IgA immune complexes in patients with dermatitis herpetiformis occur in the absence of IgA rheumatoid factor.
IgA immune complexes in patients with dermatitis herpetiformis occur in the absence of IgA rheumatoid factor.
复制标题
疱疹样皮炎患者的 IgA 免疫复合物在缺乏 IgA 类风湿因子的情况下出现。
DOI：
10.1111/1523-1747.ep12580310
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Eyre,RW
中科院分区：
文献类型：
--
作者：
Hall,RP;Eyre,RW
30%~ 40%的疱疹样皮炎（DH）患者存在含有IgA的循环免疫复合物（IgA-CIC）;然而，这些复合物的抗原组成以及它们在DH发病机制中的作用尚不清楚。尽管DH与谷蛋白敏感性肠病相关，但未能在这些IgA-CIC中检测到小麦蛋白，这表明DH中的IgA-CIC可能与伊加肾病中所见的相似，并代表伊加类风湿因子（RF）- IgG复合物。我们检查了32例DH患者，16例非DH患者的血清RF阳性乳胶固定，和15名正常人伊加和1gM RE使用酶联免疫吸附试验（ELISA）和IgA-CIC使用抗C3 ELISA。16例乳胶固定试验阳性患者中13例（81%）ELISA检测出伊加RF，15/16例（94%）ELISA检测出1gM RF。在胶乳固定阳性的患者中，ELISA检测的RF总量（伊加+ IgM RF）与胶乳固定滴度相关（r= 0.678，p = 0.004）。16例乳胶固定阳性患者中有6例（38%）也发现有伊加- CIC。使用山羊抗人C3的固相吸收降低免疫复合物的水平，但不降低IgA RF的水平，这表明检测到的IgA-CIC不代表未复合的伊加RF。与此相反，尽管31例DH患者中有12例（39%）的IgA-CIC的量范围为0.331-26.0 μg lgA/ml（nI <0.150 μg伊加/ml），但32例DH患者中只有1例（3%）的伊加RF可检测水平（7.0 μg伊加/ml，nI <2.0 μg伊加/ml）。8/32例（25%）DH患者IgM RF水平较低（1.1-1.6 μ gIgM/ml，nl < 1.0 μ gIgM/ml）。这些数据证明，伊加RF不存在于DH患者的血清中，与是否存在IgA-CIC无关，并且存在的IgA-CIC不太可能是伊加RF与自体IgG复合。
Thirty to forty percent of patients with dermatitis herpetiformis (DH) have IgA-containing circulating immune complexes (IgA-CIC); however, the antigenic composition of these complexes as well as the role they play in the pathogenesis of DH are unknown. The failure to detect wheat protein in these IgA-CIC, despite the association of DH with gluten-sensitive enteropathy, suggests that the IgA-CIC in DH may be similar to those seen in the IgA nephropathies and represent IgA rheumatoid factor (RF)- IgG complexes. We have examined the sera of 32 patients with DH, 16 non-DH patients positive for RF by latex fixation, and 15 normal subjects for IgA and 1gM RE using enzyme-linked immunosorbent assays (ELISAs) and for IgA-CIC using an anti-C3 ELISA. Thirteen of 16 (81%) latex fixation test-positive patients had IgA RF by ELISA and 15/16 (94%) had 1gM RF by ELISA. The total amount of RF detected by the ELISA (IgA + IgM RF) correlated with the latex fixation titer (r= 0.678,p= 0.004) in these latex fixation-positive patients. Six of the 16 (38%) latex fixation-positive patients also were found to have IgA- CIC. Solid phase absorption using goat antihuman C3 decreased the levels of immune complexes but not the level of lgA RF, suggesting the IgA-CIC detected do not represent uncomplexed IgA RF. In contrast, although 12 of 31(39%) patients with DH had IgA-CIC ranging in amount from 0.331-26.0 μg lgA/mI (nI <0.150 μg IgA/mI), only 1 of 32 (3%) DH patients had detectable levels of IgA RF (7.0 μg IgA/ml, nl <2.0 μg IgA/ml). Low levels of IgM RF were found in 8/32(25%) of patients with DH (1.1-1.6 μg IgM/ml, nl < 1.0 μg IgM/ml). These data document that IgA RF is not present in the sera of patients with DH independent of the presence or absence of IgA-CIC and that it is unlikely that the IgA-CIC present are IgA RF complexed with autologous IgG.