抗α-1C微管蛋白抗体在系统性硬化症中的表达及临床意义  

Significance of anti-tubulin-α-1C autoantibody in systemic sclerosis

作　　者：赵静[1] 孙峰 李云[1] 赵晓珍 徐丹 李英妮[1] 李玉慧[1] 孙晓麟[1] ZHAO Jing;SUN Feng;LI Yun;ZHAO Xiao-zhen;XU Dan;LI Ying-ni;LI Yu-hui;SUN Xiao-lin(Department of Rheumatology & Immunology, Peking University People’s Hospital, Beijing 100044, China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044

出　　处：《北京大学学报（医学版）》2020年第6期1009-1013,共5页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81801617)。

摘　　要：目的:检测抗α-1C微管蛋白(tubulin-α-1C)抗体在系统性硬化症(systemic sclerosis,SSc)患者血清中的表达,并探讨其潜在的临床意义。方法:入组SSc患者62例、系统性红斑狼疮(systemic lupus erythematosus,SLE)患者38例、原发性干燥综合征(primary Sjögren’s syndrome,pSS)患者24例和健康对照组(health control,HC)30例,收集血清,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)分别检测各组血清中抗tubulin-α-1C抗体水平。同时,用标准实验室技术测定红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)、免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)、免疫球蛋白G(Immunoglobulin G,IgG)、补体C3、补体C4、类风湿因子(rheumatoid factor,RF)、抗核抗体(antinuclear antibody,ANA)、抗着丝点抗体(anti-centromere antibodies,ACA)、抗心磷脂抗体(anticardiolipin,aCL)、抗双链DNA抗体(抗dsDNA抗体)、抗Sm抗体、抗RNP抗体、抗Scl-70抗体、抗Ro-52抗体、抗SSA抗体、抗SSB抗体、着丝点蛋白A(centromere protein A,CENP-A)、着丝点蛋白B(centromere protein B,CENP-B)等指标。记录雷诺现象和改良的Rodnan评分(modified Rodnan skin score,MRSS)等临床表现来评估SSc的疾病状态,分析抗tubulin-α-1C抗体与其他实验室指标和临床表现的关系。组间计量资料比较采用两独立样本t检验或Mann-Whitney U检验;组间计数资料比较采用卡方检验;采用绘制实验组工作曲线确定抗tubulin-α-1C抗体对诊断SSc最佳截断值并分析其诊断效能,相关性分析采用Spearman相关分析。结果:SSc患者、SLE患者、pSS患者和正常对照组血清中抗tubulin-α-1C抗体水平分别为81.24±34.38、87.84±38.52、59.79±25.24、39.37±18.7,SSc患者血清抗tubulin-α-1C抗体水平显著高于pSS患者和正常对照组,P均小于0.001。SSc患者血清抗tubulin-α-1C抗体水平与SLE组差异没有统计学意义。Spearman相关性分析示Objective:To detect the serum level of a novel autoantibody,anti-tubulin-α-1C,in patients with systemic sclerosis(SSc)and to investigate its clinical significance.Methods:Anti-tubulin-α-1C antibody levels were determined by enzyme-linked immunosorbent assay(ELISA)in 62 patients with SSc,38 systemic lupus erythematosus(SLE),24 primary Sjögren’s syndrome(pSS)patients,and 30 healthy controls(HCs).Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG),C3,C4,rheumatoid factor(RF),antinuclear antibody(ANA),anti-centromere antibodies(ACA),anticardiolipin(aCL),anti-dsDNA antibody,anti-Sm antibody,anti-RNP antibody,anti-Scl-70 antibody,anti-Ro52 antibody,anti-SSA antibody,anti-SSB antibody,centromere protein A(CENP-A),centromere protein B(CENP-B)were measured by standard laboratory techniques.Raynaud’s phenomenon and modified Rodnan skin score(MRSS)were recorded to evaluate the disease status of SSc.Independent sample t test,Chi square test,Mann-Whitney U test,Spearman rank correlation were used for statistical analyses.Results:The serum anti-tubulin-α-1C antibody concentration in SSc group was 81.24±34.38,the serum anti-tubulin-α-1C antibody concentration in SLE group was 87.84±38.52,the serum anti-tubulin-α-1C antibody concentration in pSS group was 59.79±25.24,and the serum anti-tubulin-α-1C antibody concentration in healthy group was 39.37±18.7.Multivariate analysis revealed that anti-tubulin-α-1C antibody levels were significantly increased in the SSc and SLE patients.The expression level of anti-tubulin-α-1C antibody in SSc was higher compared with the pSS group and the health control group(P<0.01).Further analysis demonstrated that the elevated anti-tubulin-α-1C antibody were correlated with the SSc inflammation and disease activity markers ESR(r=0.313,P=0.019),The levels of anti-tubulin-α-1C antibody were also significantly correlated with MRSS(r=0.636,P<0.01).The best cut-off value for the diagnose of SSc was 76.77 as mean+2

关 键 词：系统性硬化症 抗α-1C微管蛋白抗体 自身抗体 

分 类 号：R783.2[医药卫生—口腔医学]