系列抗心肌多肽自身抗体对扩张型心肌病的诊断价值

Diagnostic value of serial autoantibodies against cardiac peptides in dilated cardiomyopathy

目的 :探讨抗人工合成多肽自身抗体在扩张型心肌病 ( DCM)诊断中的价值。方法 :根据计算机预测心肌 ADP/ ATP载体 ( ANT)、β1 受体、M2 受体和肌球蛋白重链 ( MHC)抗原决定簇的氨基酸序列并合成多肽片段 ,以此片段作为抗原 ,同时用天然抗原对比 ,以酶联免疫吸附方法检测 48例 DCM患者 ( DCM组 )和 48例健康献血员 (对照组 )血清中抗心肌多肽自身抗体。结果 :DCM组中抗 ANT抗体、抗 β1 受体抗体、抗 M2 受体抗体和抗MHC抗体阳性分别有 31、2 6、2 0和 2 3例 ,与对照组比较有显著性差异 ( P <0 .0 0 5 ) ,且与天然心肌抗原检测结果高度一致 ( P <0 .0 1)。结论 :人工合成多肽可代替天然心肌抗原用于检测抗心肌自身抗体 ,抗心肌多肽抗体检测可以作为

Objective:To investigate the diagnostic value of autoantibodies against cardiac peptides in dilated cardiomyopathy (DCM) by using antigens of synthetic peptides in the examination.Method:According to computer prediction,we synthesized peptides whose amino acid sequences were derived from determinants of cardiac antigens including the adenine nucleotide translocator (ANT),β 1adrenoceptor,M 2 muscarinic receptor and myosin heavy chain (MHC).Taking this synthetic peptides as antigens,autoantibodies were examined by an ELISA method in 48 patients with DCM and 48 healthy donors,and compared the results by using natural cardiac antigens.Result:Of 48 sera from patients with DCM,31( 64.6 %) bound to the peptides derived from ANT,23 ( 47.9 %) reacted with the sequence from myosin heavy chain, 26 ( 54.2 %) and 20 ( 41.7 %) were positive in reacting with peptides from β 1adrenoceptor and M 1 muscarinic receptor respectively.These results showed significant difference between these two groups.So the antigenicity of the selected determinants was confirmed,moreover,the results were approximatelly consistent with that of natural antigen.Conclusion:Synthetic peptides derived from determinants of cardiac antigens can substitute for natural antigens to screen autoantibodies.The examination of autoantibodies against cardiac peptides can be taken as the method of immunological diagnosis of DCM.