MPO-ANCA相关性血管炎中抗溶酶体相关膜蛋白-2抗体的作用初探  

Investigation on the role of anti-lysosome-associated membrane protein-2 antibody in MPO-ANCA associated vasculitis

作　　者：桂雅迪 帅宗文[1] 胡子盈 张铭明[1] 武琳琳[1] 陈珊宇[1] 

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022

出　　处：《安徽医科大学学报》2016年第8期1196-1199,共4页Acta Universitatis Medicinalis Anhui

基　　金：中华医学会临床医学科研专项资金项目(编号:08010290107)

摘　　要：目的初步探讨抗溶酶体相关膜蛋白-2抗体(LAMP-2A)在髓过氧化物酶抗中性粒细胞胞质抗体相关性血管炎(MPO-AAV)中的存在及意义。方法采用ELISA法分别检测入选者周围血的LAMP-2A、髓过氧化物酶抗中性粒细胞胞质抗体(MPO-ANCA)、溶酶体相关膜蛋白-2(LAMP-2)、髓过氧化物酶(MPO)及活化补体C5a水平,比较LAMP-2A阳性与阴性患者间临床资料及上述指标间的差别,并分析其相关性。结果MPO-AAV患者中LAMP-2A的阳性率为48.44%,阳性率在有无肾、肺损害患者中差异无统计学意义;病例组LAMP-2水平显著高于对照组(P<0.001);LAMP-2A阳性患者C5a、MPO及LAMP-2水平显著高于阴性患者(P<0.01),并且LAMP-2A分别与C5a、MPO及LAMP-2水平呈显著正相关性(rs=0.056、0.525、0.723,P<0.001),与MPO-ANCA及BVAS无明显相关性。结论MPO-AAV中自身抗体LAMP-2A常见,其独立于自身抗体MPO-ANCA,可能通过促进补体旁路激活、结合升高的自身抗原(LAMP-2)等途径影响MPO-AAV的临床损害,更确切的作用和意义有待进一步探讨。Objective To preliminarily investigate the prevalence and role of anti-lysosome-associated membrane protein-2 antibody（LAMP-2A） in myeloperoxidase-antineutrophil cytoplasmic antibody associated vasculitis（ MPO- AAV）. Methods The peripheral blood from all patients was taken to detect LAMP-2A, myeloperoxidase-antineutro- phil cytoplasmic antibody （ MPO-ANCA ）, lysosome-associated membrane protein-2 （ LAMP-2 ）, myeloperoxidase （MPO） and activated complement CSa by ELISA. These test results and some of other clinical indices were comparatively analyzed between LAMP-2A positive and negative group, and the relationships between LAMP-2A and either of these induces were also investigated. Results The positive rate of LAMP-2A was 48.44% in MPO-AAV patients. This positive rate showed no significant difference between patients with nephric/pulmonary damage and without nephric/pulmonary involvement. The LAMP-2 level in patient group was higher than that in control group （ P 〈 0. 001 ）. The levels of CSa, MPO and LAMP-2 in patients with positive LAMP-2A were significantly higher than that in patients without LAMP-2A （P 〈 0. 01 ）. Moreover, LAMP-2A had markedly positive correlations with either of CSa, MPO and LAMP-2 （rs = 0. 056,0. 525,0. 723;P 〈 0. 001, respectively） while there was no obvious rela- tionship between LAMP-2A and MPO-ANCA or BVAS. Conclusion LAMP-2A is a common autoantibody in MPO- AAV and is independent from the other autoantibody MPO-ANCA. It might play an important role in the pathogenesis of clinical lesions in MPO-AAV by some way like promoting the activation of alternative complement pathway, combining with its elevated autoantigen LAMP-2 and so on. Further investigations on the exact roles of LAMP-2A in MPO-AAV are necessary.

关 键 词：ANCA相关性血管炎 髓过氧化物酶 抗溶酶体相关膜蛋白-2抗体 溶酶体相关膜蛋白-2 补体激活 致病机制 

分 类 号：R593.27[医药卫生—内科学]