Antibodies to endothelial cell growth factor and obliterative microvascular lesions in the synovium of patients with antibiotic-refractory lyme arthritis.
Antibodies to endothelial cell growth factor and obliterative microvascular lesions in the synovium of patients with antibiotic-refractory lyme arthritis.
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DOI：
10.1002/art.38618
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发表时间：
2014-08
影响因子：
13.3
通讯作者：
Steere, Allen C.
中科院分区：
文献类型：
--
作者：
Londono, Diana;Cadavid, Diego;Drouin, Elise E.;Strle, Klemen;McHugh, Gail;Aversa, John M.;Steere, Allen C.
内皮细胞生长因子（ECGF）最近被确定为已知的第一个自身抗原，在约20%的抗生素难治性莱姆病患者中是T细胞和B细胞反应的靶标。当前研究的目的是寻找滑膜组织中ECGF自身抗体反应与组织学结果之间的病理相关性。对14例抗生素难治性莱姆病患者和6例其他形式的慢性炎性关节炎（主要是类风湿关节炎）患者的滑膜组织进行了检查。组织切片进行化学染色和免疫染色，ELISA法检测IgG抗体对ECGF的反应。每一项发现都进行了排名，以便进行统计分析。在每一种疾病中，滑膜组织均表现为滑膜肥大、血管增生、免疫细胞浸润和纤维化。然而，在14例抗生素难治性关节炎患者中，有8例（57%）在组织中有闭塞性微血管病变，而6例其他形式的慢性炎性关节炎患者中没有一例（P=0.04）。在莱姆病患者中，5例（36%）对ECGF有自身抗体反应，5例均有闭塞性病变，而9例缺乏ECGF抗体反应的患者中仅有3例（P=0.009）。此外，ECGF抗体反应的大小与闭塞病变的范围直接相关（P=0.02），与组织中更大的血管分布直接相关（P=0.05）。ECGF自身抗体反应性与闭塞性微血管病变的相关性表明，这些自身抗体可能参与闭塞过程，提示抗ECGF抗体在抗生素难治性莱姆病患者滑膜组织中具有特定的病理后果。
Endothelial cell growth factor (ECGF) was recently identified as the first autoantigen known to be a target of T and B cell responses in about 20% of patients with antibiotic-refractory Lyme arthritis. The goal of the current study was to look for a pathologic correlate between ECGF autoantibody responses and histologic findings in synovial tissue. Synovial tissue was examined from 14 patients with antibiotic-refractory Lyme arthritis and 6 patients with other forms of chronic inflammatory arthritis, primarily rheumatoid arthritis. The tissue sections were subjected to chemical and immunostaining, and IgG antibody responses to ECGF were determined by ELISA. Each finding was ranked for statistical analysis. In each disease, synovial tissue showed synovial hypertrophy, vascular proliferation, immune cell infiltrates, and fibrosis. However, among the 14 patients with antibiotic-refractory arthritis, 8 (57%) had obliterative microvascular lesions in the tissue compared with none of 6 patients with other forms of chronic inflammatory arthritis (P=0.04). Among the patients with Lyme arthritis, 5 (36%) had autoantibody responses to ECGF, and all 5 had obliterative lesions compared with only 3 of 9 patients who lacked ECGF antibody responses (P=0.009). Moreover, the magnitude of ECGF antibody responses correlated directly with the extent of obliterative lesions (P=0.02) and with greater vascularity in the tissue (P=0.05). The correlations of ECGF autoantibody reactivity with obliterative microvascular lesions imply that these autoantibodies may be involved in the obliterative process, suggesting that anti-ECGF antibodies have specific pathologic consequences in synovial tissue in patients with antibiotic-refractory Lyme arthritis.
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影响因子：
--
作者：
Jones, Kathryn L.;McHugh, Gail A.;Steere, Allen C.
通讯作者：
Steere, Allen C.
影响因子：
5
作者：
Cadavid, D;Bai, YH;Pachner, AR
通讯作者：
Pachner, AR
影响因子：
--
作者：
STEERE, AC;DURAY, PH;BUTCHER, EC
通讯作者：
BUTCHER, EC
影响因子：
--
作者：
Shen, Shiqian;Shin, Junghee J.;Steere, Allen C.
通讯作者：
Steere, Allen C.
影响因子：
3.1
作者：
Cadavid, D;Bai, YH;Pachner, AR
通讯作者：
Pachner, AR