Bell S A, Faust H, Schmid A, Meurer M
Department of Dermatology, Ludwig-Maximilians-Universität, München, Germany.
Clin Exp Immunol. 1998 Sep;113(3):327-32. doi: 10.1046/j.1365-2249.1998.00655.x.
Autoantibodies to CRP were reported previously in patients suffering from toxic oil syndrome. This syndrome resembles autoimmune diseases such as systemic lupus erythematosus (SLE) or systemic scleroderma. We therefore examined the prevalence of antibodies to CRP and other acute-phase proteins in autoimmune diseases, including SLE, subacute cutaneous lupus erythematosus (SCLE), systemic scleroderma (SSc), and primary biliary cirrhosis (PBC), as well as in bone marrow transplantation-induced chronic graft-versus-host disease and eosinophilia-myalgia syndrome. IgG antibodies to CRP were found in 78% of SLE and in 30% of SCLE patients, while 16% of patients with PBC were positive. In up to 45% of patients with SSc predominantly IgG antibodies to ceruloplasmin were detectable. Lack of systemic involvement as in discoid lupus erythematosus and localized scleroderma (morphea) correlated with low or absent antibody formation. However, no correlation was found between anti-acute-phase protein antibodies with liver disease or other organ involvement. Adsorption studies revealed that non-native epitopes on the CRP molecule, termed modified CRP, are the main target of antibodies. Chronic inflammatory tissue injury in systemic autoimmune disease might increase the presentation of cryptic epitopes of CRP to the threshold required for T cell activation.
先前有报道称，患有中毒性油综合征的患者体内存在抗CRP自身抗体。该综合征类似于自身免疫性疾病，如系统性红斑狼疮（SLE）或系统性硬化症。因此，我们检测了自身免疫性疾病患者中抗CRP及其他急性期蛋白抗体的流行情况，这些疾病包括SLE、亚急性皮肤型红斑狼疮（SCLE）、系统性硬化症（SSc）和原发性胆汁性肝硬化（PBC），以及骨髓移植引起的慢性移植物抗宿主病和嗜酸性粒细胞增多性肌痛综合征。在78%的SLE患者和30%的SCLE患者中发现了抗CRP IgG抗体，而16%的PBC患者呈阳性。在高达45%的SSc患者中可检测到主要针对铜蓝蛋白的IgG抗体。盘状红斑狼疮和局限性硬皮病（硬斑病）中缺乏全身受累情况与低抗体形成或无抗体形成相关。然而，抗急性期蛋白抗体与肝脏疾病或其他器官受累之间未发现相关性。吸附研究表明，CRP分子上的非天然表位，即所谓的修饰型CRP，是抗体的主要靶标。系统性自身免疫性疾病中的慢性炎症组织损伤可能会增加CRP隐蔽表位的呈现，达到T细胞激活所需的阈值。
