抗α-胞衬蛋白多肽抗体在干燥综合征诊断中的意义

Significance of antibody against α-fodrin-derived polypeptide in diagnosis of Sjgren′s syndrome

目的 α 胞衬蛋白是干燥综合征 (SS)患者涎腺中的一种较特异的自身抗原。本研究利用合成的α 胞衬蛋白多肽 ,通过酶联免疫吸附 (ELISA)法检测患者血清中α 胞衬蛋白多肽抗体 ,以了解该多肽抗体在SS诊断中的意义。方法 ①固相法合成α 胞衬蛋白多肽 ;②以α 胞衬蛋白多肽作为包被抗原 ,应用ELISA分别检测原发性SS患者 74例 ,继发性SS患者 15例 ,系统性红斑狼疮(SLE)患者 4 1例 ,类风湿关节炎 (RA)患者 4 4例和正常人 5 9名血清中抗α 胞衬蛋白多肽抗体。结果 α 胞衬蛋白多肽抗体在原发性SS、继发性SS的阳性率分别为 73%和 4 0 % ,而在SLE、RA及正常人分别为 19 5 %、2 9 5 %和 3 8%。抗α 胞衬蛋白多肽抗体对原发性SS诊断的敏感性为 73% ,特异性为 88 7%。α 胞衬蛋白多肽抗体在原发性SS患者中的阳性率 (73% )明显高于继发性SS、SLE、RA患者及正常人 (P <0 0 1)。与正常人相比 ,SLE及RA患者的α 胞衬蛋白多肽抗体的阳性率亦明显升高(P <0 0 5 ) ,但在SLE与RA之间差异无显著性 (P >0 0 5 )。α 胞衬蛋白多肽抗体可能与SS患者的病情程度及预后有关。结论 ①抗α 胞衬蛋白多肽抗体对原发性干燥综合征的诊断具有参考意义 ,是与SS的病变过程有关的主要自身抗体之一。②α 胞衬蛋白多肽抗体与SS患者的?

Objective To investigate the sensitivity and specificity of anti α fodrin polypeptide antibody in Sjgren′s syndrome (SS) patients.Methods Synthesized α fodrin polypeptide was used as substrate in enzyme linked immunosorbent assay (ELISA) to detect the specific antibody in sera of SS and other rheumatic diseases.Results Antibody against α fodrin polypeptide were detected in 73% of patients with primary SS,40% of patients with secondary SS,19 5% of patients with SLE,29 5% of patients with RA,and 3 8% of normal blood donors.The positive rates of α fodrin polypeptide antibody in primary and secondary SS (73% and 40%,respectively) were significantly higer than those in SLE,RA and normal controls ( P <0 05).The sensitivity of anti α fodrin polypeptide antibody was 73% and the specificity was 88 7% in primary SS.The presence of anti α fodrin polypeptide antibody was associated with extraglandular manifestations,such as pulmonary fibrosis,cirrhosis of liver,spleen disorder,renal failure and vasculitis.Conclusion ① The α fodrin polypeptide antibody is likely to be a diagnostic marker in primary SS.② This novel autoantibody is associated with extraglandular manifestations in patients with primary SS.③ The α fodrin polypeptide protein may be an autoantigen involved in T and B cell activation leading to immune responses in SS.