目的 臨床上要診斷病人是否為全身性紅斑性狼瘡，除了依靠詳細的病史詢問及理學檢查之外，血清中一些特異性自體抗體的偵測也是診斷不可或缺。自體抗原微陣列晶片是近年新發展出的自體抗體測試方法，可以利用少量的血液樣本來偵測血液中的自體抗體。本研究嘗試用自體抗原微陣列晶片偵測紅斑性狼瘡病人血清中常出現的五種自體抗體，並評估其效力。方法 以微陣列機將自體抗原點在經poly-L-lysine處理過的顯微鏡載玻片上，製成自體抗原微陣列晶片，採集經臨床診斷有紅斑性狼瘡病人共80人的血液樣本，分別用自體抗原微陣列晶片及ELISA兩種方法偵測血液中anti-dsDNA，anti-Sm，anti-RNP，anti-Ro，anti-La 等五種自體抗體，再將兩者結果加以比較。結果 用自體抗原微陣列晶片及ELISA兩者方法偵測血清中這五種自體抗體，兩者結果的相關性分別為0.622、0.360、0.772、0.802及0.900。與ELISA做比較，自體抗原微陣列晶片用以偵測血清中這五種自體抗體的敏感度分別為95%、82%、77%、92%及94%，特異度分別為90%、90%、97%、93%及97%。結論 在臨床應用上，自體抗原微陣列晶片似乎可以提供與ELISA類似的結果，而自體抗原微陣列晶片在大量應用、擴充性、方便性及費用上具有優勢，可以利用極少量的血液樣本，進行大量而快速的檢驗。
Purpose. To compare the performance characteristics of autoantigen microarrays with those of commercial enzyme-linked immunosorbent assays (ELISAs) in detecting five common autoantibodies (anti-dsDNA, anti-Sm, anti-RNP, anti-Ro, and anti-La) in the sera of systemic lupus erythematosus (SLE) patients. Methods Serum samples were obtained from 80 SLE patients and 20 sera from healthy subjects were selected as controls in this study. Autoantigens were spotted onto poly-L-lysine microscope slides by a robotic microarrayer. The slides were incubated, first with serum samples and subsequently with Cy-5-conjugated secondary antibodies. Both microarrays and commercial ELISAs were utilized to detect the five autoantibodies in the sera of 80 SLE patients and 20 normal controls. The results were compared to assess the correlation, sensitivity and specificity between the two immunoassays. Results. The specificity of the microarray assay for each of the five autoantibodies was good (≥90%). The sensitivity of microarray assay for detecting anti-dsDNA, anti-Ro, and anti-La autoantibodies was more than 90%. In general, there was good agreement between the microarray assay and commercial ELISAs. Conclusions. The microarray is a suitable assay format for diagnosing autoimmune diseases. It may have potentially important advantages in terms of high-throughput applicability, expansibility, convenience, and cost. However, continued efforts to optimize the performance conditions are still needed.
