血栓闭塞性脉管炎是涉及多种超敏反应的自身免疫性疾病  

Thromboangiitis Obliterans Is an Autoimmune Disease Involving Multiple Hy-persensitivity Types

作　　者：郑萍 王万超 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海 [2]上海交通大学医学院上海市免疫学研究所,上海

出　　处：《临床医学进展》2023年第6期10050-10057,共8页Advances in Clinical Medicine

摘　　要：目的:本研究是基于我们早期研究报告显示的血栓闭塞性脉管炎(TAO, Buger’ Disease)可能是涉及到超敏反应III和lV的自身免疫性疾病的进一步研究。方法:测定28例TAO患者的体液免疫(IgE);采用三种免疫标记技术同步探测28例TAO血清中抗血管自身抗体和18例TAO病变血管上的抗原抗体复合物等,以确保结果的可靠性。结果:发现TAO病人血清中IgE显著升高(P < 0.01);三种免疫标记技术均发现血清中有高达86%的抗血管自身抗体(P < 0.001)和在血管壁全层有抗原抗体复合物沉积及自身抗体直接结合于血管胶原。结论:进一步证实TAO是一种自身免疫性疾病,且发现涉及多种超敏反应。其发病机制主要是III型超敏,除了与IV型有关外,还有II型的参与。IgE明显升高提示TAO患者或有被致敏原致敏的I型超敏反应的存在。Object: Our early study about thromboangiitis obliterans (TAO, Buger’s Disease) has been reported that it may be an autoimmune disease involving hypersensitivity Type III & Type IV. In this study, we further explored the immune pathogenesis of thromboangiitis obliterans based on initial re-search. Method: We detected humoral immunity (IgE) in 28 cases, antigen-antibody complex de-positing on the vessel wall in 18 cases, and anti-vessel antibodies in 28 cases using three kinds of immune-labeling technique to confirm the new findings. Result: IgE levels were significantly high (P < 0.01). As high as 86% of anti-vessel antibodies in serum were found (P < 0.001), and the au-to-antibodies against the vessel were combined directly with vascular collagen. Antigen-antibody complexes were deposited on the vascular wall. Conclusion: These findings further confirm throm-boangiitis obliterans is an autoimmune disease and involving multiple hypersensitivity reactions. This is mainly Type III hypersensitivity and type II in addition to type IV. The elevated IgE suggests that TAO may a type I hypersensitivity involved.

关 键 词：血栓闭塞性脉管炎 自身免疫性疾病 免疫标记技术 抗原抗体复合物 抗血管自身抗体 III、IV、II、I型超敏反应 

分 类 号：R54[医药卫生—心血管疾病]