甲型肝炎的免疫球蛋白－补体循环免疫复合物

CIRCULATING IMMUNOGLOBULIN CLASS-SPECIFIC IMMUNE COMPLEXES ACTIVATING COMPLEMENT IN PATIENTS WITH HEPATITIS A VIRUS INFECTION

采用捕捉法－ＥＬＩＳＡ检测１１５例甲型肝炎患者的ＩｇＭ、ＩｇＧ和ＩｇＡ特异性激活补体类循环免疫复合物（ＩｇＭ／Ｃ３－ＣＩＣ、ＩｇＧ／Ｃ３－ＣＩＣ和ＩｇＡ／Ｃ３－ＣＩＣ），其阳性率依次为４７．８％、５６．５％和４７．８％。分别与患者的性别、年龄、病程、丙氨酸转氨酶（ＡＬＴ）、黄疸指数（ＢＴ）、免疫球蛋白（Ｉｇ）和补体作比较后发现，ＩｇＭ／Ｃ３－ＣＩＣ与这些指标均无相关性；ＩｇＧ／Ｃ３－ＣＩＣ与ＡＬＴ、ＢＴ和ＩｇＡ有关，ＩｇＡ／Ｃ３－ＣＩＣ与病程、ＡＬＴ、ＢＴ和ＩｇＡ有关。结果提示，不同免疫球蛋白类型的激活补体类ＣＩＣ在甲型肝炎中的病理生理意义不同，其中ＩｇＧ和ＩｇＡ／Ｃ３－ＣＩＣ可能参与肝损害过程。甲型肝炎具有一定程度的免疫应答紊乱。

he levels of circulating IgM-specific、IgG-specific and IgA-specific 、immunecomplexes activating complement (IgM、IgG and Ig/C3-CIC)of 115 hepatitis A virus mfected patients were determined by a capturc-ELISA with sheep anti- human C3 as the capturing antibody and sheep anti-human IgM ,IgG and AIgA as the detecting ones.Their positive rates were 47.8% 56.5%and 47.8%,respectively ,showing no singificant differences in each other.Although the positive rates of IgM/C3-CIC were not related to patients’age ,sex,duration of the disease, ALT, BT,Ig and complement, the positive rates of IgG/C3-CIC were significantly higher in the goups with abnormal ALT, normal BT and increased IgA than those in patients with normal ALT , abnormal BT and normal IgA,respectively .The positive rates of IgA /C3 -CIC were significantly higher in patients with disease duration ≤20 days, abnormal ALT,BT and IgA than those in patients with disease duration >20 days ,normal ALT ,BTand IgA ,respectively .It is suggested that among the immunogolbulin class-specific immune complexes activating complement,there exists different sigificance in pathology and physiology in which IgG and IgA /C3 -CICmay be involved in the process of liver injury .It is also thought that hepatitis A may be ,in some extent ,regarded as a disease of disordered immune response.