Amylase alpha-2A autoantibodies: novel marker of autoimmune pancreatitis and fulminant type 1 diabetes.
Amylase alpha-2A autoantibodies: novel marker of autoimmune pancreatitis and fulminant type 1 diabetes.
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DOI：
10.2337/db08-0493
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发表时间：
2009-03
期刊：
影响因子：
7.7
通讯作者：
Kobayashi, Tetsuro
中科院分区：
文献类型：
--
作者：
Endo, Toyoshi;Takizawa, Soichi;Tanaka, Shoichiro;Takahashi, Masashi;Fujii, Hideki;Kamisawa, Terumi;Kobayashi, Tetsuro
目的：自身免疫性胰腺炎（AIP）和暴发性1型糖尿病的发病机制尚不清楚，尽管已知免疫介导的过程严重损害了这两种疾病的内分泌和外分泌功能。研究设计和方法：我们用一名AIP患者的血清筛选了一个λTriplEx2人胰腺cDNA文库，获得了阳性克隆。序列分析显示，10个克隆中有7个克隆与人类淀粉酶α-2A相同。利用重组cooh末端淀粉酶α-2A蛋白，建立了酶联免疫吸附检测系统，检测人淀粉酶α-2A自身抗体。结果：所有来自AIP患者的15份血清样本都识别出了重组蛋白，而来自25名慢性酒精性胰腺炎患者和25名胰腺肿瘤患者的血清样本没有识别出重组蛋白。有趣的是，88%（15/17）的暴发性1型糖尿病患者的淀粉酶α-2A自身抗体呈阳性。这些抗体在21%的急性发作型1型糖尿病患者（42例中有9例）和6%的2型糖尿病患者（67例中有4例）中检测到。结论-这些结果提示，针对淀粉酶α-2A的自身抗体是AIP和暴发性1型糖尿病的一种新的诊断标志物，并且在临床和免疫学上，AIP与暴发性1型糖尿病密切相关。
OBJECTIVE— The pathogenesis of autoimmune pancreatitis (AIP) and fulminant type 1 diabetes remains unclear, although it is known that immune-mediated processes severely compromise the endocrine and exocrine functions in both diseases. RESEARCH DESIGN AND METHODS— We have screened a λTriplEx2 human pancreas cDNA library with serum from a patient with AIP and obtained positive clones. Sequence analysis revealed that 7 of 10 clones were identical to human amylase α-2A. Using a recombinant COOH-terminal amylase α-2A protein, we developed an enzyme-linked immunosorbent assay system to detect autoantibodies against human amylase α-2A. RESULTS— All 15 serum samples from patients with AIP recognized the recombinant protein, whereas sera from 25 patients with chronic alcoholic pancreatitis and sera from 25 patients with a pancreas tumor did not. Interestingly, 88% (15/17) of patients with fulminant type 1 diabetes were positive for an autoantibody against amylase α-2A. These antibodies were detected in 21% of patients with acute-onset type 1 diabetes (9 of 42) and 6% of type 2 diabetic patients (4 of 67). CONCLUSIONS— These results suggest that an autoantibody against amylase α-2A is a novel diagnostic marker for both AIP and fulminant type 1 diabetes and that, clinically and immunologically, AIP and fulminant type 1 diabetes are closely related.
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