas J, Klaassen J, Abad-Lacruz A, Gonzàlez-Huix F, Cabré E, Fernández-Bañares F, Menacho M, Condom E, Martí-Ragué J, Gassull M A
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Am J Gastroenterol. 1998 Apr;93(4):615-8. doi: 10.1111/j.1572-0241.1998.175_b.x.
Few studies have assessed the IgA antineutrophil cytoplasmic antibody (ANCA) positivity in ulcerative colitis patients and there is no information about factors related to its synthesis and its status after colectomy. The aims of the study were to assess the serum IgA ANCA prevalence in ulcerative colitis patients, both nonoperated and operated, and to determine the clinical factors related to this positivity.
Fifty-four ulcerative colitis patients, 63 ulcerative colitis colectomized patients (32 with Brooke's ileostomy and 31 with ileal pouch anal anastomosis), and 24 controls were studied. Antineutrophil cytoplasmic antibodies were detected by specific indirect immunofluorescent assays.
The percentage of IgA ANCA was significantly higher in patients with ileal pouch anal anastomosis (45%) than in patients with Brooke's ileostomy (22%). There were no differences related to the presence of pouchitis in ileal pouch anal anastomosis patients. Patients with nonoperated extensive colitis (47%) had a significantly higher percentage of IgA ANCA than patients with proctitis (19%). Total percentage of ANCA (IgA and/or IgG) tended to be higher in ulcerative colitis and in patients with ileal pouch anal anastomosis than in patients with Brooke's ileostomy. However, in ileal pouch anal anastomosis patients, ANCA positivity was mainly due to exclusive IgA production.
A substantial percentage of ulcerative colitis patients, and especially colectomized patients with ileal pouch anal anastomosis, had IgA ANCA, suggesting that ANCA production in ulcerative colitis might be stimulated by an immune reaction in the intestinal mucosa.
很少有研究评估溃疡性结肠炎患者中IgA抗中性粒细胞胞浆抗体（ANCA）的阳性率，且关于其合成相关因素及结肠切除术后状态尚无相关信息。本研究的目的是评估非手术和手术的溃疡性结肠炎患者血清IgA ANCA的患病率，并确定与此阳性相关的临床因素。
对54例溃疡性结肠炎患者、63例接受结肠切除术的溃疡性结肠炎患者（32例行布鲁克回肠造口术，31例行回肠储袋肛管吻合术）和24例对照进行研究。通过特异性间接免疫荧光测定法检测抗中性粒细胞胞浆抗体。
回肠储袋肛管吻合术患者中IgA ANCA的百分比（45%）显著高于布鲁克回肠造口术患者（22%）。回肠储袋肛管吻合术患者中有无袋炎并无差异。非手术广泛性结肠炎患者（47%）的IgA ANCA百分比显著高于直肠炎患者（19%）。溃疡性结肠炎患者及回肠储袋肛管吻合术患者中ANCA（IgA和/或IgG）的总百分比往往高于布鲁克回肠造口术患者。然而，在回肠储袋肛管吻合术患者中，ANCA阳性主要归因于单纯的IgA产生。
相当比例的溃疡性结肠炎患者，尤其是行回肠储袋肛管吻合术的结肠切除患者，存在IgA ANCA，提示溃疡性结肠炎中ANCA的产生可能受到肠黏膜免疫反应的刺激。
