Use of antibodies recognizing cyclic citrullinated peptide in the differential diagnosis of joint involvement in systemic sclerosis
Use of antibodies recognizing cyclic citrullinated peptide in the differential diagnosis of joint involvement in systemic sclerosis
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DOI：
10.1007/s10067-006-0313-3
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发表时间：
2007-04-01
影响因子：
3.4
通讯作者：
Fantini, Flavio
中科院分区：
文献类型：
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作者：
Ingegnoli, Francesca;Galbiati, Valentina;Fantini, Flavio
目的：确定抗环瓜氨酸肽（CCP）抗体在系统性硬化症（SSc）中的患病率，并评估抗CCP抗体、影像学特征和临床表现之间的任何相关性。材料与方法：抗CCP抗体和类风湿因子（RF）进行了测试，从75例SSc患者（64名女性和11名男性）的血清样本，平均年龄为59.4岁（范围24-85），弥漫性（dcSSc）和有限的（lcSSc）皮肤受累。作为对照组，22名年龄和性别匹配的健康对照（HC）进行了检查。检查每位患者的手和手腕的标准X线片。结果：10.6%（8/75）的SSc患者血清中存在抗CCP抗体，其中lcSSc 3/44例（6.8%），dcSSc 5/31例（16.1%）。所有HC抗CCP均为阴性。在75例SSc患者中观察到19例（25.3%）RF阳性（lcSSc 10/44，22.7%; dcSSc 9/31，29%）。抗CCP阳性与关节炎（p < 0.0001）和边缘糜烂（p=0.001）之间存在统计学显著相关性。结论：我们的数据表明，关节受累是SSc的常见表现特征。在这份报告中，我们表明，抗CCP抗体也可以在SSc患者中检测到，但它们通常比成人类风湿性关节炎（RA）更不常见。因此，高滴度抗CCP抗体的发现可能有助于确定重叠综合征SSc/RA的诊断，并促进诊断和适当的治疗。
Objective: To determine the prevalence of anti-cyclic citrullinated peptide (CCP) antibodies in systemic sclerosis (SSc) and to assess any association between the presence of anti-CCP, radiographic features, and clinical manifestations. Materials and methods: Anti-CCP antibodies and rheumatoid factor (RF) were tested in serum samples from 75 patients with SSc (64 women and 11 men), with a mean age of 59.4 years (range 24-85) with either diffuse (dcSSc) and limited (lcSSc) cutaneous involvement. As a control group, 22 age- and sex-matched healthy controls (HCs) were examined. Standard radiographs of the hands and wrists were examined in each patient. Results: The presence of anti-CCP was found in sera of 10.6% (8/75) patients with SSc (lcSSc 3 of 44, 6.8%; dcSSc 5 of 31, 16.1%). None of the HCs was positive for anti-CCP. The positivity of RF was observed in 19 of 75 (25.3%) SSc patients (lcSSc 10 of 44, 22.7%; dcSSc 9 of 31, 29%). Statistically significant association was found between anti-CCP positivity and the presence of arthritis (p < 0.0001) and marginal erosions (p=0.001). Conclusion: Our data show that joint involvement is a common presenting feature of SSc. In this report, we show that anti-CCP antibodies can be detected also in patients with SSc, but they are generally less commonly present than in adults with rheumatoid arthritis (RA). Thus, the finding of high titers of anti-CCP antibodies may help to define the diagnosis of overlap syndrome SSc/RA and facilitate diagnosis and appropriate treatment.