中华皮肤科杂志 ›› 1997, Vol. 30 ›› Issue (1): 13-15.

• 论著 • 上一篇    下一篇

大疱性类天疱疮抗原分子异质性与临床的关系

林麟, 靳培英, 王峰来, 马林, 桑红桂   

  1. 中国医学科学院、中国协和医科大学皮肤病研究所, 南京 210042
  • 收稿日期:1996-01-02 修回日期:1996-04-28 出版日期:1997-02-15 发布日期:1997-02-15
  • 基金资助:
    卫生部科研基金

Study of the Relationship Between Molecular Heterogeneity of BP Antigens and Clinical Features

Lin Lin, Jin Peiyin, Wang Fenglai   

  1. Institute of Dermatology, Peking Union Medical College, Chinese Academy of Medical Sciences, Nanjing 210042
  • Received:1996-01-02 Revised:1996-04-28 Online:1997-02-15 Published:1997-02-15

摘要: 大疱性类天疱疮抗原分子存在着异质性.为了弄清抗原异质性与疾病临床表现、治疗、预后的关系,我们用免疫印迹技术检测了122例大疱性类天疱疮患者血清,94例为阳性.其中230000抗体阳性率57.4%,180000抗体阳性率88.3%.对检测阳性的94例患者分为230000蛋白抗体阳性组、180000蛋白抗体阳性组以及230000蛋白抗体与180000蛋白抗体合并阳性组3个组.分析比较了各组间临床表现形式(粘膜受损、瘢痕、粟丘疹发生情况)、疾病轻重发生比例、泼尼松最大单日治疗量和住院治疗情况.结果各组间的以上参数基本相似.但230000蛋白抗体阳性组与180000蛋白抗体阳性组,两组间在泼尼松最大单日剂量上有统计学差异,前组明显小于后组.说明180000蛋白抗原的损伤,对大疱性类天疱疮发病和疾病表现产生特殊的影响,与230000蛋白成分受损一样均有重要的意义.180000蛋白成分并非所谓的大疱性类天疱疮次要抗原.

关键词: 类天疱疮,疱性, 抗原, 异质性, 皮肤表现

Abstract: Bullous pemphigoid (BP) antigens are of molecular heterogeneity. To find out the relationship between the antigenic molecular heterogeneity and clinical features, treatment and prognosis in BP, 122 sera of BP patients were tested with immunoblotting technique. The results showed that 94 sera reacted with BP antigens extracted from normal human epidermis. Among them, 54 sera (57.4%) had BP 230kD antibody and 83 sera (88.3%) had 180kD antibody. Based on the results of immunoblotting assay, these 94 BP patients who had the positive antibodies were divided into three groups, including group I patients with 230kD protein antibody only,group Ⅱ patients with 180kD protein antibody and other minor protein antibodies, and group Ⅲ patients with both 230kD and 180kD antibodies. The pattern of clinical presentations (mucosal involvement, scarring and milia), disease severity, the largest dose of prednisone per day and duration of hospitalization were compared in these three groups. The results of comparison showed that there was no statistically significant difference among three groups in above mentioned items, except the difference of the largest dose of prednisone between the group Ⅰ and group Ⅱ (t=2.22,P<0.05). The dose of group Ⅰ was by far smaller than that of group Ⅱ, which indicated that the severity of patients with 180kD antigen was similar to that with 230kD antigen, perhaps more inportant in the pathogenesis of BP and patient's manifestations. The 180kD protein antigen can not be regarded as so-called"minor BP antigen".

Key words: Pemphigoid,bullous, Antigens, Heterogeneity, Skin manifestations