Prevalence of 13 autoantibodies and of the 16/6 and related pathogenic idiotypes in 465 patients with systemic lupus erythematosus and their relationship with disease activity
Prevalence of 13 autoantibodies and of the 16/6 and related pathogenic idiotypes in 465 patients with systemic lupus erythematosus and their relationship with disease activity
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DOI：
10.1177/096120339700600503
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发表时间：
1997-06
期刊：
影响因子：
2.6
通讯作者：
G. Villarreal;C. Drenkard;A. Villa;H. Slor;S. Shafrir;R. Bakimer;Y. Shoenfeld;D. Alarcon-segovia
中科院分区：
文献类型：
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作者：
G. Villarreal;C. Drenkard;A. Villa;H. Slor;S. Shafrir;R. Bakimer;Y. Shoenfeld;D. Alarcon-segovia
通过对465例连续系统性红斑狼疮（SLE）患者进行13种自身抗体（Aab）和两种独特型的横断面研究，我们根据疾病活动性确定了Aab的患病率，包括一般和特定器官系统。77%的SLE血清中至少有一种Aab， 56%的血清中有高滴度的Aab。病原独特型患病率低于10%，166份血清对5种以上抗原均有Aab， 9份血清对全部13种抗原均有Aab。活动性疾病患者的Aab - DNP、ssDNA、ENA、线粒体和组蛋白的患病率高于正常对照的平均值5sd。经年龄、病程和治疗强度调整后的logistic回归分析证实，活动性疾病患者Aab阳性率较高。观察到一种趋势，即从未治疗的非活动性疾病到仍在治疗的非活动性疾病，再到活动性疾病，Aab的流行率和滴度都在增加。只有22%的活动性疾病患者无Aab，且Aab数量越多，活动性疾病的发生频率越高。活动性关节炎患者，以及在较小程度上活动性皮肤粘膜受累的患者，大多数自身抗体的患病率和滴度高于其他器官系统疾病活动性患者。活动性肾脏疾病仅与抗dsdna相关，而活动性中枢神经系统疾病与抗线粒体Aab相关。我们的研究结果支持SLE作为一种免疫失调导致多克隆B细胞的观点。激活产生多个Aab。他们的档案似乎受到遗传、激素和环境因素的影响，反过来，他们对每个病人的临床情况有所贡献。疾病活动影响一些，但不是全部，Aab的存在，其中一些可能仍然存在于一些患者，甚至在缓解。
With a cross sectional study of 465 consecutive systemic lupus erythematosus (SLE) patients tested for 13 autoantibodies (Aab) and two idiotypes we determined the prevalence of Aab according to disease activity, both general and at particular organ systems. Seventy seven percent of SLE sera had at least one Aab and 56% had it at high titres. Pathogenic idiotypes had a prevalence of less than 10% and 166 sera had Aab to 5 or more antigens and 9 sera had Aab against all 13 antigens tested. Patients with active disease had increased prevalence of Aab to DNP, ssDNA, ENA, mitochondria and histones when considered at 5 s.d. above the mean of normal controls. The higher positivity of Aab in patients with active disease was confirmed in logistic regression analysis adjusted by age, disease duration, and intensity of treatment. A trend was observed of increased prevalence and titres of Aab from inactive disease without treatment, to inactive disease but still being treated, to active disease. Only 22% of patients with active disease had no Aab and the higher the number of Aab the higher the frequency of active disease. Patients with active arthritis, and to a lesser degree those with active mucocutaneous involvement, had higher prevalence and titres of most autoantibodies than patients with disease activity at other organ systems. Active renal disease associated only with anti-dsDNA, whereas active CNS disease associated with anti-mitochondrial Aab. Our findings support the vision of SLE as an immune dysregulation leading to polyclonal B cell .. activation with resulting production of multiple Aab. Their profiles seem influenced by genetical, hormonal and environmental factors and, in turn, they contribute to the clinical picture in each patient. Disease activity influences the presence of some, but not all, Aab and some of them may remain present in some patients, even in remission.