Serum Immunoglobulin G Levels to Porphyromonas gingivalis Peptidylarginine Deiminase Affect Clinical Response to Biological Disease-Modifying Antirheumatic Drug in Rheumatoid Arthritis.
Serum Immunoglobulin G Levels to Porphyromonas gingivalis Peptidylarginine Deiminase Affect Clinical Response to Biological Disease-Modifying Antirheumatic Drug in Rheumatoid Arthritis.
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DOI：
10.1371/journal.pone.0154182
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Yoshie H
中科院分区：
文献类型：
--
作者：
Kobayashi T;Ito S;Kobayashi D;Shimada A;Narita I;Murasawa A;Nakazono K;Yoshie H
确定对牙龈卟啉单胞菌肽基精氨酸脱亚胺酶 (PPAD) 的血清免疫是否影响类风湿关节炎 (RA) 患者对生物缓解病情抗风湿药物 (bDMARD) 的临床反应。在一项回顾性研究中，对 60 名接受传统合成 DMARD 治疗的 RA 患者在 bDMARD 治疗前（基线）以及 3 个月和 6 个月后的风湿病和牙周状况进行了评估。基线时测定血清抗 PPAD 免疫球蛋白 G (IgG) 水平后，根据中位值将患者分为抗 PPAD IgG 滴度高和低的两组。还确定了与 RA 相关的 8 个功能性单核苷酸多态性 (SNP) 的基因型。治疗 3 个月和 6 个月后，与抗 PPAD IgG 滴度高的患者相比，抗 PPAD IgG 滴度低的患者的疾病活动评分变化显着更大，包括使用 C 反应蛋白 (DAS28-CRP) 的 28 个关节（P = 0.04）和抗环瓜氨酸肽 (CCP) IgG 水平（P = 0.03 和 P = 0.04），尽管这些参数值具有可比性在基线。从基线到 3 个月和 6 个月后，抗 PPAD IgG 滴度与 DAS28-CRP（两者 P = 0.01）和抗 CCP IgG 水平（两者 P = 0.02）的变化呈显着正相关。多元回归分析显示，在调整年龄、性别、吸烟、牙周状况和 RA 相关 SNP 后，bDMARD 治疗 6 个月后，抗 PPAD IgG 滴度与 DAS28-CRP 变化之间存在显着正相关（P = 0.006）。 PPAD 的血清 IgG 水平影响 RA 患者对 bDMARD 的临床反应。
To determine whether serum immunity to Porphyromonas gingivalis peptidylarginine deiminase (PPAD) affects the clinical response to biological disease-modifying antirheumatic drug (bDMARD) in patients with rheumatoid arthritis (RA). In a retrospective study, rheumatologic and periodontal conditions of 60 patients with RA who had been treated with conventional synthetic DMARD were evaluated before (baseline) and after 3 and 6 months of bDMARD therapy. After serum levels of anti-PPAD immunoglobulin G (IgG) were determined at baseline, the patients were respectively divided into two groups for high and low anti-PPAD IgG titers according to the median measurements. Genotypes at 8 functional single nucleotide polymorphisms (SNPs) related to RA were also determined. After 3 and 6 months of therapy, patients with low anti-PPAD IgG titers showed a significantly greater decrease in changes in the Disease Activity Score including 28 joints using C-reactive protein (DAS28-CRP) (P = 0.04 for both) and anti-cyclic citrullinated peptide (CCP) IgG levels (P = 0.03 and P = 0.04) than patients with high anti-PPAD IgG titers, although these parameter values were comparable at baseline. The anti-PPAD IgG titers were significantly positively correlated with changes in the DAS28-CRP (P = 0.01 for both) and the anti-CCP IgG levels (P = 0.02 for both) from baseline to 3 and 6 months later. A multiple regression analysis revealed a significantly positive association between the anti-PPAD IgG titers and changes in the DAS28-CRP after 6 months of bDMARD therapy (P = 0.006), after adjusting for age, gender, smoking, periodontal condition, and RA-related SNPs. The serum IgG levels to PPAD affect the clinical response to bDMARD in patients with RA.