中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (6): 435-438.doi: 10.35541/cjd.20190913

• 论著 • 上一篇    下一篇

抗构象表位桥粒芯蛋白抗体和乙酰胆碱受体抗体滴度与寻常型天疱疮病情活动度的相关性研究

李志量    张寒梅    向睿宇    荆可    冯素英   

  1. 中国医学科学院  北京协和医学院  皮肤病医院皮肤科  江苏省皮肤病与性病学重点实验室，南京  210042
  • 收稿日期:2019-09-17 修回日期:2020-05-12 发布日期:2020-06-01
  • 通讯作者: 冯素英 E-mail:fengsuying2018@163.com
  • 基金资助:
    国家自然科学基金（81602781）；江苏省基础研究计划青年基金（BK20160153）；中国医学科学院医学与健康科技创新工程项目（CIFMS-2017-I2M-1-017）

Correlation of anti?desmoglein conformational epitope antibody and anti?acetylcholine receptor antibody titers with disease activity of pemphigus vulgaris

Li Zhiliang, Zhang Hanmei, Xiang Ruiyu, Jing Ke, Feng Suying   

  1. Department of Dermatology, Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing 210042, China
  • Received:2019-09-17 Revised:2020-05-12 Published:2020-06-01
  • Contact: Feng Suying E-mail:fengsuying2018@163.com
  • Supported by:
    National Natural Science Foundation of China（81602781）; Natural Science Foundation of Jiangsu Province of China （BK20160153）; CAMS Innovation Fund for Medical Sciences（CIFMS-2017-I2M-1-017）

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摘要： 【摘要】 目的 研究寻常型天疱疮患者血清中相关抗体滴度与病情严重程度和病情活动度的相关性。方法 收集2012—2015年于中国医学科学院皮肤病医院首次就诊的24例活动期寻常型天疱疮（PV）患者，评估患者活动期和稳定期天疱疮疾病面积指数（PDAI），并采集血清标本。采用酶联免疫吸附实验（ELISA）检测血清标本中具有致病作用的抗构象表位桥粒芯蛋白（Dsg）抗体滴度、总Dsg抗体滴度和乙酰胆碱受体（AChR）抗体滴度。计量资料比较采用t检验，计数资料比较采用Fisher 精确检验法，相关性比较采用Pearson分析。结果 活动期患者的Dsg1抗体滴度（611.4 ± 136.8）与抗构象表位Dsg1抗体滴度（585.5 ± 134.7）差异无统计学意义（t = 0.13，P = 0.89），Dsg3抗体滴度（708.6 ± 130.7）高于抗构象表位Dsg3抗体滴度（297.2 ± 54.4，t = 2.90，P < 0.01）。活动期患者的Dsg1抗体滴度及抗构象表位Dsg1抗体滴度与PDAI评分均呈正相关（r = 0.54、0.54，均P < 0.01）；Dsg3抗体滴度与PDAI评分无相关性（r = 0.11，P = 0.62），抗构象表位Dsg3抗体滴度与PDAI评分呈正相关（r = 0.53，P < 0.01）。20例稳定期患者血清中Dsg1抗体与抗构象表位Dsg1抗体滴度与首次就诊时比较均明显下降。Dsg3抗体滴度仅7例明显下降；13例仍存在较高滴度的Dsg3抗体，其中6例抗构象表位Dsg3抗体滴度明显下降，5例AChR抗体滴度由阳性转为阴性。结论 Dsg1抗体及抗构象表位Dsg1抗体滴度都可以反映病情活动度。部分患者病情活动度与Dsg3抗体滴度不一致，抗构象表位Dsg3抗体或者AChR抗体可能有助于反映病情活动度。

关键词: 天疱疮； 桥粒芯糖蛋白质1； 桥粒芯糖蛋白质3； 受体, 胆碱能； 天疱疮疾病面积指数

Abstract: 【Abstract】 Objective To investigate the correlation of related antibody titers in serum of patients with pemphigus vulgaris （PV） with disease severity and activity. Methods A total of 24 patients with active PV were collected, who firstly visited Hospital for Skin Diseases, Chinese Academy of Medical Sciences from 2012 to 2015. Pemphigus disease area index （PDAI） was evaluated in the patients with PV at active and stable stages, and serum samples were collected. Enzyme-linked immunosorbent assay （ELISA） was conducted to determine titers of pathogenic anti-desmoglein （Dsg） conformational epitope antibodies, total anti-Dsg antibodies and anti-acetylcholine receptor （AChR） antibody in serum samples. Measurement data were compared by using t test, enumeration data were compared by using Fisher′s exact test, and correlations were analyzed by using Pearson correlation analysis. Results Among the patients with active PV, there was no significant difference between the anti-Dsg1 antibody titers （611.4 ± 136.8） and anti-Dsg1 conformational epitope antibody titers （585.5 ± 134.7, t = 0.13, P = 0.89）, but the anti-Dsg3 antibody titers （708.6 ± 130.7） were significantly higher than the anti-Dsg3 conformational epitope antibody titers （297.2 ± 54.4, t = 2.90, P < 0.01）. In addition, both the anti-Dsg1 antibody titers and anti-Dsg1 conformational epitope antibody titers were positively correlated with PDAI scores in the patients with active PV （both r = 0.54, P < 0.01）; PDAI scores were not correlated with the anti-Dsg3 antibody titers （r = 0.11, P = 0.62）, but positively correlated with the anti-Dsg3 conformational epitope antibody titers （r = 0.53, P < 0.01）. Among the 20 patients with stable PV, the serum titers of anti-Dsg1 antibodies and anti-Dsg1 conformational epitope antibodies significantly decreased compared with those at their first visit; anti-Dsg3 antibody titers significantly decreased in only 7 patients, and 13 patients still had high titers of anti-Dsg3 antibodies, including 6 with declined anti-Dsg3 conformational epitope antibody titers, and 5 converted from anti-AChR antibody-positive to anti-AChR antibody-negative. Conclusions Both the anti-Dsg1 antibody and anti-Dsg1 conformational epitope antibody titers can reflect the disease activity of PV. The disease activity was not consistent with anti-Dsg3 antibody titers in some patients, and the anti-Dsg3 conformational epitope antibody or anti-AChR antibody may facilitate evaluating the disease activity of PV.

Key words: Pemphigus, Desmoglein 1, Desmoglein 3, Receptors, cholinergic, Pemphigus disease area index

引用本文

李志量 张寒梅 向睿宇 荆可 冯素英. 抗构象表位桥粒芯蛋白抗体和乙酰胆碱受体抗体滴度与寻常型天疱疮病情活动度的相关性研究[J]. 中华皮肤科杂志, 2020,53(6):435-438. doi:10.35541/cjd.20190913

Li Zhiliang, Zhang Hanmei, Xiang Ruiyu, Jing Ke, Feng Suying. Correlation of anti?desmoglein conformational epitope antibody and anti?acetylcholine receptor antibody titers with disease activity of pemphigus vulgaris[J]. Chinese Journal of Dermatology, 2020, 53(6): 435-438.doi:10.35541/cjd.20190913