CAJ | 학술논문

抗SSA/Ro抗体的靶抗原SSA/Ro核蛋白由Ro蛋白和hYRNA两部分组成，其中Ro蛋白包括Ro60和Ro52两种类型，Ro60蛋白是由Heat重复区域和vWFA区域两结构域组成， Ro52蛋白则具有三结构域蛋白家族成员的结构特征。Ro60抗原与Ro52抗原均包含一系列抗原表位，并且可分别诱导产生针对这些抗原表位的抗体，这些表位抗体与不同的疾病及临床表现相关。抗SSA/Ro抗体可经胎盘由母亲传递至胎儿，导致胎儿心肌细胞炎症损伤或干扰钙离子通道功能从而产生胎儿或新生儿房室传导阻滞，此外QTc间期延长、窦性心动过缓等心律失常也有报道。曾经认为抗SSA/Ro抗体不会对成人心脏有影响，但最新的研究发现抗SSA/Ro抗体可通过抑制KCNH2离子通道功能干扰心肌细胞复极从而导致成人QTc间期延长，并不断有报道显示抗SSA/Ro抗体与成人房室传导阻滞相关。抗SSA/Ro抗体导致心律失常的确切机制目前仍未完全阐明，抗SSA/Ro表位抗体在心律失常中的分布仍不清楚，对抗 SSA/Ro 表位抗体与心律失常间关系的研究将具有重要的理论和临床实际意义。
항SSA/Ro항체적파항원SSA/Ro핵단백유Ro단백화hYRNA량부분조성，기중Ro단백포괄Ro60화Ro52량충류형，Ro60단백시유Heat중복구역화vWFA구역량결구역조성， Ro52단백칙구유삼결구역단백가족성원적결구특정。Ro60항원여Ro52항원균포함일계렬항원표위，병차가분별유도산생침대저사항원표위적항체，저사표위항체여불동적질병급림상표현상관。항SSA/Ro항체가경태반유모친전체지태인，도치태인심기세포염증손상혹간우개리자통도공능종이산생태인혹신생인방실전도조체，차외QTc간기연장、두성심동과완등심률실상야유보도。증경인위항SSA/Ro항체불회대성인심장유영향，단최신적연구발현항SSA/Ro항체가통과억제KCNH2리자통도공능간우심기세포복겁종이도치성인QTc간기연장，병불단유보도현시항SSA/Ro항체여성인방실전도조체상관。항SSA/Ro항체도치심률실상적학절궤제목전잉미완전천명，항SSA/Ro표위항체재심률실상중적분포잉불청초，대항 SSA/Ro 표위항체여심률실상간관계적연구장구유중요적이론화림상실제의의。
The ribonucleoprotein SSA/Ro, which is the target antigen of anti-SSA/Ro antibodies, is composed of Ro proteins and hYRNAs. Ro proteins include Ro60 protein and Ro52 protein, among which, Ro60 protein consists of HEAT repeats domain and vWFA domain while Ro52 protein has the structural characteristics of TRIM family members. Both the Ro60 and Ro52 antigens are composed of a series of epitopes, which have their own specific autoantibodies, and the autoantibodies to the different epitopes may be related with miscellaneous clinical manifestations of the autoimmune diseases. Anti-SSA/Ro antibodies could be passed from mother to fetus through placenta, and then lead to inflammatory damages in fetal cardiomyocytes or interfered with the function of calcium ion channels, and eventually results in fetal or neonatal atrioventricular block. Moreover, the other arrhythmia has also been reported, such as QTc interval prolongation and sinus bradycardia. Recent studies demonstrated that also adult heart, classically considered invulnerable to anti-SSA/Ro antibodies, could be affected. Anti-SSA/Ro antibodies have inhibitory effect on KCNH2 potassium channel and disturbed myocardial repolarization, and then result in QTc interval prolongation. Besides, it was reported constantly that anti-SSA/Ro antibodies might correlate with atrioventricular block in adult. However, the exact arrhythmogenic mechanisms have not been completely clarified as yet. It was not clear that how antibodies to the epitopes on SSA/Ro distributed in arrhythmia. The study would have important theoretical and clinical significance which revealed the relationships between auto-antibodies to the epitopes on SSA/Ro and arrhythmia.