SPECIFICATION AND QUANTITATION OF CIRCULATING IMMUNE-COMPLEXES IN THE SERUM OF PATIENTS WITH ACTIVE PULMONARY SARCOIDOSIS
SPECIFICATION AND QUANTITATION OF CIRCULATING IMMUNE-COMPLEXES IN THE SERUM OF PATIENTS WITH ACTIVE PULMONARY SARCOIDOSIS
复制标题
DOI：
10.1136/thx.49.7.688
复制
发表时间：
1994-07-01
期刊：
影响因子：
10
通讯作者：
LODDENKEMPER, R
中科院分区：
文献类型：
--
作者：
SCHOENFELD, N;SCHMOLKE, B;LODDENKEMPER, R
背景-循环免疫复合体可在结节病患者血清标本中升高，并与疾病活动性有关，但其诊断意义尚不清楚。方法：对19例活动期、未经治疗的肺结节病患者检测了含免疫球蛋白A、G、M的不同类别循环免疫复合体、循环免疫复合体中补体的含量(聚乙二醇沉淀法)和补体结合循环免疫复合体水平(补体结合法)。与血清中其他指标(可溶性白介素2受体、血管紧张素转换酶、免疫球蛋白A、G、M)、支气管肺泡灌洗液(淋巴细胞、辅助细胞、抑制细胞、活化T细胞)、放射学分期和功能参数(FEV(1)、肺活量、总肺活量、传递系数(Kco)、运动时肺-动脉氧分压差)进行比较。结果：所有患者均可通过聚乙二醇沉淀法检测到循环免疫复合物，且与对照组相似。循环免疫复合物中C1q含量高于对照组，但除1例外，其余均在正常范围内。相比之下，67%的患者补体结合循环免疫复合体水平升高。循环免疫复合体与血清、支气管肺泡灌洗液或肺功能值中的任何其他参数之间没有相关性。结论：补体结合法检测活动性肺结节病循环免疫复合物的敏感性明显高于聚乙二醇沉淀法。由于循环免疫复合体水平与疾病的其他参数之间没有相关性，它们可能对疾病活动性的评估没有用处。
Background - Circulating immune complexes can be elevated in serum samples of patients with sarcoidosis and are associated with disease activity, but their diagnostic significance is not understood.Methods - The different classes of circulating immune complexes containing immunoglobulin A, G, or M, and the content of complement in circulating immune complexes (polyethylene glycol precipitation) as well as levels of complement binding circulating immune complexes (complement binding assay) were determined in 19 patients with active, untreated pulmonary sarcoidosis. The results were compared with other parameters in the serum (soluble interleukin 2 receptor, angiotensin converting enzyme, immunoglobulin A, G, and M) and the bronchoalveolar lavage fluid (lymphocytes, helper cells, suppressor cells, activated T cells), and with radiological stage and functional parameters (FEV(1), vital capacity, total lung capacity, transfer coefficient (Kco), and the alveolar-arterial oxygen difference during exercise).Results - In all patients circulating immune complexes could be detected by polyethylene glycol precipitation and were similar to control subjects. The content of C1q in circulating immune complexes was higher than in controls, yet in all but one of the cases was still within normal limits. In contrast, elevated levels of complement binding circulating immune complexes were found in 67% of the patients. No correlation was seen between circulating immune complexes and any of the other parameters in the serum, bronchoalveolar lavage fluid, or lung function values. No differences were found between radiological type I and II presentations of sarcoidosis.Conclusions - The complement binding assay showed a much higher sensitivity for the detection of circulating immune complexes in active pulmonary sarcoidosis than the polyethylene glycol precipitation method. As there was no correlation between levels of circulating immune complexes and other parameters of the disease they are probably not useful for the assessment of disease activity.