文章摘要

自身抗体在狼疮肾炎病理与诊断研究中的进展

作者: 1张 雷, 1孙 铀
1 哈尔滨医科大学附属第二医院风湿免疫科,哈尔滨 150081
通讯: 孙 铀 Email: sunyou09@126.com
DOI: 10.3978/j.issn.2095-6959.2020.01.025
基金: 国家自然科学基金(81202339)。

摘要

狼疮肾炎(lupus nephritis,LN)的发病机制较为复杂,临床医师诊断和治疗LN的依据尚未明确。尽管在以往美国风湿病学会(American College of Rheumatology,ACR)与系统性红斑狼疮国际合作诊所(Systemic Lupus International Collaborating Clinics,SLICC)修订的分类标准中,抗dsDNA与抗Sm抗体均被用作诊断系统性红斑狼疮(systemic lupus erythematosus,SLE)及LN的标志性抗体,但抗C1q、抗核小体及结缔组织生长因子等抗体也对SLE尤其LN存在较高的特异性,它们在LN的发病及演变机制中也起到较为重要的作用,有望成为诊断LN的新标志。另外,越来越多的研究者着眼于采用两种或多种相关性自身抗体的联合检测,在多种诊断依据的支持下,可以为临床诊断及治疗LN患者提供更好的依据,从而更准确高效地诊断LN,且有助于LN病理类型的确诊,提高非活动期LN的检出率。
关键词: 狼疮肾炎;抗C1q抗体;抗核小体抗体;结缔组织生长因子;联合检测

Advances in the diagnostic and pathological researches of autoantibodies of lupus nephritis

Authors: 1ZHANG Lei, 1SUN You
1 Department of Rheumatism Immunology, Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China

CorrespondingAuthor:SUN You Email: sunyou09@126.com

Foundation: This work was supported by National Natural Science Foundation of China (81202339).

Abstract

The pathogenesis of lupus nephritis (LN) is complicated, and diagnostic and treatment basis of lupus nephritis hasn’t been thoroughly illuminated by the clinicians. Notwithstanding the anti-dsDNA antibody and anti-Sm antibody are utilized as markers of systemic lupus erythematosus (SLE) in diagnostic criterion of American College of Rheumatology (ACR) and the Systemic Lupus International Collaborating Clinics (SLICC). According to the recent researches, anti-C1q, anti-nucleosome antibody (AnuA) and Connective Tissue Growth Factor (CTGF) also have rather high sensitivity towards SLE, especially LN, which means they play key roles in the occurrence of such disease as well. In addition, more and more researchers look into combined-detection based on double or multiple related autoantibodies, in order to get over the deficiency of low sensitivity for anti-Sm antibody. With the support of joint diagnostic basis, the patients will be provided a better diagnosis and a higher detection rate.
Keywords: lupus nephritis; anti-c1q antibody; anti-nucleosome antibody; connective tissue growth factor; combined-detection