Development of ultra-sensitive enzyme immunoassay for anti-acetylcholine receptor autoantibody

本文报道了一种新型的超灵敏酶免疫分析法对重症肌无力（MG）的病理生物化学研究。研究结果如下：1.建立了以乙酰胆碱受体α亚基胞外区序列对应的13种合成肽段为抗原的超灵敏酶免疫分析法（免疫复合物转移酶免疫分析）.本方法不仅能够明确诊断全身型MG，而且能够明确诊断眼型MG（灵敏度=94%）.在全身型MG患者中，本方法能够证实术前胸腺切除术的有效性（敏感性= 64%，特异性=90%），并且抗体滴度与HLA基因型（DOB 1 ^**>0302、^**>0303和^**>5031）相关。在眼MG患者中，II类HLA基因型（DQB 1 ^**>03.）结果提示，全身型MG和眼型MG的发病分别与体液免疫和细胞免疫有关。

The pathobiochemical studies on myasthenia gravis (MG) by using a novel ultra-sensitive enzyme immunoassay is described. The results from this study is as follows.1. Ultra-sensitive enzyme immunoassay (immune complex transfer enzyme immunoassay) using thirteen synthetic peptides, which corresponded to the sequence of the extra cellular domain of the acetylcholine receptor alpha-subunit, as antigens has been developed.2. The present method has enabled to definitively diagnose not only the generalized MG but also ocular MG (sensitivity=94%).3. In generalized MG patients, the present method has enabled to prognosticate the effectiveness of thymectomy before operation (sensitivity=64%, and specificity=90%) and the antibody titer has correlated with HLA genotype (DOB1^<**>0302, ^<**>0303 and ^<**>5031).4. In ocular MG patients, the class-II HLA genotype (DQB1^<**>03.) and class-I HLA (HLA-B) have correlated with effectiveness of the thymectomy.These results suggested that the pathogenicity of the generalized MG and ocular MG were related to humoral immune response and cellular immune response, respectively.