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时间:2020-05-19
《识别不同靶抗原的抗肾小球基底膜抗体与临床表型相关.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、中国血液净化2010年3月第9卷第3期ChineseJoumalofBloodPurification,March12,2010,Vo1.9,No.3·147·临床研究识别不同靶抗原的抗肾小球基底膜抗体与临床表型相关崔昭贾晓玉刘畅,z赵娟t杨瑞曲贞郑欣刘章锁赵明辉【摘要】目的研究识别不同靶抗原的抗肾小球基底膜(glomeru1arbasementmembrane,GBM)抗体与临床表型的关系。方法应用酶联免疫吸附法(enzyme一1inkedimmunosorbentassay,ELISA),以重组人Ⅱ1、C【2、o【3、C【4和lI5(IV)Nc1为相抗原,测定97例抗G
2、BM病患者血清中抗体的靶抗原,并分析其与临床病理表现的关系。69例患者血清进一步应用以正常人肾组织为底物的问接免疫荧光法(indirectimmunofluorescence,IIF)检测抗体识别的抗原表位的位置。隐匿性抗原表位的暴露采用6M尿素对组织切片进行预处婵,天然暴露抗原表何的检测则以未经处理的组织切”作为底物。结果所有患者血清均识别0【3(IV)NC1,56.7%患者同时识别Ⅱ1(IV)NC1,43.3%患者识别0【2(IV)NC1,53.6%患者识别0【4(IV)NCl,85.6%忠哲识别0【5(IV)NC1。抗0【3(iv)NC1抗体的水甲是患者确诊时的血肌酐
3、水平(,=0.308,P-0.003)以及肾脏病理肾小球rrI新月体的比例(FO.492,P<0.05)的独立决定因素。识别0【5(IV)NC1的患者血清对人然暴露的抗原表位的识别率较高(67.3%比30.0%,P-O.026),且抗cc5(IV)NC1抗体的水平与细胞性新月体的比例早正相关(O.013)。合并抗中性粒细胞胞浆抗体(antineutrophilcytoplasmicantibodies,ANCA)阳性的忠者,列‘dl(IV)NC1(7.3%比26.2%,尸=0.011)和【I4(IV)NCl(7.7%比24.4%,尸=O.023)的识别率较低。结论抗GBM抗
4、体的卡要靶抗原位1-Ⅱ3(IV)NC1,其抗体的水平是肾脏损害程度的决定囚素。天然暴露的抗原农何町能与0【5(IV)NC1相关,其抗体在疾病的发病机制中Ⅲ能发挥重要作用。合并ANCA阳性的患者,其抗体识别的靶抗原较少。【关键词】抗肾小球基底膜病;Goodpasture病;自身抗体;靶抗原;临床表中图分类号:R692文献标识码:AAnti-glomerularbasementmembraneautoantibodiesagainstdifferenttargetantigensarerelatedtopatients’clinicalphenotypeCU/Zhao,JIAX
5、iao-yu,LIUChang“ZHA0Juan,YANGRui,Q(,Zhen,ZHENGXin,L1UZhang-suo,ZHA0Ming—hui.RenalDivision,DepartmentofMedicine,PekingUniversityFirstHospital,Beo'ing100034,DepartmentofNephrologyandRheumatology,TheFirStAffiliatedHospitalofZhengzhouUniversity,Henan450052,ChinaCorrespondingoHthDrZhaoMing—hui,
6、Email:mhzhao@6,“.edu.cn[Abstract]ObjectiveToinvestigatetheassociationbetweenanti.glomemlarbasementmembraneanti.-bodiesagainstdifferenttargetantigensandtheclinicalphenotypesofpatientswithanti—GBMdisease.MethodsThetargetantigensof97serafrompatientswithanti—GBMdiseasediagnosedinourhospitalsin
7、theperiodfrom1998to2008wereinvestigatedbyenzyme—linkedimmunosorbentassay(ELISA)usingrecombinanthuman1,2,3,4and5(IV)NC1asthesolidphaseantigens.Sixty—nineserawerefurtherexaminedbyindirectimmunofluorescenceusingnormalhumanrenaltissueasthesubstrates.Sectionswerepr
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