目的:離別在血管史和自體免疫疾病的病人血清中，自現的嗜中性白血
球細胞質抗體(Anti neutrophil cytoplasmic antibody)所對抗之抗擇。
方法:將收黨來自不同臨床鐵饒、懷疑有血管吏的 160 支血清及 40
正常血清，首先利用間接螢光免疫分析法(Indirect immunofluorescence)
瀾試是否會有嗜中性白血球細胞質抗體，然後再進一步使舟酵牽連結
免疫分析法(Enzyme linked immunosorbent assay) 分析 Proteinase 3
(PR3)抗體、 Myeloperoxidase (MPO)說韓、 Lactoferrin 弘的抗體及
Lyso rme (LZ)抗體的表現。除比之外， 110 支來自全身性紅軍壞性換通告
(Syste ic lupus erythematosus)病人血清和劉文來自類風濕性關節支
(Rheumatoid arthritis)病人血清，亦使用酵素連結免疫分析法去分析
R3抗體、 MPO 抗體、 LF 抗體及 LZ 抗體的表現。
結果:在 160 丈懷疑有血管吏的血清中，以間接免疫螢光分析發現，其
60 克表現核周閣型嗜中性白血球細胞質抗體(Perinuclear antineutrophil cytoplasmic antibody) , 21 文表現細胞質型嗜中性白血球細
胞質抗體(Cytoplasmic anti-neutrophil cytoplasmic antibody) 。而在 60
支表現核周閣型嗜中性白血球細胞質抗體的血清中，典 MPO 反應有時
文、與 R3反應有 文、典 LF 反應有 文、與 LZ 反應有 丈;在 21
文表現細胞質型嗜中性白血球細胞質抗體的血清中，與 R3反應有 12
克、與 LF 反應有 文、典 LZ 反應有 文、與 MPO 反應有 丈。
110 文全身性紅距性換發病人血清中，嗜中性白血球細胞質拭
體之各種特異性抗原出現之比1Jt 分別為 R3抗髓。%、 MPO 抗體
1% LF 抗體 27.2% LZ 抗體 29.1% 。在 51 文類風濕性鵑節炎病人
血清中，嗜中性白血球細胞質抗體之各種特異性抗原出現，之比制分別
PR3 抗體 5.9% MPO 抗體 2% LF 抗體 7.8% LZ 抗體 3.92%。
結論:核周圍型嗜中性白血球細胞質抗體和細胞質型嗜中性白血球細胞
質抗體會與不同的嗜中，挂白血球細胞質抗原反應。全身性紅雄性狼蜂
病人血清與類風濕，性關節。東蜻人血清，並不常出現 PR3 MPO 抗體，
其中在全身性紅雄性狼瘡藏人血清中， LF 抗體、 LZ 抗體出現，的比倒
高，而 PR3 抗體、 MPO 抗體出現的比飼低。兔子經 MPO 免疫注射，
螢光表現 pANCA; LF 免疫注射，螢光亦表現 pANCA; HMGl&2
免疫注射，螢光表現 cANCA。
Objective. To characterize antigens recognized by classic anti
neutrophiJ cytoplasmic antibody (cANCA) and perinuclear anti
neutrophil cytopIasmic antibody (pANCA) in vasculitis and
autoimmune disease.
Methods. A total of 160 serum samples from patients with different
clinical manifestations in whom systemic vasculitides were suspected
and 40 control samples were tested for cANCA and pANCA by indirect
immunofluorescence (草的. All available sera were further tested by
enzyme-linked immunosorbent assay (ELISA) for the presence of
antibodies to proteinase 3 (PR3), myeloperoxidase (MPO), lactoferrin
(LF) and lysozyme (LZ). In addition, sera from 110 patients with
systemic lupus erythematosus (SLE) and 51 patients with rheumatoid
arthritis (RA) were also tested by ELISA for antibodies to PR3, MPO,
LF and LZ.
Results. ANCA were detected in 81 ofthe 160 sera by llF. A cANCA
pattern of fluorescence was detected in 21 sera and a pANCA pattern
was observed in 60 sera. By ELISA testing, ofthe 21 sera with cANCA,
12 sera reacted to PR3, 4 to LF, 4 to LZ and 3 to MPO. Ofthe 60 sera
with pANCA, 15 sera reacted with MPO, 13 to PR3, 8 to LF and 4 to
LZ.
The prevalence of ANCA antigenic specificities in SLE were anti-PR3品
。%; anti-MPO= 1 %; anti-LF= 27.2%; anti也Z= 29.1 %. The prevaIence
of ANCA antigenic specificities in RA were anti-PR3= 5.9兮兮; antiMPO= 2%; anti-LF= 7.8%; anti-LZ= 3.9%.
Conclusion. cANCA and pANCA are reacted witb diverse cytoplasmic
antigens of the neutropbils. Antibodies to PR3 and 1\生PO are not
common in sera from patients witb SLE and RA. Sera from patients
witb SLE contain more anti-LF and anti-LZ antibodies than anti-PR3
and anti-MPO antibodies. Rabbits anti-MPO and anti-LF antiserum
botb sbowed pANCA staining pattern and anti-HMG 1&2 sbowed a
cANCA staining pattern in indirect immuno:fluorescence.
