Studies of anti-FcepsilonRI autoantibodies in non-remitting allergic diseases.

为分析与I型变态反应相关疾病的组胺释放自身抗体，对134例慢性荨麻疹、43例变应性鼻炎、70例特应性皮炎患者和114例健康人进行了自体血清皮肤试验。阳性56例(42.4%)，0例(0%)，3例(4.3%)，2例(2.6%)。特应性皮炎患者和荨麻疹患者的血清组胺浓度均高于健康对照组，而特应性皮炎患者的细胞组胺含量高于健康对照组。这些结果提示，特应性皮炎患者的组胺释放自身抗体具有疾病特异性，细胞和血清组胺总量增加。我们采用双扩散血浆分离术治疗重度慢性荨麻疹，取得了较好的效果。用健康志愿者的嗜碱性粒细胞进行组胺释放试验表明，在自身血清皮试阳性的患者中，约70.4%的患者血清具有明显的组胺释放活性，其中抗FcepsilonRI型优于抗IgE型。为了建立一种简便的检测自身抗体的方法，我们将人胞外区和大鼠胞膜内区受体的嵌合FcepsilonRI导入大鼠肥大细胞系(RBL-3D4)。该细胞系稳定表达人FcepsilonRIα亚单位胞外区，并对抗FcepsilonRI单抗或慢性荨麻疹患者的反应脱颗粒。对荨麻疹血清的初步筛选表明，该细胞系具有特异性，比人类嗜碱性粒细胞更易于使用，但敏感度较低。如何将该细胞应用于自身抗体的研究和敏感性的提高，是今后研究的课题。

In order to analyze histamine releasing autoantibodies in diseases associated with type I allergy performed skin test by autologous sera for patients with chronic urticaria (134), allergic rhinitis (43) atopic dermatitis (70) and healthy controls (114). Fifty-six(42.4%), 0(0%), 3(4.3%) and 2(2.6%) of them showed positive reactions. Serum histamine concentrations of patients with urticaria and those atopic dermatitis were higher than those of healthy controls, but cellular histamine contents were I in patients with urticaria and higher in patients with atopic dermatitis than healthy controls. These results suggested disease specificity of the histamine releasing autoantibodies for urticana and increase of the total amount of cellular and serum histamine in patient with atopic dermatitis. We treated patient with sever chronic urticaria by double diffusion plasmapheresis with reasonable effects. Histamine release test with basophils derived from a healthy volunteer showed sera of approximately 70.4% of the patients with positive skin test by their autologous sera showed apparent histamine releasing activities with predominance of anti-FcepsilonRI type over anti-IgE type activities. In order develop a convenient method for the detection of the autoantibodies, we introduced chimeric FcepsilonRI consisting of human extracellular domain and rat trausmembrane and intracellular domains o receptor into a rat mast cell line (RBL-3D4). The cell line stably expresses the extracellular domain c human FcepsilonRI alpha-subunit and degranulated in response to either anti-FcepsilonRI monoclonal antibody or of patients with chronic urticaria. A pilot screening of the sera of urticaria suggested the cell line is : specific and easy to use than human basophils, but less sensitive. The way of application of this cel for studies of the autoantibodies and the improvement of the sensitivity is a subject for future investigations.