自身免疫性甲状腺炎血清蛋白质二硫化物异构酶A3抗体的表达

Expression of Anti-Protein Disulfide Isomerase A3 Antibodies in Patients with Autoimmune Thyroiditis

目的探讨自身免疫性甲状腺炎(AIT)患者血清蛋白质二硫化物异构酶A3抗体(PDIA3Ab)的表达,并对该抗体总IgG及各亚型与甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)及甲状腺功能(甲功)进行相关性分析。方法用ELISA法检测AIT与非AIT患者血清PDIA3Ab总IgG及各亚型滴度,电化学发光法检测TPOAb、TgAb及甲功。结果与非AIT患者相比,AIT患者血清PDIA3Ab总IgG、IgG1、IgG3滴度均显著增加(P <0.05),AIT甲功正常组与AIT甲减组血清PDIA3Ab总IgG及各亚型滴度无显著差异(P> 0.05),AIT甲减组血清PDIA3Ab IgG1亚型滴度与TgAb呈负相关(r=-0.679,P <0.05),排除TPOAb、TgAb对甲功的影响后,与促甲状腺激素(TSH)呈正相关(r=0.550,P <0.05)。AIT患者血清PDIA3Ab总IgG、IgG3亚型滴度与TPOAb、TgAb、甲功均无关(P> 0.05)。结论除甲状腺过氧化物酶(TPO)、甲状腺球蛋白(Tg)之外,PDIA3可能是AIT的一种非经典自身抗原,发挥甲状腺腺外损伤作用。

Objective To evaluate the expression of the total serum IgG and IgG subclasses of anti-PDIA3 antibody( PDIA3Ab) in patients with autoimmune thyroiditis( AIT) and discuss its association with thyroid peroxidase antibody( TPOAb),thyroglobulin antibody (TgAb),and thyroid function. Methods The PDIA3Ab total serum IgG and IgG subtype levels were detected by ELISA and thyrotrophin (TSH),free triiodothyronine( FT3),free thyroxine( FT4),TPOAb,and TgAb serum levels were detected by electrochemiluminescence immunoassays. Results Levels of PDIA3Ab total serum IgG,IgG1,and IgG3 in patients in the AIT group were significantly higher than those in the non-AIT group( P < 0.05). There were no significant differences in PDIA3Ab total IgG and IgG subtype levels in the AIT with euthyroidism group and hypothyroidism group( P > 0.05). In the AIT with hypothyroidism group,PDIA3Ab IgG1 subtype serum level was negatively correlated with that of TgAb( r =-0.679,P < 0.05),and positively correlated with that of TSH while controlling the variables of TPOAb and TgAb( r = 0.550,P < 0.05). No significant correlation was found among PDIA3Ab total IgG and IgG3 subclass,TPOAb, TgAb,TSH,FT3,and FT4 in AIT (P > 0.05). Conclusion Apart from thyroid peroxidase and thyroglobulin,PDIA3 may be a non-classical autoantigen of AIT and may play an important role in thyroid-related injury.