SLE和CTD针对髓鞘素的B细胞免疫应答

Anti CNS Myelin Component Antibody Secreting Cells in Patients with Systemic Lupus Erythematosus and other Connective Tissue Diseases

用酶联免疫斑点法（Ｅｌｉｓｐｏｔ）分别检测了２３例系统性红斑狼疮（ＳＬＥ），１８例其他结缔组织病（ＣＴＤ）患者和１９例健康对照组的外周血（ＰＢ）中神经髓鞘素、髓鞘素碱性蛋白（ＭＢＰ）和含脂质蛋白（ＰＬＰ）特异性抗体分泌细胞和ＩｇＧ、ＩｇＡ和ＩｇＭ非特异性抗体分泌细胞。结果发现ＳＬＥ和其他ＣＴＤ患者的３种特异性抗体分泌细胞均呈增高趋势，与健康对照组有非常显著的差异，ＳＬＥ患者尤为明显。临床不伴有中枢神经系统（ＣＮＳ）损害的ＳＬＥ和其他ＣＴＤ患者，也可出现ＭＢＰ和ＰＬＰ抗体分泌细胞增高，说明可能存在对ＣＮＳ髓鞘素组分的Ｂ细胞自身免疫攻击，可作为ＣＮＳ损伤的指征和神经精神性狼疮（ＮＰ－ＳＬＥ）的预报手段之一。

By enumerating cells in peripheral blood secreting IgG antibodies of paticular specificities,i.e.of CNS myelin,myelin basic protein (MBP) and myelin proteolipid protein (PLP) and cells secreting non specific antibodies of IgG,IgA and IgM isotype from 23 patients with systemic lupus erythematosus (SLE) and 18 patients with other connective tissue diseases (CTD) as well as 19 healthy control subjects.Compared to controls,the patients with SLE and the patients with CTD had elevated numbers of B cells secreting specific IgG antibodies to myelin,MBP and PLP of B cells secreting non specific IgG antibody.It reveals that an increased B cell immune responses to CNS myelin components occur in both patients` groups and paticularly in patients with SLE.5 patients out of 23 SLE patients were diagnosed neurological and psychiatric SLE (NP SLE),but EEG abnormalities and elevated numbers of anti myelin,MBP and PLP antibody secreting cells were found in 10 SLE patients and between 11 and 13 SLE patients,respectively. Therefore, these anti CNS myelin component antibody secreting cells could most probably become an useful method for demonstrating CNS damage in patients with SLE and for prognosing NP SLE,but the clinical significance of the myelin component antibody secreting cells in patients with CTD should be evaluated after a long period of time observation for the patients.