用于检测自身免疫的酶联免疫试剂盒。帮肋诊断风湿类疾病和系统性红斑狼疮等干燥综合征、硬皮病、混合性结缔组织病。
Rheumatoid autoimmune diseases are often associated with the occurrence of autoantibodies against several nuclear or cytoplasmatic antigens. These so-called anti nuclear antigens (ANA) can be divided into three groups: 1. true anti nuclear antigens (ANA): directed against dsDNA, ssDNA, histones, nucleolic RNA and DNP 2. extractable nuclears antigens: Sm (Smith), n-RNP, Scl 70, Jo-1 and PM-1 3. cytoplasmatic antigens: SS-A (Ro) and SS-B (La) In patients with Sjögren-Syndrome antibodies against the two cytoplasmatic antigens often occur in combination. Due to their strong association of SS-A and SS-B antibodies to the HLA-DR3 and DR2 phenotypes a genetic predisposition is suspected. The anti SS-A protein passes the placenta and may cause the development of SLE in neonates. Immunoreactive proteins may occur in various combinations and also bound to 'host proteins' of viral origin. They induce synthesis of polyclonal autoantibodies, of the IgG, IgM and IgA class of immunoglobulins. Especially for mixed connective tissue diseases a relation to viral infections by EBV (Eppstein-Barr-Virus) is indicated. Each class of immunoglobulins causes specific immune fluorescent pattern. Basically immunofluorescence titers correlate with the quantitation of IgG antibodies but the concentrations may considerably vary within each titer. Quantitation of IgG class antibodies extensively correlate with the diseases' activity. This makes it superior to immuno-fluorescence using HEp 2 cells, which may give variable results depending on their degree of activity. Also IF with Crithidia lucillae sometimes gives discrepant results. Today the best investigated immunoreactive antigens are double-stranded DNA (dsDNA), single stranded DNA (ssDNA), Sm (Smith), sn-RNP (small nuclear ribonucleoprotein particles), the complex RNP/Sm which is stabilized by ribonuleic acid as well as SS-A (Ro) and SS-B (La). The antigen Scl 70, a 70 kD molecular weight protein is associated with scleroderma. In rheumatoid autoimmune diseases various profiles of autoantibodies to these antigens can be detected. In a high incidence they are related to active and inactive systemic Lupus erythrematodes, mixed connective tissue diseases (Sharp Syndrome), rheumatoid arthritis, Sjögren-Syndrome, Sclerodermia, photosensitve dermatitis and drug-induced lupus. In Lupus patients typically anti-dsDNA antibodies can be detected. Patients without these antibodies very often show antissDNA antibodies and anti-SS-A and anti-SS-B are present. A strong correlation between antibody concentration and severity of the disease has been observed with higher antibody concentrations in active phases of the disease. Thus quantitation is more informative compared to simple titering by immunofluorescence. Most of these parameters are not specific for just one disease but they occur in various combinations. The pattern of different antibody combinations and their concentration together with the whole clinical picture of the patient are helpful diagnostic tools in the assessment of rheumatoid autoimmune diseases
