抗α-胞衬蛋白多肽IgA抗体对干燥综合征的诊断价值  

IgA Antibodies against α-Fodrin-Derived Polypeptide in Diagnosis of Sjgren's Syndrome

作　　者：何菁[1] 郭嘉隆[2] 李英妮[1] 丁艳[1] 韩蕾[1] 贾汝琳[1] 栗占国[1] 

机构地区：[1]北京大学人民医院风湿免疫科,北京100044 [2]吉林大学中日联谊医院,长春130033

出　　处：《中华临床免疫和变态反应杂志》2010年第2期91-96,共6页Chinese Journal of Allergy & Clinical Immunology

基　　金：北京市自然科学基金(7102155);国家十一五科技支撑计划(2008BA159B03)

摘　　要：目的以α-胞衬蛋白(α-Fodrin)多肽为抗原,采用ELISA检测干燥综合征(Sjgren's syndrome,SS)患者血清抗α-Fodrin多肽IgA抗体(α-Fodrin-derived polypeptide antibody,αF5-IgA),并分析其与SS临床表现和其他实验室指标的关系。方法以固相法合成的α-Fodrin 37-59多肽(αF5)为包被抗原,ELISA定量检测169例原发性干燥综合征(primary Sjgren's syndrome,pSS)、31例继发性干燥综合征(secondary Sjgren syndrome,sSS)、221例其他结缔组织病患者及88名健康对照者血清抗α-Fodrin37-59多肽IgA(αF5-IgA)抗体水平,并分析其与SS患者临床表现及自身抗体、IgG、IgA、血沉及血常规等的相关性。结果 ELISA定量检测抗αF5-IgA抗体,pSS和sSS组的阳性率分别为73.4%和64.5%,而类风湿关节炎、系统性红斑狼疮和健康对照组的阳性率分别是27.3%、17.8%和2.3%,抗αF5-IgA抗体在SS患者的阳性率显著高于其他结缔组织病患者及健康对照组(χ2=114.5～234.1,P<0.01)。抗αF5-IgA抗体对SS诊断的特异性为86.1%,在抗SSA、抗SSB抗体和ANA阴性的pSS患者中,抗αF5-IgA抗体的阳性率分别为48.9%、46.6%和57.1%。抗αF5-IgA抗体阳性pSS患者的肾脏受累率高于抗αF5-IgA抗体阴性患者(χ2=3.0,P<0.05)。抗αF5-IgA抗体阳性pSS患者IgG、IgA升高,血沉增快,白细胞与血小板下降的概率明显高于抗体阴性的患者(χ2=17.9～73.5,P<0.05)。结论 ELISA法可用于检测SS患者血清抗αF5-IgA抗体,该抗体为诊断SS较为特异的自身抗体之一,且抗αF5-IgA抗体对其他自身抗体阴性的SS的诊断有参考意义。Objective To detect anti-IgA-α-fodrin-derived polypeptide antibody （αF5-IgA） antibody in Sjgren＇s syndrome （ SS） and evaluate the relationship between anti-αF5-IgA antibody and clinical manifestations, serologic abnormalities.Methods Serum samples were obtained from 169 patients with primary Sjgren syndrome （pSS）, 31 patients with secondary Sjgren syndrome （sSS）, 111 systemic lupus erythematosus （SLE）, 110 rheumatoid arthritis （RA）, and 88 healthy individuals.The presence of anti-αF5-IgA antibody was examined by enzyme-linked immunosorbent assay （ ELISA）.The associations between anti-αF5-IgA antibody and the clinical features of SS were evaluated.Results Antibody against anti-αF5-IgA were present in 73.4% of primary SS patients, 64.5% of secondary SS patients, 17.8% of SLE patients, 27.3% of RA patients, and 2.3% of normal blood donors.The positivity of anti-αF5-IgA was significantly higher than those in SLE, RA, and normal controls （χ2=114.5-234.1, P0.01）.The specificity of anti-αF5-IgA was 86.1%.The presence of anti-αF5-IgA was significantly correlated with clinical manifestations , such as kidney involvement.The incidence of IgG, IgA elevation, ESR increasing, WBC and PLT reduction in αF5-IgA positive group are much higher than anti-αF5-IgA negative group of SS, （χ2=17.9-73.5, P0.05）.Conclusion The α-Fodrin may be an autoantigen in SS patient.Anti-αF5-IgA is likely to be an useful diagnostic marker in SS.

关 键 词：干燥综合征 抗α-胞衬蛋白多肽IgA抗体 酶联免疫吸附试验 

分 类 号：R593.2[医药卫生—内科学]