Graves眼病患者血清抗眼肌膜抗体与TSH受体抗体的关系

Relationship between anti-eye muscle membrane antibody and TSH receptor antibody in serum from patient with Graves ophthalmopathy

目的 评价抗眼肌膜抗体和ＴＳＨ受体抗体（ＴＲＡｂ）在Ｇｒａｖｅｓ眼病（ＧＯ）免疫发病中的作用。方法 检测Ｇｒａｖｅｓ病伴ＧＯ或无ＧＯ患者及正常对照组血清抗眼肌膜抗体和ＴＲＡｂ，进行血清抑制试验。结果 ＧＯ组血清抗眼肌膜抗体检出率明显增高，ＴＲＡｂ 阳性的特异性不及抗眼肌膜抗体。血清抑制试验中抗眼肌膜抗体阳性血清不能阻断单克隆ＴＳＨ受体抗体（３Ｂ１２）与重组人ＴＳＨ受体（３Ａ１）或眼肌膜抗原的结合。结论 血清抗眼肌膜抗体和ＴＲＡｂ 在ＧＯ自身免疫发病中的作用可能是相互独立的。

Objective To evaluate the effects of anti eye muscle membrane antibody and TSH receptor antibody(TRAb) in the immune pathogenesis of Graves ophthalmopathy (GO).Methods Anti eye muscle membrane antibodies and TRAb were detected in sera from Graves hyperthyroid patients with GO(GO group)and without GO (non GO group),bing compared with normal control.Serum inhibition assay was carried out in these sera.Results Detectable anti 64 and 95 KDa antibodies in GO group was significantly higher than those in non GO group as well as normal controls ( P <0 05 or 0 01) .Positive rates of serum TRAb were similar between GO group and non GO group( P >0 05),whereas no positive TRAb could be found in normal controls.By serum inhibition assay,we found that no serum could block 3B12,a monoclonal TSH receptor antibody,binding to 3A1,a recombinant TSH receptor,or eye muscle membrane antigens.Conclusion There are specific antibodies that recognise eye muscle membrane antigens in the sera from patients with GO.Anti eye muscle membrane antibodies might be more sensitive than TRAb in evaluating autoimmune state of GO.These antibodies might be independent of TRAb in relevant to the pathogenesis of GO. [