重症肌无力患者血清中抗干扰素-α2抗体和抗干扰素-ω抗体的临床意义

Clinical significance of anti-interferon-α2 and anti-interferon-ωantibody in myasthenia gravis

目的检测重症肌无力(MG)患者血清抗干扰素(IFN)-α2自身抗体和抗IFN-ω自身抗体水平,探讨其临床意义。方法用基于125I标记的IFN-α2、-ω、乙酰胆碱受体(AChR)和肌肉特异性酪氨酸激酶(MuSK)的放射免疫沉淀法检测2013年就诊于天津医科大学总医院神经内科的50例重症肌无力患者外周血中抗IFN-α2、-ω、AChR和MuSK抗体。并对抗IFN-α2抗体与MG患者临床特征进行分析。结果11例(22%)MG患者外周血中抗IFN-α2抗体阳性,其中8例为胸腺相关型MG(TAMG),3例为晚发型MG(LOMG)。仅检测到1例MG患者血清中抗IFN-ω抗体阳性,此患者为76岁眼肌受累的LOMG患者,同时合并抗IFN-α2抗体阳性。不同亚型MG患者外周血中抗IFN-α2抗体水平并无显著差异。抗IFN-α2抗体阳性MG患者合并其他自身免疫性疾病风险小于该抗体阴性患者。TAMG中抗IFN-α2抗体水平与反映MG严重程度的QMG评分呈负相关(r=-0.762,P=0.028)。结论中国MG患者抗IFN-α2抗体阳性MG患者合并其他自身免疫性疾病风险小于该抗体阴性患者,TAMG中抗IFN-α2抗体水平越高,患者临床症状越轻。

Objective To measure the levels of anti-interferon(IFN)-α2 antibody(IFN-α2-Ab)and anti-IFN-ωantibody(IFN-ω-Ab)and investigate their potential roles in patients with myasthenia gravis(MG).Methods Radioimmunoprecipitationassay(RIPA)based on 125I-labelled IFN-α2,-ω,acetylcholine receptor(AChR)and muscle-specific kinase(MuSK)were used to detect anti-IFN-α2-Ab,anti-IFN-ω-Ab,anti-AChR-Ab and anti-MuSK-Ab respectively in MG patients from Tianjin Medical University General Hospital,during the year of 2013.Relationship between IFN-α2-Ab and clinical characteristics in patients with MG were analyzed.Results With the RIPA,anti-IFN-α2-Ab was positive in 11(22%)patients with MG,among whom,8 were thymoma associated MG(TAMG)and 3 were late onset MG(LOMG).The double positive one was among the LOMG who was a 76-year-old ocular MG patient.Serum anti-IFN-α2-Ab levels in different subgroups of MG had no significant difference(P>0.05).MG patients with anti-IFN-α2-Ab complicated with less other autoimmune disease.Serum anti-IFN-α2-Ab levels negatively correlated with QMG score in TAMG.Conclusions MG patients with anti-IFN-α2-Ab complicate with less other autoimmune disease.The higher serum IFN-α2-Ab levels in TAMG,the slighter symptoms present.