A DISTINCT SUBSET OF ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES IS ASSOCIATED WITH INFLAMMATORY BOWEL-DISEASE
A DISTINCT SUBSET OF ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES IS ASSOCIATED WITH INFLAMMATORY BOWEL-DISEASE
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DOI：
10.1016/s0091-6749(05)80067-3
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发表时间：
1990-08-01
影响因子：
14.2
通讯作者：
TARGAN, S
中科院分区：
文献类型：
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作者：
SAXON, A;SHANAHAN, F;TARGAN, S
抗神经元胞质抗体（ANCA）最近被证明是重要的韦格纳肉芽肿病和某些其他形式的血管炎与肾小球肾炎。用固定细胞ELISA，我们证明了ANCA发生在炎症性肠病（IBD）患者的血清中，涉及结肠。在一项盲法研究中，来自25名溃疡性结肠炎（UC）患者中的21名和25名克罗恩病患者中的5名的血清在固定细胞ELISA中具有结合。克罗恩病患者的5种反应性血清与明确的结肠受累相关。UC患者中ANCA的存在不受疾病分布或活动的影响。事实上，结肠切除术后5年以上的4名UC受试者中存在此类抗体。IBD相关ANCA与Wegener肉芽肿病患者报告的ANCA不同，因为间接免疫荧光染色模式显示非颗粒核周分布（P-ANCA）。在IBD中观察到的P-ANCA不与髓过氧化物酶反应，因此与在血管炎伴新月体肾小球肾炎中观察到的P-ANCA不同。IBD，特别是UC，与P-ANCA的一个独特的子集，这可能具有重要的诊断和潜在的病理生理意义。
Antineutrophil cytoplasmic antibodies (ANCAs) have recently been demonstrated to be of importance in Wegener''s granulomatosis and certain other forms of vasculitis associated with glomerulonephritis. With a fixed-cell ELISA, we demonstrated that ANCAs occur in the serum of patients with inflammatory bowel disease (IBD) involving the colon. In a blinded study, sera from 21 of 25 patients with ulcerative colitis (UC) and five of 25 patients with Crohn''s disease had binding in the fixed-cell ELISA. The five reactive sera from patients with Crohn''s disease were associated with the presence of clear colonic involvement. The presence of ANCA in patients with UC was not influenced by disease distribution or activity. Indeed, such antibodies were present in four subjects with UC more than 5 years after colectomy. The IBD-associated ANCAs were distinct from ANCAs reported in patients with Wegener''s granulomatosis since the pattern of staining on indirect immunoflourescence exhibited a nongranular perinuclear distribution (P-ANCA). The P-ANCA observed in IBD did not react with myeloperoxidase and thus was distinct from the P-ANCA observed in vasculitis with cresentric glomerulonephritis. IBD and, in particular, UC, is associated with a distinct subset of P-ANCA, which may have important diagnostic and potential pathophysiologic implications.