目的:本研究旨在评估抗高迁移率族蛋白1(HMGB1)抗体和抗膜蛋白抗体在抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)诊断中的作用及其与不同临床表现的可能关系。
方法:该研究涉及60例AAV患者,58例非AAV自身免疫性疾病患者和50例健康受试者。采用酶联免疫吸附试验(ELISA)检测血清抗HMGB1和抗膜蛋白抗体水平,并在AAV患者治疗3个月后进行第二次测定。
结果:AAV组血清抗HMGB1和抗膜蛋白抗体水平明显高于非AAV组和HC组。抗HMGB1和抗膜蛋白诊断AAV的曲线下面积(AUC)分别为0.977和0.670。抗HMGB1水平在AAV肺部受累患者中显著升高,而肾损害患者的抗膜蛋白浓度显著升高。Anti-moesin与BVAS呈正相关(r=0.261,P=0.044),肌酐(r=0.296,P=0.024)与补体C3(r=-0.363,P=0.013)呈负相关。此外,活动性AAV患者的抗膜蛋白水平明显高于非活动性患者。诱导缓解治疗后血清抗HMGB1浓度显著降低(P<0.05)。
结论:抗HMGB1和抗膜蛋白抗体在AAV的诊断和预后中起重要作用。其可以作为AAV的潜在疾病标志物。
The study aims to evaluate the role of anti-high mobility group box 1 (HMGB1) antibody and anti-moesin antibody in the diagnosis of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and its possible relationship with the different clinical manifestations.
The study involved 60 AAV patients, 58 patients with autoimmune disease other than AAV and 50 healthy subjects. The serum levels of anti-HMGB1 and anti-moesin antibodies were determined by enzyme-linked immunosorbent assay (ELISA), and the second determination was made 3 months after treatment of AAV patients.
Serum levels of anti-HMGB1 and anti-moesin antibodies in AAV group were significantly higher than those in non-AAV group and HC group. The area under the curve (AUC) of anti-HMGB1 and anti-moesin in diagnosing AAV were 0.977 and 0.670, respectively. Anti-HMGB1 levels were significantly elevated in AAV patients with pulmonary involvement, while the concentrations of anti-moesin were significantly increased in patients with renal damage. Anti-moesin were positively correlated with BVAS (r=0.261, P=0.044), creatinine (r=0.296, P=0.024) and negatively correlated with complement C3 (r=-0.363, P=0.013). Besides, anti-moesin levels of active AAV patients were significantly higher than those in inactive patients. The concentrations of serum anti-HMGB1 could be significantly decreased after induction remission treatment (P<0.05).
Anti-HMGB1 and anti-moesin antibodies play important roles in the diagnosis and prognosis of AAV, which may act as potential disease markers for AAV.