乙型肝炎IgM和IgG-补体双特异性循环免疫复合物的意义

SIGNIFICANCE OF Ig (IgM AND IgG) AND C 3 COMPONENT-DETERMINED CIRCULATING IMMUNE COMPLEXES IN HBV INFECTED PATIENTS

对不同临床类型的乙型肝炎患者，采用捕捉法ＥＬＩＳＡ，以ＩｇＭ和ＩｇＧ类抗体排除抗原性异物的免疫反应进行比较研究。结果发现，两种反应能力在慢性ＨＢＶ感染中基本相同，表现出明显的病型差异，而在急性ＨＢＶ感染中则不同，前者反应强度显著高于后者；二者阳性率在慢性ＨＢＶ感染的临床类型中虽均随其肝损害加重而显著上升，但ＩｇＧ／Ｃ３双特异性循环免疫复合物（ＴＣＩＣ）与ＡＬＴ有关，而ＩｇＭ／Ｃ３－ＴＣＩＣ与ＡＬＴ无关；二者阳性率与Ｃ４的关系亦不同。这些结果提示，ＩｇＭ和ＩｇＧ／补体－ＴＣＩＣ的病理意义不同，免疫复合物的异质性值得注意。

By a capture-ELISA method,the immune responses of IgM and IgG classes to the clearness of antigens in the form of immune complex had been comparatively determined by the detection of IgM/C3-TCIC (two-component-determined circulating immune complexes,TCIC) and IgG/C 3-TCIC in different clinical types of hepatitis B virus (HBV) infections including 41 asymptomatic HBsAg carriers,55 acute hepatitis B,54 chronic persistent hepatitis B.55 chronic activ ehepatitis B,18 hepatic failure of hepatitis B and 52 cirrhosis after hepatitis B.We interestingly found although the two forms were similar in chronic HBV infections with the significant differences among their clinical types,both were different in acute HBV infection with the significantly higher positive rates of IgM/C 3-TCIC over those of IgG/C 3-TCIC.Our data also showed that the relationships of ALT with the positive rates revealed IgG/C 3-TCIC played an important role in liver damage but IgM/C 3-TCIC did not,both positive rates were positively associated with the degree of damaged liver of different clinical types of chronic HBV infections.Furthermore,IgG/C 3-TCIC related to serum C 4 but IgM/C 3-TCIC did not.These findings suggest that the significances of both IgM/C 3-TCIC and IgG/C 3-TCIC are not the same in pathology and physiology,which reminds us of paying attention to the study of heterologous immune complexes.