風濕性疾病病人之生體抗核抗體

IN VIVO Anti- Nuclear Antibodies in Epithelial Biopsies in Rheumatic Diseases

血清中的抗核抗體可和表皮上的細胞核結合，此現象可經由皮膚切片以免疫螢光方法檢查出來，此又叫生體抗核抗體(in vivo ANA)。過去數年來大部份學者都認為此現象出現在含有ENA抗體的風濕性疾病，尤以含RNP抗體的疾病為最多，故認為此現象可能是混合結締組織病(MCTD)之一特徵。我們作了42個切片檢查中，發現有三例生體抗核抗體，其中二個為紅斑性狼瘡，另一個為混合結 締組織病，三個病人都有血清抗核抗體陽性且都帶斑點型，其中二人含RNP抗體，另一人含SS-B抗體，為了研究生體抗核抗體，我們把含RNP及SS-B抗體之血清與正常人之皮膚切片反應，再以免疫螢光方法觀察，可發現RNP及SS-B抗體都能透過細胞膜而產生生體抗核抗體。

In vivo anti- nuclear antibody (ANA) was demonstrated by direct immunofluorescence in epidermal cells of clinically area of normal skin from three patients. The positive epidermal nuclear reaction was found to be associated with IgG. The clinical diagnoses of the patients included two with systemic lupus erythematsus (SLE) and one with mixed connective tissue disease (MCTD). Each of these patients had serum ANA of speckled type and high titer of antibody to extractable nuclear antigen (ENA). Serum antibody to ribonucleoprotein (RNP) was present in two of these three patients. Serum antibody to SS- B was found in the remaining one. In vitro testing demonstrated that normal control skin incubated with antisera to RNP and SS- B reproduced the findings observed in direct staining.