Аннотация
Анкилозирующий спондилит (АС) — хроническое иммуновоспалительное заболевание из группы спондилоартритов, при кото-
ром часто наблюдаются воспалительные заболевания кишечника (ВЗК). Аутоантитела и антимикробные антитела при-
меняют в качестве дополнительных неинвазивных диагностических маркёров ВЗК.
Цель исследования – определить уровни и частоту выявления антител, ассоциированных с ВЗК, в сыворотках больных АС.
Материал и методы. Исследованы сыворотки 44 здоровых доноров (ЗД) и 51 больных АС: 40 мужчин, 11 женщин в возрасте
44,0 (34,0–49,0) лет с длительностью заболевания 12,0 (5,0-20,0) лет. У 22% больных АС диагностированы ВЗК. Атипичные
перинуклеарные антинейтрофильные цитоплазматические антитела (пАНЦА) определяли методом НРИФ, IgG/IgA анти-
тела к S. cerevisiae (ASCA), IgG/IgA антитела (АТ) к гликопротеину 2 (GP2), IgG АТ к катепсину G, лактоферрину, эластазе
и бактерицидному белку, повышающему проницаемость (BPI) — с помощью ИФА.
Результаты. Больные АС с ВЗК отличались более высокой сывороточной концентрацией АТ к катепсину G и частотой об-
наружения атипичных пАНЦА (36,0%) и АТ к BPI (36,0%), чем пациенты с АС без ВЗК (4,8% и 8,0%) (р<0,05). Относительно
здоровых лиц, увеличение концентрации IgG АТ к GP2 наблюдалось при АС без ВЗК (р<0,05), частота выявления атипичных
пАНЦА и IgA АТ к GP2 – при АС с ВЗК (36,0% и 27,0% vs 0%, p<0,05). Больные АС без и с ВЗК имели более высокие уровни IgA
ASCA, IgA АТ к GP2, АТ к эластазе по сравнению с группой ЗД (p<0,05). АТ к эластазе при АС без ВЗК и АС с ВЗК встречались
чаще, чем у ЗД (23,0% и 33,0% vs 0%, р<0,05).
Заключение. Выявление при АС без ВЗК антител, ассоциированных с ВЗК, указывает на сходные механизмы патологической
активации иммунного ответа у больных АС и ВЗК и возможность использования данных биомаркёров для прогнозирования
развития субклинического воспаления кишечника.
Annotation
Ankylosing spondylitis (AS) is a chronic immune-inflammatory disease from the group of spondyloarthritis, which is often accompanied
by inflammatory bowel disease (IBD). Autoantibodies and antimicrobial antibodies are used as additional non-invasive diagnostic
markers of IBD.
Objectives. The aim of the study was to determine the levels and frequency of detection of IBD-associated antibodies in the sera of
patients with AS.
Material and methods. The sera of 44 healthy donors (HD) and 51 patients with AS were studied: 40 men, 11 women aged 44.0 (34.0–
49.0) years with a disease duration of 12.0 (5.0–20.0) years. IBD was diagnosed in 22% of patients with AS. Atypical perinuclear
antineutrophil cytoplasmic antibodies (pANCA) were determined by IIF, IgG/IgA antibodies to S. cerevisiae (ASCA), IgG/IgA
antibodies (AB) to glycoprotein 2 (GP2), IgG AB to cathepsin G, lactoferrin, elastase and bactericidal permeability-increasing protein
(BPI) — by ELISA.
Results. Patients with AS with IBD had a higher serum concentration of AB to cathepsin G and the frequency of detection of atypical
pANCA (36.0%) and AB to BPI (36.0%) than patients with AS without IBD (4.8% and 8.0%) (p<0.05). In comparison with HD, an
increase in the concentration of IgG AT to GP2 was observed in AS without IBD (p<0.05), the frequency of detection of atypical
pANCA and IgA AB to GP2 — in AS with IBD (36.0% and 27.0% vs 0%, p<0.05). Patients with AS without and with IBD had higher
levels of IgA ASCA, IgA AT to GP2, AT to elastase compared to HD (p<0.05). In AS without IBD and AS with IBD, the occurrence of
AB to elastase was higher than for HD (23.0% and 33.0% vs 0%, p<0.05).
Conclusion. The detection of IBD-associated antibodies in AS without IBD indicates similar mechanisms of pathological activation
of the immune response in patients with AS and IBD and the possibility of using these biomarkers to predict the development of
subclinical intestinal inflammation.
Key words: ankylosing spondylitis; inflammatory bowel diseases; antibodies to Saccharomyces cerevisiae (ASCA); atypical perinuclear
anti-neutrophil cytoplasmic antibodies (pANCA); antibodies to glycoprotein 2 (GP2); antibodies to cathepsin G, lactoferrin, elastase,
bactericidal permeability-increasing protein (BPI)
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Л И Т Е РА Т У РА ( П П . 2 – 1 0 , 1 2 — 2 5 , 2 7 — 4 0 С М .
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