丙基硫氧嘧啶诱发的小血管炎和原发性小血管炎抗髓过氧化物酶抗体亲和力的比较  

Avidity of anti-myeloperoxidase antibodies in serum from patients with propylthiouracil-induced vasculitis and patients with microscopic polyangiitis

作　　者：叶华[1] 高莹[1] 于峰[2] 郭晓蕙[1] 赵明辉[2] 

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

出　　处：《中华微生物学和免疫学杂志》2005年第4期277-281,共5页Chinese Journal of Microbiology and Immunology

基　　金：首都医学发展科研基金 (2 0 0 2 3 0 18)

摘　　要：目的　比较丙基硫氧嘧啶(PTU)相关性小血管炎和原发性小血管炎抗髓过氧化物酶(MPO)抗体亲和力的大小及其与临床表现的关系。方法　以纯化的人MPO为抗原,采用抗原抑制性酶联免疫吸附法对我院确诊的13例PTU相关性小血管炎和19例原发性显微镜下多血管炎(MPA)的患者血清中抗MPO抗体的亲和力进行检测,分析其与临床表现的关系,并对两组抗体的亲和力大小进行比较。亲和常数(aK)的值以使血清抗MPO抗体百分结合率下降5 0 %所需的抑制抗原的摩尔浓度的倒数表示。结果　PTU组不同患者血清抗MPO抗体百分结合率下降5 0 %所需的抑制抗原量差异较大,从<0 .1μg ml到>5 0 μg ml不等。亲和常数的范围为<0 .2 8×10 7mol L到>14 0×10 7mol L ,其中位数为0 .75×10 7mol L。血清中抗 MPO抗体的亲和常数与伯明翰小血管炎活动性评分(BVAS)呈正相关(r=0 .5 83,P =0 .0 37) ,与抗体滴度、受累器官数、血红蛋白(Hb)、血沉(ESR)、C反应蛋白(CRP)、血肌酐(Scr)浓度均没有相关性(P >0 .0 5 )。MPA组不同患者血清抗MPO抗体百分结合率下降5 0 %所需的抑制抗原量差异较PTU组小,从<0 .1μg ml到1.5 6 μg ml不等,亲和常数的范围为8.97×10 7mol L到大于14 0×10 7mol L ,其中位数为5 6 .0×10 7mol L。血清中抗MPO抗体的亲和常数与血?Objective To compare the avidity of antibodies for myeloperoxidase(MPO) in sera from patients with propylthiouracil(PTU) induced vasculitis and patients with microscopic polyangiitis(MPA) and their clinical association was further analyzed. Methods Sera from patients with PTU-induced vasculitis(n=13) and patients with MPA(n=19) were collected. The avidity constant(aK) of anti-MPO IgG were measured by fluid phase MPO inhibition of IgG binding in an MPO specific ELISA. The aK was defined as the reciprocal value of molar concentration of MPO in the liquid phase resulting in 50% inhibition of antibody binding. The aK values were compared between the two groups and their association with different clinical parameters was also investigated. Results In PTU group, the median aK was 0.75×107 mol/L, a significant correlation was observed between the aK and Birmingham vasculitis activity score(BVAS)(r=0.583, P=0.037). In MPA group, the median aK was 56×107 mol/L, a significant correlation was found between the aK and erythrocyte sedimentation rate(ESR)(r= 0.55, P=0.042). No correlation was observed among aK and titers of anti-MPO antibodies, number of organs involved, hemoglobin(Hb), ESR, C reactive protein(CRP), serum creatin(Scr) in PTU group; no correlation was observed between aK and titers of anti-MPO antibodies, number of organs involved, Hb, CRP, Scr and BVAS in MPA group. However, the avidity of anti-MPO antibodies in MPA group was significantly higher than that in PTU group(P=0.000). Conclusion Avidity of anti-MPO antibodies might be correlated with activity of MPA and PTU induced vasculitis. The difference of the avidity of anti-MPO antibody between the two groups might be associated with different clinical expressions.

关 键 词：抗髓过氧化物酶 原发性小血管炎 抗体亲和力 丙基硫氧嘧啶 C反应蛋白(CRP) mol/L 显微镜下多血管炎 血红蛋白(Hb) 酶联免疫吸附法 亲和常数 抗MPO 诱发 临床表现 抗体滴度 PTU 相关性 血肌酐浓度 MPA 结合率 抗原量 中位数 

分 类 号：R543[医药卫生—心血管疾病] R392.11[医药卫生—内科学]