HIGH-LEVELS OF ANTICYTOSKELETON AUTOANTIBODIES ARE FREQUENTLY ASSOCIATED WITH CHRONIC GVHD
HIGH-LEVELS OF ANTICYTOSKELETON AUTOANTIBODIES ARE FREQUENTLY ASSOCIATED WITH CHRONIC GVHD
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DOI：
10.1111/j.1365-2141.1987.tb02351.x
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发表时间：
1987-11-01
影响因子：
6.5
通讯作者：
VERNANT, JP
中科院分区：
文献类型：
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作者：
DIGHIERO, G;INTRATOR, L;VERNANT, JP
22例患者（急性髓性白血病13例，急性淋巴细胞白血病5例，慢性髓性白血病4例），平均年龄25岁（范围8-36岁），接受了来自HLA相同同胞的异基因骨髓移植（BMT）。接受骨髓移植者随访4-65个月。所有患者均给予环磷酰胺、全身照射和甲氨蝶呤预防移植物抗宿主病（GvHD）。通过临床和组织学参数评估，22例患者中有11例表现出慢性移植物抗宿主病（cGvHD）（研究时5例广泛，6例有限）。在骨髓移植前（除1例外）和以后每2或3个月采集一次血清标本。通过ELISA方法进行连续研究以确定这些血清中针对细胞骨架蛋白（肌动蛋白、微管蛋白、肌球蛋白）、dsDNA和dDNA的自身抗体的存在。同时，对每个样品进行免疫电泳和补体组分C3、C4的测量。在10/11例cGvHD患者中发现高水平的抗细胞骨架蛋白的自身抗体，而在11/11例无cGvHD患者中不存在;它们均未表现出抗DNA活性。与此同时，7例cGvHD患者的C4水平降低。在8/11例中发现单克隆免疫球蛋白IgG和IgM（2-15 g/l），但从未发现抗体活性位于M组分内。这些结果表明这些自身抗体的存在与cGvHD的发生之间存在直接关系，并表明它们可能构成与该并发症相关的免疫学标志物。然而，在该回顾性系列中，其预测价值并不明显，因为在一些患者中，它们先于cGvHD的临床体征，而在其他患者中，它们与cGvHD的发作相关。
Twenty-two patients (acute myeloid leukaemia 13, acute lymphoid leukaemia 5, chronic myeloid leukaemia 4) with an average age of 25 years (range 8-36 years), had received allogeneic bone marrow transplantation (BMT) from an HLA identical sibling. The BMT recipients were followed up for a period of 4-65 months. All patients were given cyclophosphamide, total body irradiation and methotrexate in order to prevent graft-versus-host disease (GvHD). Eleven of 22 patients exhibited chronic graft versus host disease (cGvHD) (extensive in five, limited in six at the time of the study) assessed by clinical and histological parameters. Serum samples wer collected from these patients, before BMT (except in one case) and then every 2 or 3 months. Sequential studies to determine the presence of autoantibodies against cytoskeletal proteins (actin, tubulin, myosin), dsDNA and dDNA in these sera were performed by an ELISA method. Simultaneously, immunoelectrophoresis and measurement of complement fractions C3, C4 were performed on each sample. High levels of autoantibodies against cytoskeletal proteins were found in 10/11 patients with cGvHD and were absent in 11/11 patients without cGvHD; none of them exhibited anti-DNA activity. At the same time, C4 levels were decreased in seven of these patients with cGvHD. Monoclonal immunoglobulins IgG and IgM (2-15 g/l) were found in 8/11, but the antibody activity was never found to be located within the M component. These results show a direct relationship between the presence of these autoantibodies and occurrence of cGvHD and indicate that they may constitute an immunological marker related to this complication. However, their predictive value is not clearly evident in this retrospective series as in some patients they preceded clinical signs of cGvHD, whereas in others they were associated with the onset of cGvHD.