Increased IgG Rheumatoid Factor-Positivity in the Asian Rheumatoid Arthritis Patients Irrespective of Ethnicity
Increased IgG Rheumatoid Factor-Positivity in the Asian Rheumatoid Arthritis Patients Irrespective of Ethnicity
复制标题
DOI：
10.4236/ojra.2014.41007
复制
发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
C. Too;J. Rönnelid;Y. M. Yusoff;J. Dhaliwal;N. Jinah;A. Yahya;H. Hussien;Wahinuddin Sulaiman;P. Larsson;S. Murad
中科院分区：
文献类型：
--
作者：
C. Too;J. Rönnelid;Y. M. Yusoff;J. Dhaliwal;N. Jinah;A. Yahya;H. Hussien;Wahinuddin Sulaiman;P. Larsson;S. Murad
工作目的：初步观察表明IgG类风湿因子（RF）在马来西亚类风湿关节炎（RA）患者中很常见。我们测试了这一假设，并使用多种族RA队列（马来人，中国人和印度人），以调查是否IgG RF优势可能是遗传或环境决定的。患者和方法：用ELISA法检测了171例按1987年ACR标准诊断为RA的患者、60例其他风湿性疾病患者和325例非风湿性疾病对照者血清中RF抗体IgG、RF抗体IgM和抗CCP抗体。然后在一个更大的RA病例对照队列（n = 1844）中对研究结果进行了检验。结果：在所有被调查的民族中，IgG RF均高于IgM RF。IgG RF的敏感性、特异性和诊断准确性（分别为55.6%、91.2%和80.2%）上级IgM RF，但与抗CCP相当。然而，马来西亚对照组中的IgG RF也有所增加，但根据1987年ACR标准进行临界值调整后，IgG RF相对于IgM RF的优势仍然明显。三个种族之间的自身抗体水平没有差异。受试者操作特征（ROC）曲线显示IgG RF（0.826）和抗CCP（0.867）的曲线下面积大于IgM RF（0.737）。文献综述显示，与白人和非洲裔美国人研究相比，亚洲RA患者研究中IgG RF的敏感性始终较高。结论：生活在马来西亚的不同遗传背景的RA人群中IgG RF阳性的频率增加，这表明环境因素选择性地放大了IgG RF反应。
Aim of Work: Initial observations implied IgG rheumatoid factor (RF) to be common among Malaysian rheumatoid arthritis (RA) patients. We tested this hypothesis and used a multiethnic RA cohort (Malays, Chinese and Indians) to investigate whether the IgG RF predominance might be genetically or environmentally determined. Patients and Methods: 556 serum samples comprising 171 patients classified as RA according to the 1987 ACR criteria, 60 patients with other rheumatic diseases and 325 non-rheumatic controls were tested for IgG RF, IgM RF and anti-CCP by ELISA. The findings were then tested in a larger RA case-control cohort (n = 1844). Results: IgG RF predominated over IgM RF in all the investigated ethnic groups. The sensitivity, specificity, and diagnostic accuracy of IgG RF (55.6%, 91.2% and 80.2%, respectively) were superior compared to IgM RF, but comparable to anti-CCP. IgG RF was however, also increased in the Malaysian controls, but the IgG RF superiority over IgM RF was still apparent after cutoff adjustment according to the 1987 ACR criteria. Autoantibody levels did not differ between the three ethnic groups. The Receiver Operating Characteristics (ROC) curves showed larger areas under the curves for IgG RF (0.826) and for anti-CCP (0.867) than for IgM RF (0.737). Review of the literature showed consistently higher sensitivity for IgG RF in studies of Asian RA patients as compared to Caucasian and African-American studies. Conclusion: Increased frequency of IgG RF-positive in RA populations with different genetic background living in Malaysia argues for an environmental factor selectively amplifying the IgG RF response.