论文部分内容阅读
目的了解系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者IgG4型抗核抗体检测的临床意义。方法入组SLE患者124例,并以67例类风湿关节炎(RA)患者和70例正常人为对照;酶联免疫吸附试验(ELISA)检测血清IgG4型抗核抗体水平,分析其与临床指标(血肌酐、总胆固醇、血尿素氮、血清白蛋白、血尿酸和24 h尿蛋白等)的相关性,并进一步用抗核抗体谱测定试剂盒(免疫印迹法)检测何种抗原产生IgG4型抗体。结果 SLE、RA患者的血清IgG4型抗核抗体阳性率分别为85.5%、56.7%,均显著高于正常人的18.6%(P<0.01)。SLE患者血清中IgG4型抗核抗体水平与血清C3、血清白蛋白及血清总IgG4水平分别呈正相关(r=0.55、0.42、0.52,均P<0.05);与24 h尿蛋白定量呈负相关(r=-0.47,P<0.05)。抗原特异性IgG4型抗体以组蛋白、核小体、dsDNA、Ro-52、SS-A、Sm和nRNP为主,而在15种自身抗原中,在IgG型抗核抗体阳性的SLE患者中,普遍存在IgG4亚型抗体。结论在抗核抗体阳性的SLE患者中普遍存在广谱、自身方应性的IgG4亚型抗体;IgG4型抗核抗体在SLE的发病中可能起保护作用,有望为SLE的防治提供新的策略。
Objective To investigate the clinical significance of IgG4 antinuclear antibody in patients with systemic lupus erythematosus (SLE). Methods One hundred and twenty-four patients with SLE were enrolled in this study. 67 patients with RA and 70 normal controls were enrolled in this study. Serum IgG4 antinuclear antibody levels were detected by enzyme linked immunosorbent assay (ELISA) Serum creatinine, total cholesterol, blood urea nitrogen, serum albumin, serum uric acid and 24 h urinary protein, etc.), and further detected by an anti-nuclear antibody profiling kit (immunoblot) which antigen produced IgG4 type antibody . Results The positive rates of IgG4 antinuclear antibodies in patients with SLE and RA were 85.5% and 56.7%, respectively, which were significantly higher than those in normal subjects (18.6%, P <0.01). The level of IgG4 antinuclear antibody in serum of SLE patients was positively correlated with serum C3, serum albumin and serum IgG4 (r = 0.55,0.42,0.52, all P <0.05), but negatively correlated with 24 h urinary protein r = -0.47, P <0.05). Antigen-specific IgG4 antibodies were mainly histone, nucleosome, dsDNA, Ro-52, SS-A, Sm and nRNP. Of the 15 autoantigens, in IgG type anti-SLE patients, IgG4 subtype antibodies are prevalent. CONCLUSION: A broad spectrum of autoantibodies to IgG4 subtype is prevalent in antinuclear antibody-positive patients with SLE. IgG4 antinuclear antibodies may play a protective role in the pathogenesis of SLE and may provide a new strategy for the prevention and treatment of SLE.