Сatalase抗体在系统性硬皮病患者作为疾病的诊断和预后标志物

O. Emelyanova, I. Gontar, O. Rusanova, I. Zborovskaya
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摘要

这项研究涵盖了30名表面健康的人和38名患有系统性硬皮病的患者。患者根据当前(2013年)版《世界医学协会赫尔辛基宣言》(ACR/EULAR)表示同意参加研究。患者和献血者在入院和出院前分别用免疫酶法和磁性吸附剂对血液进行过氧化氢酶抗体检测。结果发现,与对照组相比,系统性硬皮病患者过氧化氢酶氧化酶活性降低,过氧化氢酶抗体升高。我们发现有统计学意义的规律,过氧化氢酶免疫球蛋白的浓度与疾病的活动和病程有关。为了评估系统性硬皮病的活性,我们对两个参数进行了复杂的评估:酶活性和过氧化氢酶抗体水平。我们发现过氧化氢酶自身抗体多见于高活性硬皮病、亚急性和急性病程,以及累及肺、皮肤、肾脏、关节和神经系统的患者,并通过相关分析最终证实了这一点。在疾病发展的早期发现过氧化氢酶抗体尤为重要;它们具有特别的诊断重要性,它们随时间的变化可能构成评估给药治疗效率的基础。过氧化氢酶生化活性的变化,抗体滴度的升高为系统性硬皮病的诊断提供了额外的标准。在医院环境中监测这些参数有助于评估给药治疗的有效性并调整其纠正,这一点通过将血浆分离等体外技术纳入联合治疗计划得到证实。研究过氧化氢酶的生化活性和过氧化氢酶抗体的形成,扩大了我们对硬皮病发展的认识,开辟了新的研究途径。
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Сatalase antibodies in patients with systemic scleroderma as a diagnostic and prognostic marker of the disease
The study covered 30 apparently healthy individuals and 38 patients with systemic scleroderma. The patients gave their consent to participate in the study in accordance with the World Medical Association Declaration of Helsinki in the current (2013) version (ACR/EULAR). The donors and patients had their blood tested for catalase antibodies with immunoenzyme assay and using magnetic sorbents upon hospital admission and before discharge. It was found that the patients with systemic scleroderma had a reduced oxidase activity of catalase as well as elevated catalase antibodies, compared with the controls. We revealed a statistically significant regularity that the concentration of catalase immunoglobulins is associated with activity and course of the disease. To assess the activity of systemic scleroderma we performed a complex evaluation of two parameters: enzymatic activity and catalase antibody levels. It was established that catalase autoantibodies are mostly revealed in patients with high-activity scleroderma, subacute and acute course of the disease, and when the lungs, skin, kidneys, joints and nervous system were involved, which was conclusively confirmed by a correlation analysis. It is especially important that catalase antibodies should be revealed at early stage of the disease development; they are of especial diagnostic importance, and their changes over time may form the basis for assessing efficiency of administered therapy. The changes in biochemical activity of catalase, elevated antibody titers provide additional criteria of diagnosis in systemic scleroderma. Monitoring of these parameters in hospital settings helps to evaluate the effectiveness of administered therapy and adjust its correction, which is confirmed by inclusion of such extracorporal techniques as plasma separation into the combined treatment schedules. Studying biochemical activity of catalase and formation of catalase antibodies expands our understanding of scleroderma development and opens new avenues for research.
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