Halacheva K S, Manolova I M, Petkov D P, Andreev A P
Department of Molecular Biology and Immunology, Faculty of Medicine, Thracian University, Stara Zagora, Bulgaria.
Scand J Immunol. 1998 Nov;48(5):544-50.
The presence of antineutrophil cytoplasmic antibodies (ANCA) and their specificity to myeloperoxidase, lactoferrin and elastase were studied in 27 patients with thromboangiitis obliterans (Buerger's disease), including nine in mild stage of the disease (group I) and 18 in active or severe stage (group II). Serum samples were investigated for ANCA prevalence by indirect immunofluorescent technique and fixed neutrophil ELISA; the reactivity to myeloperoxidase, lactoferrin and elastase was measured by ELISA. ANCA were found in 55.5% (15/27) of the patients by indirect immunofluorescence and in 59.25% (16/27) by fixed neutrophil ELISA. A highly significant positive association was observed between the values obtained by the two methods. Only six of 15 ANCA-positive sera reacted with myeloperoxidase and four of 15 with lactoferrin. One ANCA-negative serum reacted with elastase. Antimyeloperoxidase, antilactoferrin and antielastase autoantibodies were found only in the severe group. There was statistically significant difference in the frequency of ANCA in sera of patients with thromboangiitis obliterans versus control sera. ANCA were predominantly found in group II (66.7%; 12/18) compared to group I (33.3%; 3/9) and the levels of antimyeloperoxidase, antilactoferrin and antielastase antibodies correlated with disease severity. Therefore, detection of ANCA can be a helpful serological test for the diagnosis of thromboangiitis obliterans.
对27例血栓闭塞性脉管炎（伯格氏病）患者进行了抗中性粒细胞胞浆抗体（ANCA）及其对髓过氧化物酶、乳铁蛋白和弹性蛋白酶的特异性研究，其中9例处于疾病轻度阶段（I组），18例处于活动期或重度阶段（II组）。采用间接免疫荧光技术和固定中性粒细胞酶联免疫吸附测定（ELISA）检测血清样本中ANCA的流行情况；通过ELISA测定对髓过氧化物酶、乳铁蛋白和弹性蛋白酶的反应性。通过间接免疫荧光法在55.5%（15/27）的患者中检测到ANCA，通过固定中性粒细胞ELISA法在59.25%（16/27）的患者中检测到ANCA。两种方法获得的值之间观察到高度显著的正相关。15份ANCA阳性血清中只有6份与髓过氧化物酶反应，15份中有4份与乳铁蛋白反应。1份ANCA阴性血清与弹性蛋白酶反应。仅在重度组中发现抗髓过氧化物酶、抗乳铁蛋白和抗弹性蛋白酶自身抗体。血栓闭塞性脉管炎患者血清中ANCA的频率与对照血清相比有统计学显著差异。与I组（33.3%；3/9）相比，ANCA主要在II组（66.7%；12/18）中发现，抗髓过氧化物酶、抗乳铁蛋白和抗弹性蛋白酶抗体的水平与疾病严重程度相关。因此，检测ANCA可作为血栓闭塞性脉管炎诊断的一种有用的血清学检测方法。
