CLINICAL-SIGNIFICANCE OF ANTIBODIES AGAINST NEUTROPHILS IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE AND PRIMARY SCLEROSING CHOLANGITIS
CLINICAL-SIGNIFICANCE OF ANTIBODIES AGAINST NEUTROPHILS IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE AND PRIMARY SCLEROSING CHOLANGITIS
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DOI：
10.1136/gut.33.5.657
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发表时间：
1992-05-01
期刊：
影响因子：
24.5
通讯作者：
WIEDMANN, KH
中科院分区：
文献类型：
--
作者：
SEIBOLD, F;WEBER, P;WIEDMANN, KH
最近在炎症性肠病和原发性硬化性胆管炎患者的血清中检测到抗中性粒细胞核周抗体（pANCA）的存在。为了评估其临床意义，通过肝切片和中性粒细胞离心切片的间接免疫荧光和免疫印迹，对 126 名炎症性肠病患者（80 名克罗恩病、46 名溃疡性结肠炎和 22 名原发性硬化性胆管炎患者）的血清进行了 pANCA 检测。在 88% 的溃疡性结肠炎患者中，83% 的患者发现了抗中性粒细胞的核周抗体。使用免疫荧光检测，在原发性硬化性胆管炎和炎症性肠病患者中，40% 的原发性硬化性胆管炎但无炎症性肠病患者和 25% 的克罗恩病患者中，溃疡性结肠炎和原发性硬化性胆管炎的 pANCA 滴度范围为 1:10 至 1:1000（中位数为 1:100）。克罗恩病中只有 4 名患者的 pANCA 滴度超过 1:10，而在溃疡性结肠炎中，高滴度的 pANCA 主要出现在活动性疾病中，使用以超声中性粒细胞作为抗原的免疫印迹系统，82% 的原发性硬化性胆管炎患者血清与多达 5 种不同的血清发生反应。决定簇，而只有 12% 的克罗恩病患者血清和 11% 的溃疡性结肠炎患者血清检测到其中一个决定簇，表明 pANCA 反应涉及不同的抗原。
The presence of perinuclear antibodies against neutrophils (pANCA) has been detected recently in sera of patients with inflammatory bowel disease and primary sclerosing cholangitis. In order to evaluate their clinical significance, sera from 126 patients with inflammatory bowel disease (80 Crohn's disease and 46 ulcerative colitis and 22 patients with primary sclerosing cholangitis were examined for pANCA by indirect immunofluorescence on liver sections and cytocentrifuge slides of neutrophils and by immunoblot. Perinuclear antibodies against neutrophils were found in 83% of patients with ulcerative colitis in 88% of patients with primary sclerosing cholangitis and inflammatory bowel disease, in 40% of patients with primary sclerosing cholangitis but without inflammatory bowel disease, and in 25% of patients with Crohn's disease using the immunofluorescence test. Titres of pANCA ranged from 1:10 to 1:1000 in ulcerative colitis and primary sclerosing cholangitis (median 1:100), whereas in Crohn's disease only four patients had titres of more than 1:10. The occurrence of pANCA did not correlate with clinical activity of Crohn's disease and primary sclerosing cholangitis whereas in ulcerative colitis high titres of pANCA were found mainly in active disease. Using an immunoblot system with sonified neutrophils as antigen, 82% of sera from patients with primary sclerosing cholangitis reacted with up to five different determinants, whereas only 12% of sera from patients with Crohn's disease and 11% of sera with ulcerative colitis detected one of the determinants, suggesting different antigens involved in pANCA reaction.