检测特异性抗体用于日本血吸虫病疗效考核的研究

STUDIES ON THE DETECTION OF SPECIFIC CIRCULATING ANTIBODIES AND ITS VALUE OF INDICATING THE EFFECT OF CHEMOTHERAPY IN SCHISTOSOMIASIS

为探讨特异性ＩｇＧ及其亚类对日本血吸虫病的疗效考核价值，用直接ＥＬＩＳＡ及间接ＥＬＩＳＡ 方法检测了２６４ 份治疗前和治疗后不同时间慢性血吸虫病病人以及５０ 份正常人血清中虫卵抗原（ＳＥＡ）和成虫抗原（ＡＷＡ）特异性ＩｇＧ、ＩｇＧ１ 和ＩｇＧ４。结果ＩｇＧＳＥＡ 及ＩｇＧ４ＳＥＡ在治疗后３ 个月出现有显著意义的下降且于治疗后１２ 个月降至正常；ＡＷＡ特异性抗体均于治疗后６ 个月才下降，其中仅ＩｇＧ４ＡＷＡ 于治疗后１２ 个月降至正常；ＩｇＧ４ＳＥＡ／ＡＷＡ 在治疗后１２ 个月时的阴转率最高（９７．７ ％） ，ＩｇＧＳＥＡ 次之（７５％ ）。表明治疗后ＳＥＡ 特异性ＩｇＧ 及ＩｇＧ４ 下降较ＡＷＡ特异性抗体快；ＩｇＧ４ 为一短期抗体，尤其ＩｇＧ４ＳＥＡ，可作为判断日本血吸虫病是否治愈的指标。

In order to understand the value of specific IgG and its subclasses in indicating treatment effect, we used both soluble egg antigens(SEA) and adult worm antigens(AWA) of Schistosoma japonicum to measure the specific IgG and IgG1/IgG4 in 264 serum samples of patients with schistosomiasis before and after chemotherapy by using ELISA. The control sera(50 samples) came from normal persons who did not live in endemic areas and were confirmed by negative stool examination. The result showed that the anti egg circulating antibodies(CAb) in sera of the patients infected with S. japonicum disappeared more quickly than anti adult worm antibodies after therapy. Anti SEA IgG and IgG4 both had significant decline in 3 months after treatment and became normal in 12 months after therapy. All of the anti adult worm antibodies didnt have a significant decline till 6 months after chemotherapy, and only anti AWA IgG4 fell to normal in 12 months after treatment. The negative conversion rates of anti SEA IgG4 and anti AWA IgG4 were the same and also the highest(97.7%) in 12 months after therapy. The negative conversion rate of anti SEA IgG was the second(75%). Both IgG and IgG4 anti SEA descended more quickly than antibodies adult worms. The specific IgG4 was a short duration antibody which was able to indicate the effect of treatment in schistosomiasis japonica especially anti SEA IgG4. Key words\ Schistosomiasis, short duration antibody, IgG subclass瑁? ｃｏｎｔｉｎｕｏｕｓ ｌｉｇｈｔ ｅｘｐｏｓｕｒｅ，ｔｈｅ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｉｎ ｒａｔ ｒｅｔｉｎａｓ ｄｒｏｐｐｅｄ ｄｒａｍａｔｉｃａｌｌｙ ｗｉｔｈｉｎ ｔｈｅ ｆｒｉｓｔ １ ｏｒ ２ ｄａｙｓ，ｔｈｅｎ ｃｈａｎｇｅｄ ｓｌｏｗｌｙ．Ｉｎ ｃｅｒｔａｉｎ ｐｅｒｉｏｄ ｏｆ ｔｉｍｅ，ｔｈｅ ｌｏｎｇｅｒ ｌｉｇｈｔ ｅｘｐｏｓｕｒｅ ｗａｓ ｒｅｃｅｉｖｅｄ，ｔｈｅ ｌｏｗｅｒ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｉｎ ｒａｔ ｒｅｔｉｎａｓ ｗｅｒｅ ｒｅｃｏｒｅｄｅｄ．Ａｓ ｔｈｅ ｔｉｍｅ ｏｆ ｒｅｃｏｖｅｒｙ ｉｎ ｄａｒｋ ｉｎｃｒｅａｓｅｄ，ｔｈｅ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｇｒａｄｕａｌｌｙ ｉｎｃｒｅａｓｅｄ，ａｎｄ ｆｏｌｌｏｗｅｄ ａ ｄｒｏｐ ｉｎ ａｂｏｕｔ ｏｎｅ ｗｅｅｋ，ｔｈｅｎ ｃｏｎｔｉｎｕｅｄ ｔｏ ｉｎｃｒｅａｓｅ．Ｔｈｅ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｉｎ ｒａｔ ｒｅｔｉｎａｓ ｇｒｅａｔｌｙ ｄｅｃｒｅａｓｅｄ ａｆｔｅｒ ｃｏｎｔｉｎｕｏｕｓ ｅｘｐｏｓｕｒｅ ｔｏ ｌｉｇｈｔ，ａｎｄ ｔｈｅ ｔｉｍｅ ｏｆ ｌｉｇｈｔ ｅｘｐｏｓｕｒｅ ｃｌｏｓｅｌｙ ｃｏｒｒｅｌａｔｅｄ ｗｉｔｈ ｔｈｅ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｉｎ ｃｅｒｔａｉｎ ｐｅｒｉｏｄｅ ｏｆ ｔｉｍｅ．Ｉｔ ｉｓ ａ ｇｏｏｄ ｗａｙ ｔｏ ａｎａｌｙｚｅ ｔｈｅ ｒｈｏｄｏｐｓｉｎ ｌｅｖｅｌｓ ｉｎ ｒａｔ ｒｅｔｉｎａｓ ｓｉｍｐｌｙ ｂｙ ｓｐｅｃｔｒｏｐｈｏｔｏｍｅｔｅｒｙ．