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研究生:吳怡瑩
研究生(外文):Yi-Ying Wu
論文名稱:自體抗體在C型肝炎感染病人之研究
論文名稱(外文):Autoantibodies in patients with hepatitis C infection
指導教授:蔡嘉哲蔡嘉哲引用關係
指導教授(外文):Gregory J. Tsay
學位類別:碩士
校院名稱:中山醫學院
系所名稱:免疫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:64
中文關鍵詞:抗E3抗體自體抗體C型肝炎感染抗嗜中性白血球細胞質抗體
外文關鍵詞:anti-E3autoantibodyHepatitis C virus (HCV) infectionANCA
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之前已有文獻指出C型肝炎感染與自體免疫疾病、自體免疫和慢性C型肝炎有關。為了了解C型肝炎感染病人產生anti-dihydrolipoamide dehydrogenase (anti-E3),anti-dihydrolipoamide acetyltransferase (anti-E2),anti-SSA/Ro (60KD),anti-SSA/Ro (52kD),anti-SSB/La,anti-topoisomerase II,anti-cardiolipin (aCL),anti-dsDNA,anti-ssDNA,anti-nuclear antibodies (ANA),rheumatoid factor (RF), anti-neutrophil cytoplasmic antibody (ANCA),anti-PR3 (anti-proteinase 3),anti-MPO (anti-myeloperoxidase) ,anti-actin抗體的發生率,我們利用間接免疫螢光法,酵素免疫分析法(ELISA),西方點墨法和Rheumatoid factor kit去檢測與分析。Anti-E3 antibody,ANCA和rheumatoid factor在C型肝炎病人中的陽性率很高分別為53.3 %,55.6%和56%。Anti-SSA/Ro (52kD),anti-SSA/Ro (60kD),anti-SSB/La,aCL,anti-dsDNA,anti-ssDNA,anti-Topo II,anti-PR3,anti-MPO,anti-actin在C型肝炎病人的產生率分別為1.2%,3.9%,4.1%,10.3%,8.5%,15.6%,0%,55.6%,4.8%,0%。Anti-E2 antibody測到3.3% C型肝炎病人陽性反應。RF測到56.5% C型肝炎病人陽性反應。ANA測到15.8% C型肝炎病人陽性反應。Anti-E3 antibodies 在C型肝炎病人中的陽性率( 53.5% )比在原發性膽汁肝硬化的病人高 ( 27% ) ( P<0.01 )。Anti-E3 antibody和ANCA在 C型肝炎病人中的陽性率很高。由這些資料顯示Anti-E3 antibody和ANCA可能與C型肝炎感染後的免疫反應有關。
Hepatitis C virus (HCV) infection has been found to be strikingly associated with autoimmune diseases, autoimmunity and chronic hepatitis. The aim of the present study was to investigate the frequency and the significance of antibodies to dihydrolipoamide dehydrogenase (E3), dihydrolipoamide acetyltransferase (E2), SS-A/Ro (60KD), SS-A/Ro (52 kD), SS-B/La, topoisomerase II, anticardiolipin (aCL), dsDNA, ssDNA, nuclear antibodies (ANA), rheumatoid factor (RF), neutrophil cytoplasmic antibody(ANCA), PR3 (proteinase 3), and MPO (myelo-peroxidase) in 516 patients with HCV infection by indirect immunofluoresence assay, particle latex agglutination test, enzyme linked immunosorbent assay (ELISA), and immunoblotting.Anti-E3 antibody, ANCA and RF were found in 53.3 %, 55.6% and 56%, respectively, of patients with HCV infection. ANA were found in 15.8%, anti-ssDNA antibodies in 15.6%, anti-dsDNA antibodies in 8.5%, ACL in 5%, anti-SSB/La in 4.1%, anti-SSA/Ro (60 kD) antibodies in 3.9%, anti-E2 antibodies in 3.3% and anti-SSA/Ro (52 kD) in 1.2 %, anti-Topo II in 0%, anti-PR3 in 55.6%, anti-MPO in 4.8%, anti-actin in 0%. Anti-E3 antibodies were found more frequently in patients with HCV infection (53.3%) than in patients with primary biliary cirrhosis (27%) (P<0.01).Anti-E3 antibodies and ANCA were present in a high prevalence in patients with HCV infection. These data suggest that E3 and ANCA were associated with the immune response of HCV infection.
目 錄
目錄頁次
中文摘要05
英文摘要06
一、導論 …………07
自體免疫07
自體抗體07
C型肝炎病毒感染背景介紹11
病毒感染與自體抗體13
研究動機與目的14
二、材料與方法 …………16
血清來源16
間接免疫螢光法16
蛋白質純化17
酵素免疫分析法 (ELISA)26
類風濕性因子檢驗27
三、實驗結果 …………28
C型肝炎感染病人產生的自體抗體(檢測試劑)28
C型肝炎感染病人產生的自體抗體(製備抗原)29
C型肝炎感染病人抗E3抗體的產生與否與臨床症狀之關係32
C型肝炎感染病人自體抗體的產生與接受interferon-α治療之關係33
四、討論 …………34
C型肝炎感染病人與自體免疫疾病的相關性34
C 型肝炎感染病人產生抗嗜中性白血球細胞質抗體34
C型肝炎感染病人產生anti-E3抗體35
C型肝炎感染病人產生anti-E3抗體與否與臨床症狀相關性35
C型肝炎感染病人產生的自體抗體35
C型肝炎感染病人產生自體抗體與接受interferon-α治療相關性37
C型肝炎感染病人產生自體抗體的可能原因38
Anti-E3 抗體及cANCA抗體也出現在C型肝炎感染病人38
圖表 …………
圖一 使用間接免疫螢光法分析C形肝炎感染病人血清中抗核抗體。40
圖二 使用間接免疫螢光法分析C形肝炎感染病人血清中抗嗜中性白血球細胞質抗體。41
圖三 以Nickel columm分別純化SSA/Ro(52kD及60kD)蛋白。42
圖四 以Nickel columm純化SSB/La蛋白。43
圖五 以Nickel columm純化Topo II蛋白。44
圖六 以ELISA方式使用E3當抗原檢測正常人、原發性膽汁肝硬化病人及C形肝炎感染病人。45
圖七 以純化出來的E3當抗原用西方點墨法分析C形肝炎感染病人及正常人。46
表一 用臨床檢驗方式檢測C形肝炎感染病人。47
表二 使用間接免疫螢光法檢測C形肝炎感染病人中抗嗜中性白血球細胞質抗體及以ELISA方式檢測C形肝炎感染病人中與抗嗜中性白血球細胞質抗體有關的目標抗原。48
表三 以ELISA方式使用製備抗原檢測C形肝炎感染病人。49
表四 以ELISA及western blot方式使用製備抗原檢測C形肝炎感染病人。50
表五 C型肝炎感染病人抗E3抗體的產生與否與臨床症狀之關係。51
表六 C型肝炎感染病人自體抗體的產生與IFN-α治療之關係。52
附表 之前研究指出C形肝炎感染病人產生自體抗體的發生率。53
參考文獻 …………54
附錄 …………60
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