The case for a descriptive generic nomenclature
The case for a descriptive generic nomenclature
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描述性通用术语的情况
作者：
V. Lennon
致编辑：我的同事和11-4之前已经回答了Dalmau博士和P~S博士提出的几个问题。其中一些观点显然值得重申和进一步澄清。参考L到4和6到9给出了更多细节。斯隆-凯特林的同事们忽略的主要一点是，我们喜欢的描述性通用命名法是基于在一组组织底物上进行的标准化分析中的严格的免疫荧光染色标准。这些标准排除了表面上与PCA-1、Anna-1或Anna-2有简单相似之处的抗体，这三种副肿瘤性自身抗体的特异性正在讨论中，或者被命名为“Yo”、“Hu”和“Ri”。5表和图1总结了我们实验室用来定义PCA-1、Anna-1和Anna-2特异性抗体的免疫染色标准。图2展示了一些由自身抗体鉴定的蛋白质的蛋白质印迹特征，这些抗体由这些严格的免疫荧光特征定义。首先，应该指出的是，在过去10年里，我自己在梅奥诊所的实验室和波斯纳博士在斯隆-凯特琳研究所的实验室都用各自实验室偏爱的方法研究了数千名患者的血清。执业临床医生可以放心，这两个独立小组的出版物对我们各自实验室所定义的副肿瘤自身抗体的临床/肿瘤学意义得出的结论基本一致。第二点是，与斯隆-凯特林研究人员青睐的神经组织重组蛋白免疫印迹和免疫过氧化物酶染色的组合相比，修辞不能解决关于优化的免疫荧光技术的相对敏感性和特异性的问题。每种方法都有优点和局限性。例如，偶尔患者血清中的高滴度、非器官特异性自身抗体的混合物(如抗核和抗线粒体)将排除对神经元限制性免疫球蛋白特异性的明确免疫荧光检测。在那些不常见的情况下，建议进行蛋白质印迹分析。另一方面，我们用间接免疫荧光法检测了Pca-1和Anna-2抗体，并用重组Yo和Ri蛋白进行商业Western印迹试验，在几例血清阴性的患者中发现了预测的肿瘤。为了确定一种血清学方法在临床测试中是否优于另一种方法，需要对独立实验室在一个公正的小组主持下进行的试验中获得的编码血清的结果进行并排比较，该小组可以由美国神经病学学会或临床免疫学会召集。2 Dalmau博士和波斯纳博士正确地注意到，梅奥诊所采用的方法在未来8年的副肿瘤自身抗体血清学测试中不断得到改进。3，4，6-9。‘4我们试图保持最初的通用术语
To the Editor: My colleagues and 11-4 have previously addressed several of the points raised by Drs. Dalmau and P ~ s n e r . ~ Some of these points clearly merit reiteration and further clarification. References l to 4 and 6 to 9 give more detail. The principal point missed by our Sloan-Kettering colleagues is that the descriptive generic nomenclature we favor is based on rigorous immunofluorescence staining criteria in a standardized assay performed on a panel of tissue substrates. These criteria exclude antibodies that yield simply a superficial resemblance to PCA-1, ANNA-1, or ANNA-2, the three paraneoplastic autoantibody specificities under discussion6 and alternatively named “Yo,” “Hu,” and “Ri.”5 The table and figure 1 summarize the immunostaining criteria that our laboratory uses to define antibodies of PCA-1, ANNA-1, and ANNA-2 specificities. Figure 2 demonstrates Western blot characteristics of some of the proteins identified by autoantibodies defined by these strict immunofluorescence characteristics. At the outset, it should be noted that in the past 10 years, my own laboratory at Mayo Clinic and Dr. Posner’s laboratory at the Sloan-Kettering Institute have both studied thousands of patients’ sera by methodologies preferred by our individual laboratories. The practicing clinician can be reassured that publications from these two independent groups are in substantial agreement about conclusions to be drawn concerning the clinical/oncologic significance of paraneoplastic autoantibodies defined by our individual laboratories’ riter ria.^,"'^ A second point is that rhetoric cannot resolve questions about the relative sensitivity and specificity of an optimized immunofluorescence technique compared with the combination of recombinant protein Western blots and immunoperoxidase staining of neural tissues favored by the Sloan-Kettering investigators. Each methodology has merits and limitations. For example, a mixture of high-titered, non-organ-specific autoantibodies in occasional patients’ sera (eg, antinuclear and antimitochondrial) will preclude definitive immunofluorescence detection of a neuron-restricted IgG specificity. In those infrequent cases, Western blot analysis is indicated. On the other hand, we have detected PCA-1 and ANNA-2 antibodies by indirect immunofluorescence, and the predicted tumors were found, in several patients whose sera were negative by commercial Western blot tests with recombinant Yo and Ri proteins. Determination of whether one serologic approach is superior t o another for purposes of clinical testing will require a side-byside comparison of results obtained for coded sera by independent laboratories in a trial performed under the auspices of an impartial panel, such as could be convened by the American Academy of Neurology or the Clinical Immunology Society.2 Drs. Dalmau and Posner a re correct in noting tha t the methodologies employed a t Mayo Clinic have been continuously refined in 8 years of serologic testing for paraneoplastic autoantibodies on a prospective clinical basis.3,4,6-9.’4 We have attempted to maintain the eneric terminologies originally
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重症肌无力患者胸腺 B 细胞克隆分泌的血清抗体和单克隆抗体定义了纹状体抗原。
影响因子：
5.2
作者：
Williams,CL;Lennon,VA;Momoi,MY;HowardJr,FM
通讯作者：
HowardJr,FM
自身抗体结合来自小细胞肺癌的溶解的钙通道-omega-芋螺毒素复合物：兰伯特-伊顿肌无力综合征的诊断辅助。
影响因子：
8.9
作者：
Lennon,VA;Lambert,EH
通讯作者：
Lambert,EH
影响因子：
8.9
作者：
David W. Kimmel;Brian P. O'Neill;V. A. Lennon
通讯作者：
David W. Kimmel;Brian P. O'Neill;V. A. Lennon
DOI：
10.1073/pnas.88.8.3451
发表时间：
1991-04-01
影响因子：
11.1
作者：
FATHALLAHSHAYKH, H;WOLF, S;FURNEAUX, HM
通讯作者：
FURNEAUX, HM
DOI：
10.1073/pnas.84.13.4552
发表时间：
1987-07-01
影响因子：
11.1
作者：
DROPCHO, EJ;CHEN, YT;OLD, LJ
通讯作者：
OLD, LJ