目的建立酶联免疫吸附试验(ELISA)法检测抗毒蕈碱3受体多肽(M3RP)抗体的方法,探讨该抗体在干燥综合征(SS)诊断中的意义。方法以固相合成的多肽M,RP为包被抗原,ELISA定量检测94例干燥综合征,160例其他结缔组织病及200名正常人血清中的抗M3RP抗体水平,并分析其与SS临床表现的相关性。结果抗M3RP抗体在原发干燥综合征(pSS)、继发干燥综合征(sSS)患者中阳性率分别为84.6%和81.3%,在其他结缔组织病和正常对照组中的阳性率分别为8.8%和1%。M3RP抗体在SS患者中阳性率显著高于其他结缔组织病患者及正常对照组(尸〈0.01)。而且,M3RP抗体在pSS和sSS中的特异性均为91.3%。pSS患者与sSS患者抗M3RP抗体阳性率差异无统计学意义。抗M3RP抗体与SS患者临床表现和脏器受累情况无明显相关性。该抗体在抗α-胞衬蛋白、抗SSA、抗SSB和抗核抗体阴性的S患者中抗M3RP抗体的阳性率分别为85%、89.3%、88.9%和95.2%。在pSS中,抗M3RP抗体阳性的患者血清中IgG水平明显高于抗体阴性的患者。结论①ELISA法可检测pSS和sSS患者血清中的抗M3RP抗体,该抗体为诊断SS的较为特异的自身抗体之一。②抗M3RP抗体对其他自身抗体阴性的SS诊断有参考意义。
Objective To establish the enzyme-linked immunosorbent assay (ELISA) method in detecting the anti-M3RP antibody in Sjogren's syndrome (SS) patients, and to explore the significance of this autoantibody in the diagnosis of SS. Methods The synthesized M3 receptor polypeptide was used as antigen in ELISA to detect the anti-M3RP antibody in sera of patients with SS, other CTDs and healthy controls, and the association between the clinical features of SS and anti-M3RP antibody was analyzed. Results Antibodies against M3RP were detected in 84.6% patients with pSS and 81.3% with sSS, 8.8% with other CTD and 1% in healthy controls. The positive rates of antibodies in pSS and sSS were higher than those in other CTDs and healthy controls. The presence of anti-M3RP antibodies had no significant correlation with clinical manifestations and internal organ involvement. Furthermore, the positive rates of anti-M3RP antibodies in anti-α-fodrin, SSA, SSB, and ANA antibodies negative SS patients were 85%, 89.3%, 88.9% and 95.2%, respectively. Conclusion ① Anti-M33RP antibody is a specific serum marker for the diagnosis of SS. ② Anti-M3RP antibody is a complementary parameter in the diagnosis of antibody-negative SS.