叶文芳+刘健+黄永平+黄雄峰+王叙德+潘淳

【摘 要】目的：分析39例强直性脊柱炎患者和20例健康体检者的血清免疫球蛋白（IgG1、IgG2、IgG3、IgG4、IgA、SIgA、IgM）、淋巴细胞自噬蛋白Beclin1、自噬指标微管相关蛋白l轻链（LC3-Ⅱ）、磷脂酰肌醇三磷酸激酶（PI3K）、AKT、哺乳动物雷帕霉素靶蛋白（mTOR），观察上述指标的变化并对其相关因素进行分析。方法：选取39例强直性脊柱炎患者为AS组，另设20例健康体检者为健康对照组，采用ELISA方法检测2组血清免疫球蛋白（IgG1、IgG2、IgG3、IgG4、IgA、SIgA、IgM），运用Western blot方法检测2组淋巴细胞自噬蛋白Beclin1、LC3-Ⅱ、PI3K、AKT、mTOR的变化。结果：①2组

免疫球蛋白比较，IgA、IgG1、IgG3较健康对照组显著升高（P < 0.05或P < 0.01）。②2组细胞自噬相关指标比较，PI3K、mTOR较健康对照组明显升高（P < 0.05或P < 0.01）。③相关性分析结果显示，AS患者PI3K与LC3-Ⅱ呈负相关。④相关性分析结果显示，AS患者IgG1、IgG2、IgG3、IgG4与mTOR呈正相关，SIgA与Beclin1呈正相关。结论：AS患者存在体液免疫功能的紊乱和细胞自噬指标的变化，且各项指标存在一定的相关性。

【关键词】 脊柱炎，强直性；免疫球蛋白；自噬蛋白；自噬通路

Changes and Correlation Analysis of Immunoglobulin and Autophagy in Patients with Ankylosing Spondylitis

YE Wen-fang，LIU Jian，HUANG Yong-ping，HUANG Xiong-feng，WANG Xu-de，PAN Chun

【ABSTRACT】Objective：To observe the changes and analyze the related factors of serum immunoglobulin（IgG1，IgG2，IgG3，IgG4，IgA，SIgA，IgM），lymphocyte autophagy protein Beclin1，LC3-Ⅱ，PI3K，AKT and mTOR in 39 patients with ankylosing spondylitis and 20 healthy subjects.Methods：Thirty nine cases of ankylosing spondylitis were selected as an AS group，and 20 healthy subjects were selected as a control group，using ELISA method to detect serum immunoglobulin（IgG1，IgG2，IgG3，IgG4，IgA，SIgA，IgM） of the two groups，and using Western blot to detect the changes of Beclin1，LC3-Ⅱ，PI3K，AKT and mTOR.Results：①According to the comparison of immunoglobulin of the two groups，the levels of IgA，IgG1 and IgG3 in the AS group were significantly higher than those in the control group（P < 0.05 or P < 0.01）.②PI3K and mTOR of the AS group were obviously higher than those in the control group（P < 0.05 or P < 0.01）.③Correlation analysis showed that PI3K in the AS group was negatively correlated with LC3-Ⅱ.④Correlation analysis showed that IgG1，IgG2，IgG3 and IgG4 in the AS group were positively correlated with mTOR，and SIgA were positively correlated with Beclin1.Conclusion：There are changes of humoral immune function and autophagy index in patients with ankylosing spondylitis，and there is a certain correlation between the indexes.

【Keywords】spondylitis，ankylosing；immunoglobulin；autophagy protein；autophagy pathway

強直性脊柱炎（ankylosing spondylitis，AS）是一种慢性进行性脊柱关节病，属于自身免疫性疾病。本病早期无特异性症状，可出现炎症性腰背痛和腰背部僵硬，晚期可发生永久性关节畸形。早期诊断有助于控制病情进展，减少致残率，对AS的治疗具有重要意义[1]。据报道，AS患者体内存在免疫球蛋白的异常[2]。笔者分别对20例健康体检者和39例AS患者的血清免疫球蛋白（IgG1、IgG2、IgG3、IgG4、IgA、SIgA、IgM）、淋巴细胞自噬蛋白Beclin1、自噬指标微管相关蛋白l轻链（LC3-Ⅱ）、磷脂酰肌醇三磷酸激酶（PI3K）、AKT、哺乳动物雷帕霉素靶蛋白（mTOR）进行检测，并对各项指标进行分析，从免疫球蛋白和细胞自噬的新角度研究，希望能指导AS的早期诊断、治疗及预后。……