RESUMEN
We have demonstrated that the inability to secrete the water soluble glycoprotein form of the ABO blood group antigens into saliva is significantly more common in patients with Graves' disease than control subjects (40% vs 27%: P less than 0.025) but not among those with Hashimoto's thyroiditis or spontaneous primary atrophic hypothyroidism. Non-secretion is associated with increased susceptibility to infection and to asymptomatic carriage of some microorganisms. Although Yersinia enterocolitica has been found to express antigen cross reactive with the TSH receptor, we did not find an increased prevalence of Yersinia species in the faeces of 107 patients with Graves' disease. The isolation rate (less than 1%) was similar to that observed in the local population with diarrhoeal illness. Salivary IgA levels determined by whole cell ELISA with Y. enterocolitica 03 were not elevated in the majority of specimens examined. The results suggest that in contrast to reports from Scandinavia, there is no strong evidence that yersiniae play a role in the pathogenesis of Graves' disease among patients in South east Scotland. Non-secretors are significantly over represented among patients with several other autoimmune diseases; however, with the exception of antitubulin antibodies, non-secretors with Graves' disease did not have more antibodies to other human antigens than secretor patients.
Asunto(s)
Autoanticuerpos/análisis , Enfermedades Autoinmunes/etiología , Glicoproteínas/metabolismo , Enfermedad de Graves/etiología , Yersiniosis/inmunología , Yersinia enterocolitica , Sistema del Grupo Sanguíneo ABO/inmunología , Adulto , Anticuerpos Antibacterianos/análisis , Enfermedades Autoinmunes/inmunología , Reacciones Cruzadas , Femenino , Glicoproteínas/inmunología , Enfermedad de Graves/inmunología , Humanos , Inmunoglobulina A/análisis , Antígenos del Grupo Sanguíneo de Lewis/inmunología , Masculino , Persona de Mediana Edad , Saliva/inmunologíaRESUMEN
The ability of enzyme linked immunosorbent assays (ELISA) to detect Lewis and H antigens in secretions obtained from 280 autopsies was assessed. The ELISA results were compared with those for matched blood specimens examined by agglutination of erythrocytes by monoclonal anti-Lewis(a) and anti-Lewis(b) antibodies. There was good agreement between the results for the two tests and the ELISAs could be used to determine secretor status of the subject. While determination of ABO group with monoclonal anti-A and anti-B was possible even with lysed blood, the results for Lewis typing by erythrocyte agglutination were poor if the sample was lysed or partially lysed. Detection of the antigens by ELISA was as efficient among elderly subjects as among younger ones and both H and Lewis antigens could be detected on erythrocytes and in secretions up to 127 h after death.