Clinical correlations with Porphyromonas gingivalis antibody responses in patients with early rheumatoid arthritis.
Clinical correlations with Porphyromonas gingivalis antibody responses in patients with early rheumatoid arthritis.
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DOI：
10.1186/ar4289
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发表时间：
2013
影响因子：
4.9
通讯作者：
Steere AC
中科院分区：
文献类型：
--
作者：
Arvikar SL;Collier DS;Fisher MC;Unizony S;Cohen GL;McHugh G;Kawai T;Strle K;Steere AC
先前的研究表明，类风湿性关节炎（RA）患者中牙龈卟啉单胞菌（Pg）抗体的频率增加，牙龈卟啉单胞菌是牙周病的主要病原体。然而，这些患者通常患有长期疾病，与这些抗体的临床相关性不一致。我们的目的是研究早期RA患者在疾病缓解抗风湿药物（DMARD）治疗前后的Pg抗体应答及其临床相关性。采用酶联免疫吸附试验（ELISA）检测50例DMARD初治RA患者的血清样本，并进行全Pg超声处理。为了进行比较，检测了晚期RA患者、其他结缔组织疾病（CTD）患者、年龄相似的健康医院人员和血库供体的血清样本。早期RA患者的PG抗体应答与标准RA生物标志物、疾病活动和功能的测量相关。在入组时，50例早期RA患者中有17例（34%）对Pg有阳性免疫球蛋白G（IgG）抗体反应，43例晚期RA患者中有13例（30%）。RA患者的Pg抗体应答显著高于健康医务人员和血库献血员（P < 0.0001）。此外，RA患者往往比其他CTD患者具有更高的Pg抗体反应性（P = 0.1），CTD患者往往比健康参与者具有更高的Pg反应性（P = 0.07）。与Pg抗体阴性的RA患者相比，Pg抗体阳性的早期RA患者更易发生抗环瓜氨酸肽（anti-CCP）抗体反应，其抗CCP水平显著升高（P = 0.03），且抗Pg抗体水平与抗CCP水平呈正相关（P < 0.01）。此外，在进入研究时，Pg阳性抗体组具有更高的类风湿因子值（P = 0.04）和较高的炎症标志物（红细胞沉降率，或ESR）（P = 0.05），他们的疾病活动性得分往往更高，（基于28个关节计数（DAS 28）-ESR和临床疾病活动指数的疾病活动评分）和更多功能障碍（健康评估问卷）。在PG阳性患者中，DMARD治疗12个月后疾病活动性仍明显增加。早期RA患者的一个子集有阳性Pg抗体反应。这些反应与抗CCP抗体反应性相关，与ESR值相关程度较低。在PG阳性患者中有更大的疾病活动性的趋势，并且在DMARD治疗12个月后这种趋势仍然存在。这些发现与Pg在RA患者亚组的疾病发病机制中的作用一致。
Prior studies have demonstrated an increased frequency of antibodies to Porphyromonas gingivalis (Pg), a leading agent of periodontal disease, in rheumatoid arthritis (RA) patients. However, these patients generally had long-standing disease, and clinical associations with these antibodies were inconsistent. Our goal was to examine Pg antibody responses and their clinical associations in patients with early RA prior to and after disease-modifying antirheumatic drug (DMARD) therapy. Serum samples from 50 DMARD-naïve RA patients were tested using an enzyme-linked immunosorbent assay with whole-Pg sonicate. For comparison, serum samples were tested from patients with late RA, patients with other connective tissue diseases (CTDs), age-similar healthy hospital personnel and blood bank donors. Pg antibody responses in early RA patients were correlated with standard RA biomarkers, measures of disease activity and function. At the time of enrollment, 17 (34%) of the 50 patients with early RA had positive immunoglobulin G (IgG) antibody responses to Pg, as did 13 (30%) of the 43 patients with late RA. RA patients had significantly higher Pg antibody responses than healthy hospital personnel and blood bank donors (P < 0.0001). Additionally, RA patients tended to have higher Pg antibody reactivity than patients with other CTDs (P = 0.1), and CTD patients tended to have higher Pg responses than healthy participants (P = 0.07). Compared with Pg antibody-negative patients, early RA patients with positive Pg responses more often had anti-cyclic citrullinated peptide (anti-CCP) antibody reactivity, their anti-CCP levels were significantly higher (P = 0.03) and the levels of anti-Pg antibodies correlated directly with anti-CCP levels (P < 0.01). Furthermore, at the time of study entry, the Pg-positive antibody group had greater rheumatoid factor values (P = 0.04) and higher inflammatory markers (erythrocyte sedimentation rate, or ESR) (P = 0.05), and they tended to have higher disease activity scores (Disease Activity Score based on 28-joint count (DAS28)-ESR and Clinical Disease Activity Index) and more functional impairment (Health Assessment Questionnaire). In Pg-positive patients, greater disease activity was still apparent after 12 months of DMARD therapy. A subset of early RA patients had positive Pg antibody responses. The responses correlated with anti-CCP antibody reactivity and to a lesser degree with ESR values. There was a trend toward greater disease activity in Pg-positive patients, and this trend remained after 12 months of DMARD therapy. These findings are consistent with a role for Pg in disease pathogenesis in a subset of RA patients.
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影响因子：
4.3
作者：
Leung, W. Keung;Chu, Chun Hung;Ng, Sam K. S.
通讯作者：
Ng, Sam K. S.
影响因子：
--
作者：
Keller, Joseph J.;Kang, Jiunn-Horng;Lin, Herng-Ching
通讯作者：
Lin, Herng-Ching
影响因子：
27.4
作者：
Forslind, K;Ahlmén, M;Svensson, B
通讯作者：
Svensson, B
DOI：
10.1002/art.24345
发表时间：
2009-04-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Collier, Deborah S.;Kay, Jonathan;Grant, Richard W.
通讯作者：
Grant, Richard W.
影响因子：
3.9
作者：
Hitchon, Carol A.;Chandad, Fatiha;El-Gabalawy, Hani S.
通讯作者：
El-Gabalawy, Hani S.