抗リン脂質抗体症候群におけるエリア-抗リン脂質抗体測定試薬の臨床的有用性  [in Japanese] Clinical significance of antiphospholipid antibody measured by EliA anticardiolipin antibodies and anti-β2Glycoprotein I antibodies in antiphospholipid syndrome  [in Japanese]

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Author(s)

    • 藤枝 雄一郎 FUJIEDA Yuichiro
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 志田 玄貴 SHIDA Haruki
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 奥 健志 OKU Kenji
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 坊垣 暁之 BOHGAKI Toshiyuki
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • AMENGUAL Olga AMENGUAL Olga
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 堀田 哲也 HORITA Tetsuya
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 保田 晋助 YASUDA Shinsuke
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University
    • 渥美 達也 ATSUMI Tatsuya
    • 北海道大学大学院医学研究科内科学講座 免疫・代謝内科学分野 Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University

Abstract

抗カルジオリピン抗体(抗CL)-IgG/IgM,抗β<sub>2</sub>-グリコプロテインI(抗β<sub>2</sub>GPI)-IgG/IgMは抗リン脂質抗体症候群(APS)の診断基準で認められた臨床検査であるが,本邦では抗CL-IgMや抗β<sub>2</sub>GPI-IgG/IgMはルーチン検査として確立していない.抗CL-IgG/IgM,抗β<sub>2</sub>GPI-IgG/IgM測定キット(Phadia:EliA<sup>TM</sup>)を用いることによるAPSの診断における本邦での有用性を検討した.229例(APS群100例,非APS群129例)の保存血清を用い,EliA<sup>TM</sup>抗CL(CL-IgG,CL-IgM)およびEliA<sup>TM</sup>抗β<sub>2</sub>GPI(β<sub>2</sub>-IgG, β<sub>2</sub>-IgM)を測定した.感度,特異度,ROC曲線下面積はそれぞれ抗CL-IgG(45%,94%,0.80),抗CL-IgM(20%,94%,0.54),抗β<sub>2</sub>-IgG(33%,98%,0.88),抗β<sub>2</sub>-IgM(16%,99%,0.64)であった.APS100例で抗CL-IgG陰性55例のうち,抗CL-IgM,抗β<sub>2</sub>-IgG,抗β<sub>2</sub>-IgMのいずれかが陽性である症例は10例であった.複数の抗リン脂質抗体検査を組み合わせることで,APS診断の感度向上が確認された.

Anticardiolipin antibodies (aCL-IgG/IgM) and anti-β<sub>2</sub>-glycoprotein I antibodies (aβ<sub>2</sub>GPI-IgG/IgM) are laboratory tests included in the current classification criteria for definite antiphospholipid syndrome (APS). However, not all of these assays have been commercially available in Japan. We investigated the efficacy of aCL-IgG/IgM and aβ<sub>2</sub>GPI-IgG/IgM assays using fluorescence enzyme immunoassay (Phadia:EliA<sup>TM</sup>) for the diagnosis of APS in Japan. This study comprised 229 sera from patients (100 with APS and 129 without APS). The diagnosis of APS was made according to Sydney revised Sapporo criteria. EliA<sup>TM</sup>Cardiolipin and EliA<sup>TM</sup>β<sub>2</sub>-Glycoprotein (Phadia AB. Uppsala Sweden) were used to detect aCL IgG/M and aβ<sub>2</sub>GPI IgG/M, respectively. Sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were as follows; aCL-IgG (45%, 94%, 0.80), aCL-IgM (20%, 94%, 0.54), aβ<sub>2</sub>GPI-IgG (33%, 98%, 0.88) and aβ<sub>2</sub>GPI-IgM (16%, 99%, 0.64) respectively. aCL-IgM, aβ<sub>2</sub>GPI-IgG or aβ<sub>2</sub>GPI-IgM were detected in 10 patients (18%) with aCL-IgG negative. The use of Phadia:EliA<sup>TM</sup>antiphospholipid antibodies assays improve the diagnostic yield of thrombotic risk in APS patients.

Journal

  • Japanese Journal of Clinical Immunology

    Japanese Journal of Clinical Immunology 37(5), 430-436, 2014

    The Japan Society for Clinical Immunology

Codes

  • NII Article ID (NAID)
    130004875940
  • Text Lang
    JPN
  • ISSN
    0911-4300
  • Data Source
    J-STAGE 
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