多抗原组合筛查试剂筛查自身免疫性肝病的临床意义

孙丽梅; 赵艳明; 王一鹏; 赵丹彤; 张海萍; 李卓敏; 王熠; 马胤雪; 闫惠平; 刘燕敏

doi:10.3969/j.issn.1001-5256.2014.05.005

多抗原组合筛查试剂筛查自身免疫性肝病的临床意义

DOI: 10.3969/j.issn.1001-5256.2014.05.005

1. 首都医科大学附属北京佑安医院感染与免疫研究中心
2. 首都医科大学附属北京佑安医院临床检验中心
3. 首都医科大学附属北京佑安医院肝病免疫科

基金项目:

首都特色临床发展基金资助项目(2011-2018-05)；吴阶平医学基金肝病医学部肝病实验诊断研究基金(LDWMF-SY-2011B011)；

详细信息

中图分类号: R575.22
计量
- 文章访问数: 2954
- HTML全文浏览量: 26
- PDF下载量: 627
- 被引次数: 0
出版历程
- 出版日期: 2014-05-20

Analysis of clinical significance of combined antigen screening reagents for autoimmune liver disease

Research funding:

摘要

摘要:
目的探讨自身免疫性肝病多抗原组合筛查试剂的临床意义。方法选择2011年9月至2012年9月在首都医科大学附属北京佑安医院就诊的肝病患者140例,健康献血员30例,PBC患者家属8例。分别应用筛查试剂（ELISA）法（以AMA-M2、sp100、gp210、LKM-1、SLA/LP为混合靶抗原）、常规检测项目包括间接免疫荧光法（IFA）、免疫印迹法（IBT）、AMA-M2 ELISA法检测178例血清样本。组间比较采用χ2检验。结果 178例样本,应用筛查试剂检测阳性70例（50%）,强阳性49例。70例阳性样本采用常规试剂进一步检测自身抗体,IFA检测抗核抗体（ANA）阳性61例,AMA阳性63例。其中61例ANA阳性样本中21例荧光核型为核膜型,但IBT检测抗gp210抗体16例为阳性,5例为阴性。63例AMA阳性样本,应用AMA-M2 ELISA法检测AMA-M2 60例为阳性,3例为阴性。49例强阳性样本应用常规检测,其中抗gp210抗体单独阳性2例、抗sp100抗体单独阳性5例、AMA-M2单独阳性20例、抗gp210抗体和AMA-M2同时阳性12例、抗sp100抗体和AMA-...
- 肝硬化,胆汁性 /
- 肝炎,自身免疫性 /
- 酶联免疫吸附测定
Abstract:
Objective To investigate the clinical significance of combined antigen screening reagents for autoimmune liver disease ( AILD) . Methods A total of 140 patients with liver diseases who visited the Beijing You'an Hospital affiliated to Capital Medical University from September 2011 to September 2012, as well as 30 healthy blood donors and 8 relatives of patients with primary biliary cirrhosis ( PBC) , were included in the study. The serum samples from the 178 subjects were tested by enzyme- linked immunosorbent assay ( ELISA) for detection of AMA- M2, anti- sp100 antibodies, anti- gp210 antibodies, anti- LKM- 1 antibodies, and anti- SLA / LP antibodies, as well as indirect immunofluorescence assay ( IFA) for autoantibodies, immunoblotting ( IB) for antibody profiles, and AMA- M2 ELISA. Results Of the 140 patients tested by screening reagents, 70 ( 50%) had positive results, and 49 of them had strong positive results. Of the 70 positive cases, 61 were positive for ANA and 63 were positive for AMA, as shown by IFA; 21 of the 61 ANA- positive cases had a rim pattern of staining. The IB showed that 16 cases were positive for anti- gp210 antibodies, and 5 cases were negative. The AMA- M2 ELISA showed that 60 of the 63 AMA- positive cases were positive for AMA- M2. Of the 49 strong positive cases, 2 were positive for anti- gp210 antibodies, 5 for anti- sp100 antibodies, 20 for AMA- M2, 12 for both anti- gp210 antibodies and AMA- M2, and 10 for both anti- sp100 antibodies and AMA- M2, as shown by conventional tests. Among the 178 subjects, all the 65 PBC patients were positive for PBC- related antibodies by conventional tests, while 63 of these PBC cases had positive results using the screening reagents, with a coincidence rate of 96. 9% ( 63 /65) ; the number of positive cases detected using conventional reagents was insignificantly higher that determined by screening reagents ( χ2= 0. 016, P > 0. 05) . Four cases tested positive for autoantibodies using screening reagents, but had negative results using conventional reagents. Conclusion The combined antigen screening reagents for AILD have the advantages of high sensitivity, high specificity, easy operation, high efficiency, and low cost, and they can be used in the preliminary screening for AILD.
- liver cirrhosis, biliary /
- hepatitis, autoimmune /
- enzyme-linked immunosorbent assay

HTML全文

参考文献(15)

[1] LINDOR KD, GERSHWIN ME, POUPONR, et al.Primary biliary cirrhosis[J].Hepatology, 2009, 50 (1) :291-308.

[2] MANNS MP, CZAJA AJ, GORHAM JD, et al.Diagnosis and management of autoimmune hepatitis[J].Hepatology, 2010, 51 (6) :2193-2213.

[3] Chinese Society of Hepatology, Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline for prevention and treatment of chronic hepatitis B[J].J Clin Hepatol, 2011, 27 (1) :Ⅰ-ⅩⅥ. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南[J].临床肝胆病杂志, 2011, 27 (1) :Ⅰ-ⅩⅥ.

[4]Chinese Society of Hepatology and Chinese Society of Infectious Diseases and Parasitology, Chinese Medical Association.Guidelines for prevention and treatment of hepatitis C[J].J Clin Hepatol, 2004, 12 (4) :197-203. (in Chinese) 中华医学会肝病学分会、传染病与寄生虫病学分会.丙型肝炎防治指南[J].临床肝胆病杂志, 2004, 12 (4) :197-203.

[5]HOOFNAGLE JH.Drug-induced liver injury network (DILIN) [J].Hepatology, 2004, 40 (4) :773.

[6]ACHENZA MI, MEDA F, BRUNETTA E, et al.Serum autoantibodies for the diagnosis and management of autoimmune liver diseases[J].Expert Rev Gastroenterol Hepatol, 2012, 6 (6) :717-729.

[7]BOGDNAOS DP, INVEMIZZI P, MACKAY IR, et al.Autoimmune liver serology:current diagnostic and clinical challenges[J].World J Gastroenterol, 2008, 14 (21) :3374-3387.

[8]YAN HP.Detection of autoantibodies and standardization of result report[J].J Clin Hepatol, 2011, 27 (6) :595-597. (in Chinese) 闫惠平.自身免疫性肝病的自身抗体检测及报告规范[J].临床肝胆病杂志, 2011, 27 (6) :595-597.

[9]INVEMIZZI P, SELMI C, RANFTLER C, et al.Antinuclear antibodies in primary biliary cirrhosis[J].Semin Liver Dis, 2005, 25 (3) :298-310.

[10]LI YZ, LIU L, SUN GQ, et al.Diagnostic values of cloning and expression of nuclear envelope protein autoantigens gp210, p62, and LBR and their antibodies for primary biliary cirrhosis[J].Chin J Lab Med, 2005, 28 (11) :1120-1125. (in Chinese) 李永哲, 刘镭, 孙国庆, 等.核包膜蛋白gp210、p62和LBR自身抗原基因克隆表达及其抗体在原发性胆汁性肝硬化中的诊断价值[J].中华检验医学杂志, 2005, 28 (11) :1120-1125.

[11] ZHANG FC, XU D, LIU W.Study of the relations between primary biliary cirrhosis and anti-gp210 and anti-spl00 antibody[J].Chin J Rheumatol, 2009, 13 (12) :808-811. (in Chinese) 张奉春, 徐东, 刘炜.抗gp210抗spl00抗体与原发性胆汁性肝硬化活动性的相关性[J].中国风湿病杂志, 2009, 13 (12) :808-811.

[12]WORMAN HJ.Nuclear envelope protein autoantigens in primary biliary cirrhosis[J].Hepatol Res, 2007, 37 (Suppl 3) :s406-s411.

[13]JURAN BD, LAZARIDIS KN.Update on the genetics and genomics of PBC[J].J Autoimmune, 2010, 35 (3) :181-187.

[14]ZHANG SL, ZHAO JW, SUN ZQ, et al.Development and evaluation of a novel multiple-antigen ELISA for serodiagnosis of tuberculosis[J].Tuberculosis (Edinb) , 2009, 89 (4) :278-284.

[15]HARA Y, CHIN CY, MOHAMED R, et al.Multiple-antigen ELISA for melioidosis-a novel approach to the improved serodiagnosis of melioidosis[J].BMC Infect Dis, 2013, 13:165.

施引文献

资源附件(0)

访问统计