CAJ | 학술논문

目的初探血清抗神经节苷脂(GM1)抗体与系统性红斑狼疮(SLE)临床特征的相关性.方法采用改良酶联免疫双抗夹心(ELISA)法,对48例SLE患者血清中的抗GM1-IgM/IgG抗体和抗GQ1b-IgM/IgG抗体水平进行检测,同时检测10例类风湿关节炎(RA)、5例干燥综合征(SS)、1例混和性结缔组织病(MCTD)、1例多发性肌炎(PM)及97名健康对照(HC)的血清样品.对其中5例SLE患者随访3个月,比较前后血清抗体水平.48例SLE患者包括7例神经精神性SLE(NPSLE)与41例非神经精神性SLE(non-NPSLE)患者.以健康对照组99%参考值上限作为阳性界值,进行Fisher确切概率法x2检验、单因素方差分析、Dunnett t检验.结果首先确立了中国人血清抗GMI-IgM/IgG抗体与抗GQ1b-IgM/IgG抗体的阳性界值,取99%参考值上限,分别为0.411、0.408、0.481和0.441.SLE患者血清抗GM1-IgG抗体水平显著高于对照组(0.33±0.09与0.27±0.05,P<0.05),而血清抗GM1-IgM抗体、抗GQ1b-IgM抗体、抗GQ1b-IgG抗体水平在各组中差异无统计学意义(P>0.05).根据我们所建立的阳性界值,SLE患者血清抗GM1抗体阳性率为19%(抗GM1-IgM抗体为4%,抗GM1-IgG抗体为15%).血清抗GM1-IgM/IgG抗体、抗GQ1b-IgM/IgG抗体水平与SLE患者是否伴发神经精神性表现、抗dsDNA-IgG抗体阳性与否及治疗3个月前后SLE疾病活动指数均无明显关联(P>0.05).结论 SLE患者外周循环中存在对神经节苷脂GM1的免疫应答,并可能参与了SLE的发病过程.血清抗GM1抗体和抗GQ1b抗体水平和SLE临床特征无明显关联.
목적 초탐혈청항신경절감지(GM1)항체여계통성홍반랑창(SLE)림상특정적상관성.방법 채용개량매련면역쌍항협심(ELISA)법,대48례SLE환자혈청중적항GM1-IgM/IgG항체화항GQ1b-IgM/IgG항체수평진행검측,동시검측10례류풍습관절염(RA)、5례간조종합정(SS)、1례혼화성결체조직병(MCTD)、1례다발성기염(PM)급97명건강대조(HC)적혈청양품.대기중5례SLE환자수방3개월,비교전후혈청항체수평.48례SLE환자포괄7례신경정신성SLE(NPSLE)여41례비신경정신성SLE(non-NPSLE)환자.이건강대조조99%삼고치상한작위양성계치,진행Fisher학절개솔법x2검험、단인소방차분석、Dunnett t검험.결과 수선학립료중국인혈청항GMI-IgM/IgG항체여항GQ1b-IgM/IgG항체적양성계치,취99%삼고치상한,분별위0.411、0.408、0.481화0.441.SLE환자혈청항GM1-IgG항체수평현저고우대조조(0.33±0.09여0.27±0.05,P<0.05),이혈청항GM1-IgM항체、항GQ1b-IgM항체、항GQ1b-IgG항체수평재각조중차이무통계학의의(P>0.05).근거아문소건립적양성계치,SLE환자혈청항GM1항체양성솔위19%(항GM1-IgM항체위4%,항GM1-IgG항체위15%).혈청항GM1-IgM/IgG항체、항GQ1b-IgM/IgG항체수평여SLE환자시부반발신경정신성표현、항dsDNA-IgG항체양성여부급치료3개월전후SLE질병활동지수균무명현관련(P>0.05).결론 SLE환자외주순배중존재대신경절감지GM1적면역응답,병가능삼여료SLE적발병과정.혈청항GM1항체화항GQ1b항체수평화SLE림상특정무명현관련.
Objective To explore the correlation of anti-ganglioside antibodies with clinical features of systemic lupus erythematosus (SLE). Methods Samples of serum were collected from 48 patients with SLE. Three were male and 45 were female. Their average age was 33±12 (15～59). The serum anti-ganglioside antibodies of 10 patients with rheumatoid arthritis (RA), 4 with Sj(o)gren's syndrome (SS), 1 patient with mixed connective tissue disease (MCTD), 1 with polymyositis (PM), and 97 healthy controls(HC) were alsoexamined. Levels of anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies in the serum were examined by amodified ELISA. Anti-dsDNA-IgG antibody of SLE was tested according to the ELISA kit protocol. The associations of anti-GM1-IgM/IgG and anti-GQ1b-IgM/IgG antibodies with clinical features were analyzed. x2test, one-way ANOVA, Dunnett t-test were used for statistical analysis. Results By using modified ELISA,the upper limit of reference value of anti-GM1-IgM/IgG antibodies, anti -GQ1b-IgM/IgG antibodies in the serum of Chinese SLE patients were 0.411, 0.408, 0.481 and 0.441 res-pectively. 19% patients with SLE were sero-positive for anti-GM1 antibody, 4% for IgM antibody isotype and 15% for IgG antibody isotype. Anti-GM1-IgG antibody was significantly increased in the serum of patients with SLE (0.33±0.09), higher than that of the HC (0.27±0.05) (P<0.05), RA (0.29±0.08), SS(0.27±0.06), PM ( 0.288 ), but one of the MCTD( 0.423 ).There was no significant associations between anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies and NPSLE and anti-dsDNA-IgG antibody (P>0.05). Conclusion Peripheral autoimmune response against GM1 can be detected in SLE patients, and it may be involved in the pathogenesis of SLE. No association of antiGM1-IgM/IgG antibodies or anti-GQ1b-IgM/IgG antibodies with clinical features of SLE can be discovered.