TiBiP CHl NGHIEN CLFU Y HOC • " ' '
KHANG THE KHANG NHAN VA KlfiU LANG DONG HUYNH QUANG TREN TE BAO HEP - 2 6^ BENH NHAN
MAC BENH MO UEN KET TU" MI§N
Le Huydn M y \ Le HQ'u Doanh^ Pham Dang Bang^ Trdn Hgu Khang*
^B$nh vien Da Lieu Trung uong; ^Tru-dng Dai hQC Y Ha N^
Benh md lien kit ((f midn la cac benh ly gay ton thuong nhieu ca quan trong co the Sy cd m$t khang IhS khang nhan dime coi la tieu chuan vang trong chan doan cac benh m6 lien k4t fy mien. Nghidn cCfu su dijng kl thuat mien djch huynh guang gian ti§p (MDHQGT) tren te bao Hep - 2 d4 xac dinh khang the khang nhSn va Ifieu ling dQng huynh quang tren te bao Hep - 2 cua cac benh nhan mSc b^nh mo lien ket tu ml§n den kham va dieu tn tai benh vien Da liiu Tmng uong. Kdt qua cho thiy ty 1$ khang the khang nhSn duong llnli bang kl thuat miin dich huynh quang gian tiep tren td bao Hep - 2 la 97.5 %. Lang dpng hu^nh quang kiiu d6m dan thuin chiem 38.46%. ddm + bao tu^ng 20,51%. ddng nhat dan thuan va ddm + ddng nhit 17.95%.
ddm + hanh nhan, ddng nhat + dom rdi rac 2.56% Xac dmh khang the khang nhan b^ng kTthu$t miin d/cfi huynh quang gian tiSp tren t§ bao Hep - 2 gop phan chin doan b$nh md lien ket tw miin.
Td khoa: b|nh mo lien k i t t y miln, ki§u l i n g dpng huynh quang, khang the, m i i n djch hujnh quang gian ti4p tren t i bao Hep-2, k i t tua m i l n djch protein
I. DAT
V A N D EBdnh md lien k i t tu' mien (autoimmune connective tissue diseases - ACTDs) la ede bdnh nguy h i i m , gay tdn thu'ang nhiiu c o quan trong co the, anh hu'ang d i n sdc khoe cung nhLF de doa cuoc sdng cua ngu'ai bdnh Khdng the khdng nhdn (ANA) va cac tu- khang t h i dLFOC coi la tieu chuan vang trong c h i n doan cac bdnh md lien k i t tu' midn. H i i u rd cac khang the khang nhdn khdng chi giup Idm sang id CO c h i benh sinh ma eon gOp phan theo ddi d i i u tri va tien lu'ang mdt sd bdnh ly md hen k i t t u midn [1; 2] KT thuat midn dich huynh quang gidn t i i p trdn t i bao Hep - 2 s d dung t i bao Hep - 2 nhu' mdt c o c h i t n i n d i phat hidn cdc loai khang t h i khdng nhan.
Oia chilien he L6 Huyen My, benh vien Da lieu Trung uong
Email lemy_vieln3m@yahoa com Ngaynh$n 03/4/2014 Ngay dupe chap thuan 26/06/2014
khang hat nhan, khang cac thdnh phan cua bao tu'ang [3], U'ng dung nhdng thanh tyu ve midn dich hoc nhu' kT thudt midn dich hu^nh quang gidn tiep tren t i bao Hep - 2 vd klthu^t kit tua midn djch protein cho phdp phdt hifin khang t h i khdng nhan va cac khdng the khang lai nhieu thanh phin ciu true t i bao VI vdy, Chung tdi thu'c hien d i tai ndy voi mgc tieu. Xdc dmh ty Id khang t h i khang nhan vd kieu-ling dong huynh quang trdn t i bdo Hep- 2 d bdnh nhan mic bdnh md Hdn kit tu- miin
II. 0 6 l TU'gNG VA PHUaNG PHAP
1.061 tu'O'ng
Bdnh nhdn du'p'c chin dodn xdc dinh mk cac bdnh md lidn kit ty midn nhu"
- Lupus ban do hd thong (SLE)' theo tifeu chuin hdi thip khOp hoc My (ACR) 1997,
- Xa cdng bi hd thing' theo tieu chuin h$i thap khdp hoc My (ACR) 1980.
TCNCYH 88 {3)-2014.
• r^P CHl NGHIEN CU'U Y HOC - Viem bi c o ' Theo bd tidu c h u i n chan
dodn cua Nhat Ban ndm 1985.
- Bdnh md lidn k i t phdi hop- Theo bd tidu chuin c h i n dodn cua Alarcon - Segovia
2. Phu'cng phap: nghien edu md ta.
- Cac bu'de t i i n hanh:
+ L i y mau tTnh mgch 3ml vao dng khdng ehdng ddng, de d nhidt dd phdng trong 30 phdt, ly tdm vdi tdc dd 2000 vong/15 phut Chat p h i n h u y i t thanh vao dng 1,5ml, lu'u o tu lanh sau - 80°C.
+ Thu'c hidn kT thudt midn djch hu^nh quang gidn t i i p trdn t i bdo Hep - 2 Huyit thanh benh nhan du'oc u vOi c o c h i t (te bao Hep-2) trong 30 phiit Sau do, nhdng khang the khdng gdn vao t i bao Hep - 2 se du'oc rda sach tru'Oc khi cho khang t h i c i p 2 cO g i n c h i t ddnh d i u huynh quang. Khdng t h i danh d i u sd lidn k i t vOi immunoglobulin cua huyit thanh bdnh nhdn da g i n vdo khdng nguydn tren t i . b d o Hep - 2 Nhdng vi tri ed cd dmh khdng t h i se nhin t h i y du'p'c du'Oi kinh hien vi huynh quang, Huynh quang du'oc l i n g dpng du'di cac hinh thai ddng n h i t , ddm, ngoa' vi, d i m - rOi rgc, hach nhdn, bdo tu-ong,
•^ Thu'c hidn kT thudt k i t tua midn dich protein Nudi cay t i bao K562 - t i bao ung thu' ddng hdng, bach c i u d ngu'Oi. Danh dau
III. KiT QUA
phdng xg cdc t i bdo K562 b i n g 358- methionine. Danh toi cdc t i bdo K562 dd du'oc danh d i u phdng xa de pha v d cau true vd ly trich cdc thdnh p h i n te bdo. U huyit thanh bdnh nhdn vOi cac hat protein A Sepharose, ede khang thd sd gdn vao cdc hat protein A Sepharose 0 hdn hap khdng t h i - hat protein A Sepharose vOi ede thdnh p h i n ly trich t d t i bao K562, cac khang t h i dac hidu n i u ed se k i t hop vOi cdc thdnh p h i n khdng nguydn cua t i bdo tao thanh phde hop khang nguydn - khang the - protein A Sepharose.
Tdch khang nguyen - khang t h i khoi phdc hop khang nguyen - khang the - hat protein A Sepharose. Dien di trdn gel polyacrylamide cd SOS vd doc k i t qua
3. Dja d i i m va thdi gian nghien c d u : benh nhan tai benh vien Da lidu Trung u'ang, ky thuat k i t tiJa midn dich protein tai khoa Da, tru'dng Dai hoe Kanazawa - Nhat Ban
ThOi gian nghien edu t d thang 1 nam 2013 d i n thang 12 nam 2013
4. X d ly s d lieu: theo chu'ang trinh SPSS 1 3 0
Dao ddc nghien c d u : Nghidn cdu nay da du'oc thong qua Hoi ddng dao ddc bdnh vien Da lidu Trung u'ang, sd 436/HDKH-BVDLTW, ngay 23/8/2013
1. Phan bo benh nhan theo nhdm benh
Bang 1. Phan bd benh nhan theo nhom benh (n = 40) STT
1 2 3 4
SLE X a ci>ng bi Vi6m bi ccy Overlap
Nhom benh
T6ng so
n 28 7 4 1 40
%
70,0 17,5 10,0 2,6 100
TiJP CHl NGHIEN C l f U Y HQC •
Nlibm SLE co s6 \uang benh nhSn dong nhat (n = 28, chiem 70%), tiSp theo \i nhom x c cCfng bi (n = 78, c h i i m 17,5%), viem bi co (n = 4, chiem 10%), cu6i cCing i4 nhom overlap (n = 1, chiem 2,5%),
2. TJ l§ ANA dircxng tinh phat hien bSng kl thuat mlin djch huynh quang gian tiip tr§n t i bao Hep - 2
Bang 2. Ty IS ANA duwng tinh phat hien b i n g kT thuat mlSn djch huynh quang gian tiip tren t i bao Hep - 2 (n = 40)
STT 1 2 3 4 Tong
Nhom benh SLE
X o ci>ng bi ViSm bi Off Overlap so
n 28 7 4 1 40
n 28 7 4 1 39
ANA du'ang tinh
%
70,0 17,5 10,0 2,S 97,5
39/40 bdnh nhan cd k i t qua ANA duang tinh xac dinh b i n g kT thugt xdt nghidm miln djch huynh quang gian t i i p trdn te-bao Hep - 2. Ty Id khdng the khang nhdn du'ang tinh 0 nhdm SLE Id 96,43%, d cdc nhdm cOn lai Id 100%. Ty Id ndy tinh chung cho cdc nhdm Id 97,5%.
3. Kieu Idng dong huynh quang tren t i bao Hep - 2
Bang 3. Ty Id cac kidu Idng dong huynh quang tren t i bao Hep - 2 (n = 39)
K i i u Idng dong huynh quang n %
Dom don thuan 38,46
2 Ddng nhat dan thuan Ddm + Bdo tu'ang 4 Ddm + Ddng n h i t Dom + Hgeh nhan 6 Dong nhat + Ddm - rdi rac
^ Kieu ddm don thudn c h i i m ty Id cao n h i t (38,46%), tiep den Id ddm + bao tu'ang (20.51%), ddng nhit dan t h u i n va ddm + ddng n h i t (17,95%).
TCNCYH 88 (3) - 2014
• TAP CHi NGHIEN CU'U Y HOC 4. Ty Id cac khang t h i tu'O'ng dng vdi kidu Idng dpng huynh quang tren td bao Hep - 2 Bang 4. Ty le cac khang thd tuvng dng kiiu ling dong huynh quang tren td bao Hep - 2 (n = 39)
Kieu huynh quang Cac khang t h i n
Ddng nhat don thuan
Khdng t h i khang U1 RNP
Khang the khang SSA 1 Khang t h i khang P165/140 1
Kh^ng the chi^a biet 2
Am tinh 1 l o n g s6
Khang the khang U1 RIMP Khang the khang U1 RNP, SSA Khang the khang Smith, U1 RNP, SSA
7 6 2 2 Khang the khang U1 RNP, Scl -70
Ddm dan thuan Khang the khang Scl - 70 Khang the khang NXP - 2 Khang the chu'a biet Am tinh Tdng so
Ddm + ddng n h i t
Khang t h i khdng U1 RNP, SSA Khang the khang U1 RNP Khang t h i khang SSA Khang the khang Scl - 70, SSA Am tinh
Tdng sd
Dom + bdo tu'ang
Khang the khdng SSA Khang t h i khang U1 RNP, SSA Khang t h i khang U1 RNP. SSA, SSB, Smith Khang t h i khang RNAPl/lll/ll
Khang the khang MDA - 5 Khang the chu'a biet
TAP CHI NGHIEN C l X ) Y HOC • Kiiu huynh quang
Dim + bao ttrong Dong nhit + dom - r&i rac Dong nhit - hach nhan
Cac khang thi Kh^ng the khang U1 RNP long so
Kh4ng thi khang U1 RNP, SSA Khang the khang Sd - 70
N 1 8 1 1 06i vol kieu d6ng nhat don t h u i n , cac
khang the du'oc phat hien ia khang the khang U1 RNP (28,57%). khang the khang SSA (14.29%), khang the khang p155/140 (14,29%). 0 kieu d i m do'n thuan, ty le khang the khang U1 RNP (40 %), khang the khang U1 RNP va Ro/SSA (13,33 %), khang the khang Smith. U1 RNP va Ro/SSA (13,33 %), Kiiu a i m + dong nhat. cac khang the du-g-c phat hiSn ia khang the khang U1 RNP va Ro/
SSA (28,57%), khang the khang U1 RNP (28,57%), khang the khang Ro/SSA (14,29%), khang t h i khang Scl 70 va Ro/SSA (14,29%). Kieu dom + bao tuang, ty ie khang t h i khang Ro/SSA (25 %), khang the khang U1 RNP va Ro/SSA (12,5 %), khang t h i khang RNAP l/lll/ll (12,5 %), khang the khang MDA - 6 (12,5 %), khang the khang U1 RNP, Ro/SSA, SSB va Smith (12,6 %), khang the khang U1 RNP (12,5 %). Loai khang the tirong u-ng vol kieu d i n g n h i t + dom - rdi rac ia khang t h i khang U1 RNP va Ro/SSA. Loai khang t h i tu'ang ung vol k i l u dong nhat + hach nhan khang the khang Scl - 70.
IV. BAN LUAN
NghiSn ctpu cua chiing toi co t i n g so 40 bSnh nhan. g i m 4 nhom benh. SLE- 28 b6nh nhan (70%); xo cij-ng bi: 7 bSnh nhan (17,5%), viem bi co, 4 benh nhan (10%), Overlap- 1 b«nh nhan (2.5%).
Si dung Wi thuat m i i n dich hu>nh quang gian tiep trSn t i bao Hep - 2 de xac dinh khang the khang nhan, chung toi thu d u o c k i t
qua duong tinh 39/40 bgnh nhan. Ty ie ANA duong tinh ia 97,5% Benh nhan c6 k i t qua ANA am tinh thuoc nh6m SLE nSn ty ie ANA duong tinh trong nhom nay la 96,43%, c6n ty ie ANA duong tinh trong cac nhom xo ci>ng bi, vi&m bi CO va overlap ia 100%
Trong cac kieu l i n g dong huynh quang d u o c xac djnh, kieu d i m don t h u i n chiem ty ie cao nhat (38.46%). t i i p d i n la d i m + bao tuong (20,51%). d i n g n h i t don thuan va dim
•f d i n g n h i t (17.95%). Kieu d i m la k i i u ling dong hu>nh quang gap trong n h i i u b§nh mo iiSn k i t t u m i i n nhu SLE, lupus ban do bin c i p . benh m6 lien k i t phoi hop, hpi clii>ng Sjogren K i i u d i n g n h i t gap chu y i u a cSc benh SLE, lupus do t h u i c , xo cling bi Ii6 t h i n g [2], NghiSn ci>u cua chung tSi, hai nh6m benh chiem ty le cao nhat ia SLE (70 %) va xo cung bi (17,5 %>) nen ty i f l i n g dong hujnl) quang kieu d i m va d i n g nhat cao ia hop i}.
Khang the khang nhan la tieu chuan vSng trong chan doan cac benh mi3 lien k i t t u miin, trong do m i l n dich h u f n h quang gian t i i p trSn t i bao Hep - 2 ia p h u o n g phap t i f u chuan de.
xac dinh ANA, Ty 16 khang the khang nhan duong tinh trong kl thuat m i i n dich hufnh quang gian t i i p tren te bao Hep - 2 la khSc nhau d i i vdi cac nghien cuu, Theo nghiSn cuu cua Hennque A. Mariz (2011) (4], trong nhom benh ma lien k i t t u m i l n , ty le ANA duong tinh la 90,2 %, Ty le ANA a nhdm xa ciJng bi theo R. Hesselstrand (2003) [6] ia 84%, NghiSn c u u cua chung toi c6 ty le ANA cao hon cac nghien c u u nay, nguySn nhSn
TCNCYH 88 (3) - 2014
• TAP CHi NGHIEN CCfU Y HOC chu yeu cd Id do sd lU'p'ng bdnh nhdn trong
nghien CLFU han c h i Hon nu'a, nh&ng benh nhdn nhdm x o cirng bi vd vidm bi c o d i u id nhu'ng benh nhan ndi trCi, tridu chd-ng benh tu'ang ddi rd rdng va tinh trang bdnh thu'dng nang, do dd ty Id ANA du'ang tinh cao.
Phdt hidn khdng the khang nhdn bdng kT thuat midn djch huynh quang gian t i i p trdn t i bdo Hep - 2 la xdt nghidm ed dp nhay cao Phdi hp'p vdi thdm khdm lam sdng vd khai thde tien su' bdnh, chi dinh xdt nghidm ndy de phat hidn ANA mang lai hO-u ich trong c h i n dodn vd tidn lu'ang, theo ddi d i i u tn Vi vay, dii da du'oc sCr dyng trdn t h i gidi trong mdt thdi gian ddi, kT thuat xdt nghidm nay v l n cd nhO-ng u'u diem vd thu'd'ng la xdt nghidm d i u tay du'oc chi djnh trong chan dodn bdnh md lidn k i t t y midn, Vd'i nhieu phdng xdt nghiem trdn t h i gidi, m i i n djch huj'nh quang gidn tiep tren t i bao Hep - 2 la xet nghidm sang loe ddi vol nhO-ng bdnh nhan cd cdc tndu ehu'ng hu'd'ng tdi bdnh md lidn k i t tu' midn [2]
SCr dung phu'ang phdp k h u y i c h tdn midn djch protein, chung tdi xdc dmh du'oc 9 loai khang the khdng t h i khdng U1 RNP, SSA, SSB, Smith, N X P - 2 , M D A - 5 , p155/140, S c l - 70 vd RNAP l/lll/ll. Khdng t h i khdng U1 RNP Id tidu chuan chan doan bdnh md lien k i t phdi hop. Ngoai ra ed the gdp trong cac benh SLE, vidm khdp dgng t h i p , hdi chieng Ray- naud tidn p h a t . . Khang the khang Smith cd dd ddc hieu cao ddi v d i bdnh lupus ban do hd thdng. Trong giai doan lui benh, khdng the khang DNA chudi kep ed t h i tro v i gia tn binh thu'dng nhu'ng khang the khang Smith v i n du'ang tinh. Do do, dinh lU'p'ng khdng the khang Smith cd y nghTa trong c h i n dodn SLE, ddc bIdt khi gid tri khang t h i khang DNA chudi kdp d' ngu'6'ng binh thu'dng.
Khdng the khdng Ro (SSA) vd La (SSB) gdp trong lupus d' tre s o sinh, lupus bdn c i p d da.
bdnh nhan lupus cd tdn thu'ang than va phdi, hpi chLpng Sjogren Khang the khdng Scl - 70 gap d 25 - 4 0 % benh nhdn x o cLfng bi hd thdng tdn, thu'ang da lan toa, cd hdn quan cac tdn thu'ang phdi nang, tien lU'p'ng x i u Khang the khdng RNAP l/lll/il gap 6' 4 - 2 0 % bdnh nhan x o cu-ng bi hd thdng, hdn quan vdi tdn thu'ang than.
Khdng the khang p i 55/140 hay cdn gpi Id Tif l y - Transcriptional intermediary factor 1 - khang t h i khang y i u td trung gian phien ma
• l y , gap trong viem bi c o phdi hp'p vd'i ung thu', vidm bi c o d- tre em Khang thd khang NXP - 2 hay cdn goi Id MJ thu'dng hen quan den vidm bi c o cd co ciFng co, teo co, tdn thu'ang chLrc ndng co. Khdng t h i khdng MDA - 5 hay cdn goi Id CADM - 1 4 0 la khdng the khdng gen lien quan tdi su' biet hda melanoma 5, gap trong vidm bi co, viem da ca ed bdnh ly phdi t i i n trien nhanh
& kieu ddm, cdc loai khdng the xac dmh du'oc la khang t h i khang U1 RNP, SSA, Smith, Scl - 70, MJ Cdn d kieu ddm + bao tu-ong, cac khang the phat hien du'oc la khang t h i khang U1 RNP, SSA, SSB, MDA - 5, RNAP l/lll/ll va Smith, K i t qua cua chung tdi cung phu hop vdi cdc tac gia Laura M [2], Wendy Sebastian [6], cac khang t h i khang U1 RNP, Smith, SSB, tu'ang ling vdi l i n g dong huynh quang trdn t i bao Hep - 2 k i i u ddm. Khdng t h i khdng SSA tu'ang irng vdi l i n g dong huynh quang trdn t i bao Hep - 2 k i i u ddm hoac bdo tu-ong, khdng the khdng Scl - 70 tu'ang u'ng kieu ddm hoac ddng n h i t , khdng the khdng RNAP l/lll/ll tu'ang u'ng kieu ddm hoac hach nhan, khang t h i khang MDA - 5 tu'ang u'ng vdi k i i u bdo tu'ang. Cd hai bdnh nhan, mdt l i n g dong huynh quang trdn te bao Hep - 2 t h i ddm, mdt t h i ddm + bdo tu-ong, nhu'ng khi lam kT thuat k i t tua midn djCh protein, k i t qua bdng protein lan lu'p't Id 90/34
TAP CHI NGHIEN CU'U Y HOC • vd 150/36. Nhu'ng protein ed trong lU'p'ng phdn t u nhu" vay khdng tuong i>ng vdi loai khdng t h i da b i i t ndo, do dd, hai bdnh nhdn ndy cd t h i mang nhO-ng loai khdng the md se du'O'c xdc dinh trong tuong lai 0 kieu ddng n h i t , cdc khdng t h i du'oc phdt hien la khang t h i khdng U1 RNP, khang t h i khang SSA, khang the khang p155/140 Cdc khang the thu'dng gap trong t h i ddng n h i t la khdng t h i khdng dsDNA, nucleosome, histone Tuy nhien, kT thudt k i t tua midn djch protein khdng phdt hidn duoc nhi/ng khang t h i khang dsDNA, nucleosome, histone. Ngu-di ta sir dyng cac kT thudt khac nhii ELISA. de xac djnh nhu'ng khdng t h i nay Nghien ciru cua chiing tdi cung gidng nhu nghidn CLFU cua Wendy Sebastian, tde gia cung phdt hidn dui^c cdc khdng t h i khdng U1 RNP vd SSA tuong u'ng vdi k i i u ddng nhat [6] Cdn khdng the khang p155/140 v i n du'oc y van xac dinh tu'ang irng vdi k i i u l i n g dpng hui-nh quang ddng n h i t hodc ddm
Cac tu- khdng t h i ddng vai trd quan trong trong c h i n dodn, mot sd hti'u ich trong theo ddi, tidn lu-ong bdnh. KT thudt m i l n djch huynh quang gian tiep trdn t i bdo Hep - 2 khdng chi giup Ich cho chan dodn, k i i u l i n g dong huynh quang trdn t i bdo Hep - 2 cdn cd the giCip chiing ta djnh hu'ong loai khang the cd kha ndng tdn tai trong h u y i t thanh benh nhdn, tCr dd chi dinh cdc kT thudt xdt nghidm t i i p theo de xdc dinh khdng the.
V. K i r LUAN
Qua nghidn CLFU trdn 40 bdnh nhdn mdc bdnh md lidn k i t t u midn, chung tdi thu du'p'c k i t qua ty Id khdng t h i khdng nhdn duong tinh b i n g kT thudt midn dich hu^nh quang gian t i i p trdn t i bdo Hep-2 Id 97,5 %. L i n g dong huynh quang k i i u ddm don t h u i n c h i i m 38,46%, ddm + bao tuang (20,51%), ddng n h i t don t h u i n va ddm + ddng nhat (17,95%),
ddm + h?nh nhan, ddng n h i t + ddm - rdi rac (2,56%). Phat hidn khang the khdng nhan b i n g kT thuat midn dich huynh quang gidn tiip trdn t i bdo Hep - 2 Id xet nghidm ed dd nhay cao, nen du'oc su' dyng la xet nghidm sdng Ipc ddl vdi nhUng bdnh nhan cd cdc trieu chi>ng hu'ong tdi benh md lidn k i t t u midn.
Lm c a m o r i
Chiing tdi chdn thdnh cdm an benh vidn Da lidu Trung u o n g , khoa Da trifdng Dai hpc Tong hpp Kanazaw/a. Nhat Ban dd giup dd hoan thanh nghien ciFu nay
TAI LIEU THAM KHAO
1. Arthur Kavanaugh (2000). Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. Arch Pathol Lab Med. (124), 7 1 - 8 1 . 2. Laura M. Stinton, Marvin J . Fritzler (2007) A clinical approach to autoantibody testing In systemic autoimmune rheumatic disorders. Autoimmunity Reviews, (7), 77 - 84
3. Michael HertI (2011). Autoantibody detection using indirect immunofluorescent on hep - 2 cells. Autoimmune diseases of 'the skin, 2 4 - 3 1 ,
4. Henrique A. MarIz et al (2011) Pattern on the Antinucjear Antibody - HEp - 2 test is a critical parameter for discriminating Antinu- clear Antibody - positive healthy individuals and patients with autoimmune rheumatic dis- eases. Arthritis & Rheumatism. 63(1), 191 - 200.
5. R. Hesselstrand (2003). The associa- tion of antinuclear antibodies w/ith organ in- volvement and survival in systemic sclerosis.
Rheumatology, (42), 534 - 540.
6. Wendy Sebastian (2010) Correlation of antinuclear antibody immunofluorescence patterns \N\th immune profile using line immunoassay in the Indian scenario. Indian J
TCNCYH 88 (3) - 2014
• TAP Onr NGHIEN CU'U Y HQC
Pathol Microbiol, (SZ). 427 - 432
Summary
DETECTION OF ANTINUCLEAR ANTIBODIES AND FLUORESCENT PATTERNS IN PATIENTS WITH AUTOIMMUNE CONNECTIVE TISSUE DISEASES BY INDIRECT IMMUNOFLUORESCENT ON HEP - 2 CELLS
Autoimmune connective tissue diseases (ACTDs) affect many organs in the body. The pres- ence of antinuclear autoantibodies (ANAs) is considered as the gold standard in the diagnosis of autoimmune connective tissue diseases. Objective The aim of this study was to use indirect immunofluorescence on Hep - 2 cells (IIP) method to identify the presence of antinuclear autoanti- bodies in sera of patients with ACTDs in Vietnam National Hospital of Dermatology and Venereol- ogy. The result showed that ANAs were present in 39 patient with ACTDs (97.5%) The ANA pat- terns were Nuclear speckled (38,46%), nuclear specked and cytoplasmic (20.51%), nuclear speckled and nuclear homogenous (17.95%), speckled - nucleolar (2 56%), homogenous - dis- crete speckled (2 56%). Detection of ANAs by IIP can be a valuable tool for the diagnosis of ACTDs.
Keywords: Autoimmune connective tissue diseases, indirect immunofluorescence, antinu- clear autoantibodies
