黄芪多糖降低红斑狼疮小鼠抗磷脂抗体和尿蛋白的作用

为了研究黄芪多糖对抗磷脂抗体和尿蛋白的影响 ,本研究选用病理及组织学改变类似人类红斑狼疮的自发SLE模型NZB×NZWF1小鼠观察不同剂量黄芪多糖对其抗心磷脂 (anticardiolipin ,aCL)、抗磷脂酰胆碱 (antiphosphatidylcho line,aPC)、抗磷脂酰丝氨酸 (antiphos phatidylserine ,aPS)、抗磷脂酰肌醇 (an tiphos phatidylinositol,aPI)、抗磷脂酸 (an tiphosphatidicacid ,aPA)抗体和抗磷脂酰乙醇胺 (anti phosphatidylethanolamine,aPE)抗体的水平、尿蛋白含量的影响。1 8只 8周龄的自发SLE模型雌性小鼠NZB×NZWF1 ,从美国Jack…     

抗心磷脂抗体检测及其影响因素的研究

目的：研究血清样品稀释度、温度、离子强度以及样品检测间隔时间对血清抗心磷脂抗体（ＡＣＡ）检测结果的影响。方法：采用酶联免疫吸附测定法（ＥＬＩＳＡ）检测ＡＣＡ。结果：血清样品最佳稀释度为１：５０;３７℃时光吸收值比２２℃和２５℃的光吸收值显著下降;１５ｍｏｌ／Ｌ ＮａＣｌ可明显抑制ＡＣＡ与抗原结合（Ｐ〈０．０１）,抑制率平均为４５．４％,包被１４ｄ以上的检测结果明显高于１ｄ和７ｄ的测定结果（Ｐ〈０．     

免疫抑制剂对系统性红斑狼疮抗心磷脂抗体的影响

目的 观察系统性红斑狼疮（ｓｙｓｔｅｍｉｃ ｌｕｐｕｓ ｅｒｙｔｈｅｍａｔｏｓｕｓ,ＳＬＥ）中抗心磷脂抗体（ａｎｔｉｃａｒｄｉｏｌｉｐｉｎ ａｎｔｉｂｏｄｉｅｓ,ＡＣＡ）的阳性率与临床关系,以及免疫抑制剂对ＡＣＡ的滴度的影响。方法 用酶联免疫吸附法（ＥＬＩＳＡ）的ＡＣＡＩｇ含量测定药盒,作血清ＡＣＡ含量测定。对１７例ＳＬＥ的患者入院及治疗３个月后行ＡＣＡ滴度对比。结果ＡＣＡＩｇＧ、ＡＣＡＩｇＡ、Ａ     

系统性红斑狼疮患者妊娠失败与抗心磷脂抗体间关系的研究

研究６３例ＳＬＥ女患者中有妊娠失败史者与各项自身抗体及其他体液免疫的关系，表明妊娠失败与抗心磷脂抗体（ＡＣＡ）有非常显著的关系（Ｐ＜０．０１）．而与其他自身抗体未见明显关系，认为ＡＣＡ在ＳＬＥ患者中是引起妊娠失败的重要因素。此外ＡＣＡ还与Ｃ＿３、Ｃ＿４免疫指标呈负相关（Ｐ＜０．０５或Ｐ＜０．０１）。     

抗心磷脂抗体的检测

本文介绍一种检测ＡＣＡ的ＥＬＩＳＡ方法，该法重复性好、特异性强、敏感性高，方法简便。１４４份正常人血清ＢＩ的Ｘ＋２ＳＤ作为正常值上限，其中ＩｇＧ－ＡＣＡＢＩ为２．３５，ＩｇＡ－ＡＣＡ为２．０６，ＩｇＭ－ＡＣＡ为２．５，ＳＬＥ和ＲＡ患者ＡＣＡ阳性率（４６％和３５％）明显高于正常人群（３．５％，Ｐ＜０．０５）。ＳＬＥ患者中各类ＡＣＡ检出阳性率为ＩｇＧ４４％，ＩｇＭ３０％，ＩｇＡ２２％，因此，ＡＣＡ值可     

ELISA检测抗心磷脂抗体在脑血管病的临床意义

本文采用ELISA法检测170例脑血管病患者和90例健康对照血清中的IgG、IgA与IgM型ACL,其中病例组脑出血58例、出血性脑梗塞10例,单灶脑梗塞92例;多灶性脑梗塞10例。结果除病例组脑出血及出血性脑梗塞患者IgG型ACL平均结合指数(BI)与对照组同型ACL比较无明显差别外,其它各病组血清中各型ACL平均BI明显高于对照组(P<0.05和P<0.01),脑出血及出血性脑梗塞组IgA-ACL、IgM-ACL也明显高于对照组(P<0.01)。出血性脑梗塞IgA、IgM型ACL又明显高于脑出血(p<0.05和p<0.01)。多发性脑梗塞三型ACL显著高于单灶性脑梗塞(P<0.01);单灶性脑梗塞ACL显著高于脑出血(P<0.01)。ACL浓度变化与病情轻重呈正相关。提示ACL在脑血管病患者中出现与消失是疾病过程中机体产生的自身免疫反应,ACL的检测可作为预测中风发生或对其临床病情的估价。     

红斑狼疮合并抗磷脂抗体和抗磷脂抗体相关性肾病急性肾组织病理损伤的临床特点

 目的 分析系统性红斑狼疮（SLE）合并抗磷脂抗体（APL）和抗磷脂抗体相关性肾病（APLN）的急性肾组织病理损伤患者的临床特点,以促进对APLN的研究。 方法 回顾性分析北京协和医院2000年~2005年期间100例SLE患者的临床特点及预后。分研究组：7例SLE合并APL和APLN急性损伤患者;2个对照组：APL阴性合并APLN急性损伤样病变7例（对照组1）,APL阴性且无APLN肾组织病理损伤86例（对照组2）。结果 研究组患者的血压为156±13/92±9mmHg,肾活检时血肌酐为159±88μmol/L。高血压的发生率为85.7%,血肌酐升高的比例为42.8％。随诊2年时血肌酐为114±60μmol/L。与对照组2相比,研究组的血压（包括收缩压、舒张压及平均动脉压）、血肌酐水平以及肾功能不全的比例明显增高,随诊2年后的血肌酐也更高（P<0.05）。但研究组与对照组1相比无显著差异。结论 SLE合并APL及APLN急性损伤患者的血压和血肌酐水平较高,肾脏预后较差。     

系统性红斑狼疮和梅毒患者抗磷脂抗体比较及意义

目的：比较系统性红斑狼疮（SLE）和梅毒患者血清抗磷脂抗体（APA）的异同及其意义。方法：应用ELISA和快速血浆反应素环状卡片试验（RPR）法检测32例SLE和77例梅毒患者血中6种抗心磷脂（CL）、抗磷脂酸（PA）、抗磷脂酰丝氨酸（PS）、抗磷脂酰乙醇胺（PE）、抗磷脂酰胆碱（PC）、抗磷脂酰肌醇抗体（PI）的APA。结果：（1）梅毒患者血清RPR的滴度为1：16、1：8和1：1（抗PE抗体除外）及RPR的滴度为1：4的6种APA IgG的吸光度（A）值，以及RPR的滴度为1：1的抗PA IgG抗体、滴度为1：8的抗PC IgG抗体和滴度为1：32、1：16及1：8的抗PI IgG抗体的阳性率，均显著低于SLE患者；（2）梅毒患者血清RPR的滴度为1：4的4种APA IgM和滴度为1：1的5种APA IgM的A值，以及RPR滴度为1：1梅毒患者抗CL、抗PS和抗PC IgM抗体及滴度为1：32的抗PA IgM的阳性率，均显著低于SLE患者。结论：SLE和梅毒患者血清的A值和阳性率均有所不同，检测A值有助于SLE与梅毒患者的鉴别。     

264例系统性红斑狼疮患者抗磷脂抗体与抗核抗体、抗双链DNA抗体关系的研究

目的 分析系统性红斑狼疮(SLE)患者抗磷脂抗体(APL)特征及其与抗核抗体(ANA)核型、抗双链DNA抗体(anti-dsDNA)之间的关系,为SLE患者系统性治疗提供参考。方法 选取2018年1月至2021年12月就诊于首都医科大学附属北京同仁医院的SLE患者264例,回顾性分析患者APL[狼疮抗凝物(LA)、抗心磷脂抗体(ACA)、和抗β₂糖蛋白I抗体(anti-β₂GPI)]与ANA核型特征、anti-dsDNA的关系。结果 264例患者中164例(62.12%)LA阳性、22例(8.33%)ACA阳性、38例(14.39%)anti-β₂GPI阳性、260例(98.48%)ANA阳性和136例(51.52%)anti-dsDNA阳性。在164例LA阳性的SLE患者中,LA弱阳性表达92例(56.10%),LA阳性表达52例(31.71%),LA强阳性表达20例(12.19%)。ACA、anti-β₂GPI和LA均阳性16例。260例ANA阳性的SLE患者中,胞核均质型48例(18.46%)...     

系统性红斑狼疮合并抗磷脂抗体相关性肾病的肾组织病理学特点

 摘要：目的 分析系统性红斑狼疮（SLE）患者合并抗磷脂抗体相关性肾病（APLN）的肾组织病理学表现,以促进对APLN的认识。 方法 回顾性分析北京协和医院2000年至2005年期间155例SLE肾活检患者中APLN及APLN样肾组织病理学表现特点,及其与APL的关系。分为2组：抗磷脂抗体（APL）阳性组（37例,23.9％)和APL阴性组(118例,76.1％)。结果 155例SLE患者中APLN及APLN样肾组织病理学表现共55例（35.5%）,包括急性表现（即血栓性微血管病, 9.0％）和慢性表现（29.7%）。慢性表现中纤维性肾内动脉增生46例（29.7％）、纤维性或细胞纤维性肾内动脉阻塞12例（7.7％）、局灶性肾皮质萎缩共3例（1.9%）、肾小管甲状腺样化8例（5.2％）。其中APL阳性组 的APLN肾组织病理学表现共23例（占阳性组62.1%）,APL阴性组共32例（占阴性组27.1%）。Logistic回归分析表明,APL阳性组的APLN肾组织学表现发生率（62.1% vs 27.1%）及慢性表现和急性表现的发生率均显著高于APL阴性组（P均<0.05）。结论 SLE患者合并APLN的肾组织病理学表现发生率较高,APLN的肾组织病理学表现与APL存在显著相关性。     

Immunoadsorption plasmapheresis as a treatment for pregnancy complicated by systemic lupus erythematosus with positive antiphospholipid antibodies.

PROBLEM: Our purpose was to study the effect of maternal immunoadsorption plasmapheresis (IA) on the outcome of pregnancies complicated by systemic lupus erythematosus (SLE) with positive antiphospholipid antibodies, which were known to have a strong correlation with abortion or stillbirth. METHOD OF STUDY: Eight pregnancies in 7 patients with SLE were treated according to our protocol. They were all positive for the lupus anticoagulant. The treatments provided in these cases were as follows: an oral low-dose steroid; oral low-dose aspirin; and IA. The outcomes of the pregnancies were then studied. RESULTS: Of eight pregnancies, seven resulted in preterm deliveries, and cesarean sections were performed at 26-36 weeks of gestation. In one case, intrauterine fetal death occurred at 24 weeks of gestation. The other seven pregnancies resulted in live births (survival rate of 87.5%). CONCLUSION: IA improves the outcome of pregnancy complicated by SLE with positive antiphospholipid antibodies, without increasing steroid dosage.     

The effect of polyamines on the binding of anti-DNA antibodies from patients with SLE and normal human subjects

Antibodies to DNA (anti-DNA) are the serological hallmark of systemic lupus erythematosus (SLE). To elucidate specificity further, the effect of polyamines on the binding of anti-DNA antibodies from patients with lupus was tested by ELISA to calf thymus (CT) DNA; we also assessed the binding of plasmas of patients and normal human subjects (NHS) to Micrococcus luteus (MC) DNA. As these studies showed, spermine can dose-dependently inhibit SLE anti-DNA binding to CT DNA and can promote dissociation of preformed immune complexes. With MC DNA as antigen, spermine failed to inhibit the NHS anti-DNA binding. Studies using plasmas adsorbed to a CT DNA cellulose affinity indicated that SLE plasmas are mixtures of anti-DNA that differ in inhibition by spermine and binding to conserved and non-conserved determinants. Together, these studies demonstrate that spermine can influence the binding of anti-DNA autoantibodies and may contribute to the antigenicity of DNA.     

Antiphospholipid antibodies and reproduction: the antiphospholipid antibody syndrome

In women who have a diagnosis of APS (both clinical and laboratory criteria) the chance for successful pregnancy is reduced. In these cases, treatment appears to be a clear option, particularly in the case of prior thromboembolic events. The current preference of treatment for women with RPL and aPL antibodies is subcutaneous heparin and aspirin. This treatment should begin with a positive pregnancy test and continue postpartum. It is unclear, at this time, what treatment, if any, is required for women who do not meet all the criteria for diagnosis of APS, but who are known to have aPL antibodies. In some cases, these women were tested because of a prior false-positive test for syphilis, with subsequent identification of aPL antibodies. More recently, women undergoing IVF were tested and found to have an increased incidence of aPL antibodies. It was suggested that aPL antibodies are associated with infertility and failure to implant. However, a summary of published reports indicate that positive aPL antibodies in patients undergoing IVF do not influence ongoing pregnancy rates. This subject, however, remains an area of active investigation because aPL antibodies were shown to interact with the syncytiotrophoblast and cytotrophoblast layers and could, theoretically, after implantation.     

The NOD Mouse as a Model of SLE

In addition to developing a high incidence of type 1 diabetes caused by a specific autoimmune response against pancreatic β cells in the islets of Langerhans, NOD mice also demonstrate spontaneous autoimmunity to other targets including the thymus, adrenal gland, salivary glands, thyroid, testis, nuclear components and red blood cells. Moreover, treatment of pre-diabetic NOD mice with an intravenous dose of heat killed Mycobacterium bovis (M. bovis; bacillus Calmette-Guerin (BCG)) protects them from developing type 1 diabetes, but instead precipitates an autoimmune rheumatic disease similar to systemic lupus erythematosus (SLE), characterised by accelerated and increased incidence of haemolytic anaemia (HA), anti-nuclear autoantibody (ANA) production, exacerbation of sialadenitis, and the appearance of immune complex-mediated glomerulonephritis (GN). The reciprocal switching between the two phenotypes by a single environmental trigger (mycobacterial exposure) raised the possibility that genetic susceptibility for type 1 diabetes and SLE may be conferred by a single collection of genes in the NOD mouse. This review will focus on the genetic components predisposing NOD mice to SLE induced by BCG treatment and compare them to previously determined diabetes susceptibility genes in this strain and SLE susceptibility genes in the BXSB, MRL and the New Zealand mouse strains     

Induction of experimental systemic lupus erythematosus (SLE) in mice with severe combined immunodeficiency (SCID).

A model in which experimental SLE is induced in normal mice by the injection of a human anti-DNA MoAb expressing a common idiotype 16/6 Id has been established in our laboratory. In the present study we have attempted the induction of experimental SLE in mice with SCID by the transfer of lymphocytes obtained from mice with experimental SLE. Disease could not be induced by direct immunization of SCID mice with the 16/6 Id nor by transfusion of normal splenocytes and immunization with the 16/6 Id thereafter. In contrast, disease was induced in SCID mice which were transplanted with splenic lymphocytes obtained from SLE afflicted BALB/c mice. The disease was expressed by the presence of high titres of antibodies and glomerular immune complex deposits were present in the kidney sections of these mice. Mice that received spleen cells from donors with experimental SLE together with the 16/6 Id developed higher titres of autoantibodies and had, in addition to the immune complex deposits, glomerular histological pathology. The model of experimental SLE induction in SCID mice should help in the elucidation of the role of different cell types in the pathogenesis of SLE.     

Phospholipid binding of antiphospholipid antibodies and placental anticoagulant protein

We evaluated the interaction of antiphospholipid antibodies (aPL) with placental anticoagulant protein I (PAP I), a calcium-dependent phospholipid binding protein which may act as a natural anticoagulant. Clotting assays showed additive prolongation of clotting times with aPL and PAP I. ELISA and vesicle phospholipid binding studies showed PAP I inhibition of aPL binding to phospholipid but no inhibition of PAP I-phospholipid binding by aPL. aPL and PAP I interact additively in anticoagulant activity inin vitro clotting systems and compete for phospholipid in ELISA system. These data support the hypotheses that aPL and PAP I may recognize similar phospholipid epitopes and thatin vivo interaction may occur.     

免疫PCR方法在血清抗Sm抗体测定中的应用

目的：将免疫PCR方法应用于血清抗Sm抗体测定中,方法：采用SaHIgG-DNA探针建立了血清抗Sm抗体免疫PCR检测方法。结果：该法测定SLE患者血甭抗Sm抗体的特异性强。敏感性是ELISA方法的10^7倍。批内和批间变异系数分别为2.3%-4.8%和3.7%-6.9%。而且与ELISA方法呈高度正相关。结论：免疫PCR方法用于血清抗Sm抗体测定具有临床实用价值。     

Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): A systematic review

Background

Adrenal insufficiency (AI) is associated with high morbidity and mortality. The aim of this systematic review was to enhance diagnostic approaches and summarize therapeutic strategies in the management of AI in patients with systematic lupus erythematosus (SLE) or antiphospholipid syndrome (APS).