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在类风湿性关节炎中发现局部性粘膜自身抗体分泌的证据
Veerle F A M Derksen1, Klara Martinsson2, Anouk G van Mourik1
1Leiden University Medical Center, Leiden, The Netherlands.
Arthritis & rheumatology (Hoboken, N.J.)
|October 18, 2024
概括
在类风湿性关节炎患者的唾液中发现了ACPA,anti-CarP和AAPA等自身抗体. 然而,这些抗修饰蛋白抗体没有在下胃肠道中检测到,这表明口腔粘膜是生产地点.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 抗修饰蛋白抗体 (AMPA),包括抗素蛋白抗体 (ACPA),在类风湿性关节炎 (RA) 患者的分泌物中发现.
- 之前的研究在和唾液中检测到AMPA,但肠道的作用仍然未被检查.
研究的目的:
- 为了调查AMPA (ACPA,抗碳amylated蛋白抗体 [anti-CarP]和抗乙化蛋白抗体 [AAPA]) 在RA患者的各种粘膜部位,包括肠道的存在.
- 为了确定粘膜自身抗体的产生是否发生在下部胃肠道.
主要方法:
- 从RA患者和健康志愿者中收集了三组结合的便,阴道洗,唾液和血清样本.
- 内部酶链接免疫吸收试验用于分析分泌中的AMPA,使用未经修改的作为对照.
- 在便样本中测量了总IgA和抗大肠杆菌IgA,以确认测定功能.
主要成果:
- 在血清阳性RA患者的唾液中检测到ACPA,anti-CarP和AAPA IgA (9%-40%的患病率).
- 从RA患者或健康捐赠者的便或大肠洗样本中没有发现AMPA.
- 检测证实了便中IgA和特定的抗大肠杆菌IgA的存在,这表明了检测的敏感性.
结论:
- 在ACPA-血清阳性RA患者的唾液中存在ACPA,抗CarP和AAPA IgA.
- 没有发现AMPA的证据在RA患者的下部胃肠道 (便/液洗).
- 这些发现表明,RA的粘膜自身抗体分泌可能发生在口腔中,而不是下肠.
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