丙硫氧嘧啶相关性小血管炎和原发性小血管炎血清髓过氧化物酶抗体抗原决定簇结合谱的比较  

Epitope mapping of myeloperoxidase antibodies in propylthiouracil induced vasculitis and microscopic polyangiitis

作　　者：叶华[1] 郭晓蕙[1] 赵明辉[2] 高莹[1] 张颖[2] 高妍[1] 

机构地区：[1]北京大学第一医院内分泌科,100034 [2]北京大学第一医院肾内科,100034

出　　处：《中华内科杂志》2004年第12期915-919,共5页Chinese Journal of Internal Medicine

摘　　要：目的　比较丙硫氧嘧啶 (PTU)相关性小血管炎和原发性小血管炎髓过氧化物酶(MPO)抗体的抗原决定簇结合谱。方法　以人MPO制备的MPO亲和层析柱 ,分别从 1例PTU相关性小血管炎和 1例显微镜下型多血管炎 (MPA)患者的血浆置换液中分离纯化MPO抗体 (Pab1和Pab2 ) ,并经辣根过氧化物酶标记 (Pab1 HRP和Pab2 HRP)。以Pab1 HRP和Pab2 HRP以及两种鼠抗人MPO单克隆抗体 (3D8和 6B9)分别作为识别MPO分子上不同抗原决定簇的探针 ,应用竞争性ELISA对 10例PTU引起的抗中性粒细胞胞浆抗体 (ANCA)阳性小血管炎患者和 10例MPA患者血清中MPO抗体的抗原决定簇结合谱进行比较研究。结果　PTU组 10例标本均可抑制 3D8,平均抑制率为 4 4 7% ,9/ 10例标本可抑制 6B9,平均抑制率为 35 6 % ;MPA组 10例标本均可抑制 3D8和6B9,平均抑制率分别为 6 8 4 %和 6 2 2 % ,与PTU组相比差异具有显著性 (P <0 0 1)。两组标本对Pab1 HRP的平均抑制率均达 80 %以上 ,MPA组标本对Pab2 HRP的抑制率均值显著大于PTU组(76 3%比 5 8 9% ,P <0 0 1)。结论　丙硫氧嘧啶相关性小血管炎和MPA患者血清中的MPO抗体均可识别MPO分子上多个抗原决定簇 ,二者识别的抗原决定簇有一定程度的交叉 ,但PTU组识别的抗原决定簇可能较局限。抗原决定簇结合谱?Objective To compare the epitopes of antibodies for myeloperoxidase (MPO) in the serum from patients with propylthiouracil (PTU) induced vasculitis and microscopic polyangiitis (MPA). Methods Serum samples from patients with PTU induced vasculitis ( n =10) and MPA ( n =10) were collected and used to inhibit monoclonal antibodies against human MPO 3D8 and 6B9 and then affinity was purified, horseradish peroxidase conjugated and human MPO antibodies determined (Pab1 HRP, Pab2 HRP) in a competitive inhibition ELISA system using soluble human MPO as solid phase ligands. The Pab1 HRP and Pab2 HRP were affinity purified from plasma exchanges of a patient with PTU induced vasculitis and a patient with MPA. The inhibition rates were evaluated and compared between PTU group and primary MPA group. Results In PTU group, all the 10 serum samples could inhibit 3D8; the average inhibition rate was 44.7%, 9/10 of the serum samples could inhibit 6B9; the average inhibition rate was 35.6%; In MPA group, all 10 serum samples could inhibit 3D8 and 6B9; the average inhibition rates were 68.4% and 62.2%. Serum in both groups could inhibit Pab1 HRP and the inhibition rates were both more than 80%; the average inhibition rate for Pab2 HRP in MPA group was significantly higher than that in PTU group (76 3% vs 58.9%, P <0.01). Conclusions MPO antibodies from patients with PTU induced vasculitis and patients with primary MPA could recognize more than one epitopes on native MPO molecule. Although the epitopes were overlapping between the two groups, the epitopes of MPO antibodies from patients with PTU induced vasculities might be more restricted.

关 键 词：丙硫氧嘧啶 血管炎 髓过氧化物酶 抗体 抗原决定簇结合谱 

分 类 号：R593.9[医药卫生—内科学]