狼疮性肾炎中抗内皮细胞抗体和抗心磷脂抗体的关系

The relationship between antiendothelial cell antibodies and anticardiolipin antibodies

目的进一步探讨狼疮性肾炎(LN)中抗内皮细胞抗体(AECA)和抗心磷脂抗体(ACA)的关系。方法采用ELISA方法对58例LN患者血清进行了AECA和ACA检测,并应用免疫印迹方法对AECA的抗原进行分析。结果在狼疮性肾炎中AECA与ACA阳性率分别为36.2%和39.7%,在23例ACA阳性患者中,17例AECA阳性,而35例ACA阴性患者中只有4例AECA阳性,两者比较具有显著性差异(P<0.01),并且两组抗体具有一定的相关性。AECA和ACA阳性患者均有血小板减少倾向,血清IgG水平增高(P<0.05),C_3水平降低(P<0.05)及抗核抗体阳性率增高的特点。与内皮细胞分子量16 000和20 000以及同时与27 000,29 000抗原相结合的抗体常常存在于ACA阳性患者。结论 LN中AECA与ACA具有高度相关性,并且表现为相似的临床特征;AECA的某些抗原成分与ACA的某些抗原成分相同或并存,可能是这两组抗体密切相关的原因之一。

Objective To investigate the relationship between antiendothelial cell antibodies(AECA)and anticardiolipin antibodies(ACA)in patients with lupus nephritis. Methods 58 sera from patients with lupus nephritis were studied. ELISA technique were used to detect both AECA and ACA, and immunoblotting was performed to determine specific endothelial targets. Results The prevalence of IgG-AECA and IgG-ACA positive were 36.2% and 39.7% respectively in the patients with lupus nephritis. 17 out of 23 patients with ACA had higher titers of AECA, while only 4 out of 35 patients without ACA were AECA positive(P<0.01). Significantly higher incidences of thrombocytopenia, higher level of serum IgG, lower level of serum C_3, and higher prevalence of ANA, anti-dsDNA antibodies were found in lupus nephritis patients either with ACA of AECA positive. Antibodies against endothelial cell 16 000, 20 000 doublet and simultaneously against 27 000, 29 000 doublet had higher presence in ACA positive patients. Conclusion AECA was significantly elevated in patients with ACA positive lupus nephritis. The high prevalence of AECA in sera from patients with ACA may be in part related to the concomitant presence of antibodies against some specific endothelial cell antigens.