Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis
Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis
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DOI：
10.1002/art.11223
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发表时间：
2003-10-01
影响因子：
--
通讯作者：
van Venrooij, WJ
中科院分区：
文献类型：
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作者：
Rantapää-Dahlqvist, S;de Jong, BAW;van Venrooij, WJ
客观的。评估随后发展为类风湿性关节炎 (RA) 的个体中抗环瓜氨酸肽 (抗 CCP) 抗体的患病率和预测价值，并确定与任何同种型类风湿因子 (RF) 的关系。方法。一项病例对照研究嵌套在瑞典北部健康与疾病研究和瑞典北部产妇队列中。 RA患者是在症状出现前几年采集样本的献血者中发现的。从同一队列中随机选择年龄、性别、采样日期和居住区域相匹配的对照受试者。使用酶免疫测定法测定抗CCP抗体和RF。结果。 83 名 RA 患者被确定在出现任何关节疾病症状之前曾献血（RA 发生前中位 2.5 年 [四分位距 1.1-4.7]）。在RA发病前获得的样本中，抗CCP自身抗体的流行率为33.7%，IgG-RF为16.9%，IgM-RF为19.3%，IgA-RF为33.7%（与对照相比均非常显着）。在出现任何 RA 症状之前 > 1.5 年且小于或等于 1.5 年检测这些自身抗体的灵敏度分别为：抗 CCP 为 25% 和 52%，IgM-RF 为 15% 和 30%，IgG-RF 为 12% 和 27%，IgA-RF 为 29% 和 39%。在条件逻辑回归模型中，发现抗 CCP 抗体和 IgA-RF 是 RA 的显着预测因子。结论。抗 CCP 抗体和所有同种型的 RF 比 RA 的发病早了几年。抗CCP和IgA-RF的存在预测RA的发展，其中抗CCP抗体具有最高的预测价值。这表明瓜氨酸化以及抗 CCP 和 RF 自身抗体的产生是 RA 的早期过程。
Objective. To evaluate the prevalence and predictive value of anti-cyclic citrullinated peptide (anti-CCP) antibodies in individuals who subsequently developed rheumatoid arthritis (RA) and to determine the relationship to rheumatoid factor (RF) of any isotype.Methods. A case-control study was nested within the Northern Sweden Health and Disease Study and the Maternity cohorts of Northern Sweden. Patients with RA were identified among blood donors whose samples had been taken years before the onset of symptoms. Control subjects matched for age, sex, date of sampling, and residential area were selected randomly from the same cohorts. Anti-CCP antibody and RFs were determined using enzyme immunoassays.Results. Eighty-three individuals with RA were identified as having donated blood before presenting with any symptoms of joint disease (median 2.5 years [interquartile range 1.1-4.7] before RA). In samples obtained before the onset of RA, the prevalence of autoantibodies was 33.7% for anti-CCP, 16.9% for IgG-RF, 19.3% for IgM-RF, and 33.7% for IgA-RF (all highly significant compared with controls). The sensitivities for detecting these autoantibodies > 1.5 years and less than or equal to1.5 years before the appearance of any RA symptoms were 25% and 52% for anti-CCP, 15% and 30% for IgM-RF, 12% and 27% for IgG-RF, and 29% and 39% for IgA-RF. In conditional logistic regression models, anti-CCP antibody and IgA-RF were found to be significant predictors of RA.Conclusion. Anti-CCP antibody and RFs of all isotypes predated the onset of RA by several years. The presence of anti-CCP and IgA-RF predicted the development of RA, with anti-CCP antibody having the highest predictive value. This indicates that citrullination and the production of anti-CCP and RF autoantibodies are early processes in RA.