摘要
目的:建立抗水通道蛋白4(AQ-4)抗体的检测方法,评估抗AQ-4抗体在神经精神狼疮(NPSLE)中的临床意义。方法:用3段AQ-4细胞外肽段包板,建立基于肽抗原的间接酶联免疫吸附(ELISA)检测方法,检测49例健康人、54例其他风湿病患者(32例多肌炎/皮肌炎,10例干燥综合征和12例类风湿关节炎患者)、105例系统性红斑狼疮(SLE)患者和103例NPSLE患者的血清中的抗AQ-4抗体;检测22例非风湿病患者、31例SLE患者、96例NPSLE、27例合并结核感染的SLE患者和8例隐球菌脑膜炎患者的脑脊液标本中抗AQ-4抗体。结果:以健康人(对照组)的平均光密度(OD)+3标准差(SD)为临界值,血清标本阳性率在其他风湿病组为1.8%(1/54);SLE组为14.3%(15/105);NPSLE组为22.3%(23/103)。脑脊液标本阳性率在对照组为0%;SLE组为12.9%(4/31);NPSLE组为29.2%(28/96);SLE合并结核性脑膜炎者为37%(10/27);SLE合并隐球菌脑膜炎者为0%(0/8)。SLE组合并NPSLE组患者的血清和脑脊液中的抗AQ-4抗体显著增加(P<0.01),SLE组血清和脑脊液中的抗AQ-4抗体水平相似(P>0.05)。NPSLE组脑脊液中的抗体检出率(29.2%)较血清中抗体检出率(22.3%)增高(P<0.01)。在SLE合并TB组的脑脊液中,抗AQ-4抗体的检出显著增高(P<0.01)。结论:抗AQ-4抗体在SLE和NPSLE患者的血清和脑脊液中显著升高,尤其是脑脊液中。SLE合并结核性脑膜炎患者的抗AQ-4抗体显著升高,提示抗AQ-4抗体是狼疮合并结核性脑病的易患因素。
Objective:To establish the method of testing anti-aquaporin 4(AQ-4) antibodies and evaluate the clinical significances of anti-AQ-4 antibodies in NPSLE.Methods: Three peptides from the extracellular domain of AQ-4 protein were synthesized and coated as antigen.The IgG type anti-AQ-4 antibodies were assayed in the sera of 49 healthy controls,54 patients with other rheumatic diseases,105 patients with systemic lupus erythematosus(SLE),103 patients with neuropsychiatric SLE,and in cerebral spine fluid samples of 22 patients without rheumatic disease,31 patients with SLE,96 patients with NPSLE and 27 SLE patients with tuberculous meningitis,and 8 SLE patients with cryptococcal meningitis.Results: The cutoff values were determined by the average optical density of control group plus 3 standard deviations.In sera samples,there were only 1.8%(1/54)positive in healthy controls,14.3%(15/105) in SLE group,22.3%(23/103) in NPSLE group.In CSF samples,there were 0% in control group,12.9%(4/31) in SLE group,29.2%(28/96) in NPSLE group,37%(10/27)in SLE patients with tuberculous meningitis,0%(0/8)in SLE patients with crypoccoccal meningitis.In either sera samples or CSF samples,the positive rate of anti-AQ-4 antibodies was significant higher in NPSLE than that of in SLE patients(P0.01).The anti-AQ-4 antibodies in CSF samples(29.2%)were significant higher than that of in sera samples(22.3%)(P0.01)in NPSLE patients,but there was no difference in SLE group(P0.05).In the CSF samples,the level of anti-AQ-4 antibodies in SLE patients with tuberculous meningitis than that of in other groups(P0.01).Conclusions: Anti-AQ-4 antibodies were significant higher in sera and CSF of NPSLE patients,especial in CSF,and the relative higher positive rate of anti-AQ-4 antibodies in SLE patients with tuberculous meningitis suggested that anti-AQ4 antibodies may increase the infection chances in SLE patients.
出处
《中国临床医学》
2010年第4期601-603,共3页
Chinese Journal of Clinical Medicine
关键词
抗体
系统性红斑狼疮
抗原
Antibodies
Systemic lupu erythematosus
Antigen