| 自身免疫性视网膜病变血清抗视网膜抗体的检测 |
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| 引用本文： | 曾惠阳,刘谦,彭晓燕.自身免疫性视网膜病变血清抗视网膜抗体的检测[J].眼科,2018,27(6):451. |
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| 作者姓名： | 曾惠阳 刘谦 彭晓燕 |
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| 作者单位： | 100005.首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室 |
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| 摘 要： | 目的 探讨自身免疫性视网膜病变（autoimmuneretinopathy，AIR）患者血清抗视网膜抗体（anti-retinal antibodies, ARA）检测的临床应用价值。设计 前瞻性比较性病例系列。研究对象 临床疑似AIR患者、健康人对照及其他视网膜病变对照包括原发性视网膜色素变性（retinitis pigmentosa，RP）、双眼葡萄膜炎、白点综合征患者。方法 选取2016年9月-2018年5月北京同仁医院就诊的临床疑似AIR患者17例作为实验组，健康人20例作为对照组，RP患者18例、双眼葡萄膜炎患者9例、白点综合征患者6例作为其他视网膜病变对照组。通过免疫印迹法检测各组受检者血清 ARA，比较各组的阳性率及差异。主要指标 血清恢复蛋白（recoverin），烯醇化酶α（α-enolase），碳酸酐酶II（carbonic anhydraseII，CAII），塌陷反应介导蛋白5（collapsin response mediator protein 5，CRMP5）抗体。结果 临床疑似AIR组、其他视网膜病变对照组及健康人部分受试者血清中均有不同种类ARA检出。一种或两种以上抗体表达阳性率在临床疑似AIR组分别为76.5%及64.7%，在其他视网膜病变对照组分别为54.5%及30.3%，在健康受试者分别为33.3%及0%。RP患者抗体阳性率为33.3%。各组中以α-enolase及CA II抗体表达阳性率最高；recoverin抗体特异性存在于癌症相关性视网膜病变患者（cancer-associated retinopathy, CAR）血清中。结论 临床疑似AIR患者血清中ARA存在率较高，明显高于健康人及RP患者；二个以上ARA表达明显高于其他视网膜病变，故对该疾病具有重要辅助诊断价值。血清ARA的存在必须与临床体征结合才能确诊AIR。
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| 关 键 词： | 自身免疫性视网膜病变 抗视网膜抗体 |
| 收稿时间： | 2018-07-18 |
Detection of serum anti-retinal antibodies in patients with autoimmune retinopathy |
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| ZENG Hui-yang,LIU Qian,PENG Xiao-yan.Detection of serum anti-retinal antibodies in patients with autoimmune retinopathy[J].Ophthalmology in China,2018,27(6):451. |
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| Authors: | ZENG Hui-yang LIU Qian PENG Xiao-yan |
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| Affiliation: | Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China |
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| Abstract: | Objective To explore the presence and role of serum anti-retinal antibodies (ARA) in the patients with autoimmune retinopathy (AIR). Design Prospective comparative case series. Participants Serum of patients with presumed AIR and control cases including retinitis pigmentosa (RP), binocular uveitis, white dot syndrome and healthy donors. Methods 17 patients with presumed AIR, admitted to Beijing Tongren hospital from September 2016 to May 2018 were included. Serum samples of all patients with presumed AIR, 18 patients with RP, 9 patients with uveitis, 6 patients with white dot syndrome and 20 healthy donors were obtained and were analyzed for presence of ARAs by Western bolt assay. Main Outcome Measures Presence of serum ARAs including recoverin，α-enolase，carbonic anhydrase II (CAII) and CRMP5. Results ARAs were present in the serum of either patients with presumed AIR, some of healthy donors or control cases including RP, uveitis and white dot syndrome. One or more serum ARAs were present in the 76.5% of the patients with AIR, 54.5% the patients with other retinopathies and 33.3% healthy donors, while two or more serum ARAs were observed in the 64.7% of the patients with AIR, 30.3% the patients with other retinopathies and 0% healthy donor respectively. ARAs were found in the serum of 33.3% of patients with RP. α-enolase and CAII antibody were most commonly observed in each group . Recoverin antibody seemed to be specifically present in the patients with cancer associated retinopathy (CAR). Conclusion Presence of serum ARAs in the AIR patients occurred significantly more often compared with patients with RP and healthy donors. Presence of two or more ARAs occurred significantly more often than that of control cases. Presence of serum ARAs has an important diagnostic value for confirmation of AIR when combined with clinical manifestations. |
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| Keywords: | autoimmune retinopathy anti-retinal antibodies |
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