Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis.
Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis.
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DOI：
10.1186/ar1767
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发表时间：
2005
影响因子：
4.9
通讯作者：
Huizinga TW
中科院分区：
文献类型：
--
作者：
van der Helm-van Mil AH;Verpoort KN;Breedveld FC;Toes RE;Huizinga TW
瓜氨酸蛋白抗体（抗环瓜氨酸肽[抗 CCP] 抗体）对类风湿性关节炎 (RA) 具有高度特异性，并且在疾病症状出现之前出现，表明这些抗体在 RA 中具有致病作用。我们最近表明，不同的遗传风险因素与抗 CCP 阳性疾病或抗 CCP 阴性疾病相关。这些数据很重要，因为它们表明不同的致病机制是抗 CCP 阳性疾病或抗 CCP 阴性疾病的基础。同样，这些观察结果提出了一个问题：抗 CCP 阳性 RA 和抗 CCP 阴性 RA 是否是临床上不同的疾病实体。因此，我们研究了具有抗 CCP 抗体的 RA 患者与没有这些自身抗体的患者相比是否具有不同的临床表现和病程。在 454 名 RA 患者的队列中，228 名患者抗 CCP 阳性，226 名患者抗 CCP 阴性。比较两组的早期症状、压痛和肿胀关节计数、入组时的 C 反应蛋白水平，以及 4 年随访期间的肿胀关节计数和放射学破坏。具有和不具有抗 CCP 抗体的 RA 患者在晨僵、早期症状的类型、部位和分布、患者的疾病活动度和 C 反应蛋白方面没有差异。纳入时不同关节的平均压痛和肿胀关节数量相似。随访时，具有抗 CCP 抗体的患者关节肿胀更严重，放射学破坏更严重。然而，受影响关节的肿胀、骨侵蚀和关节间隙变窄的分布是相似的。总之，有或没有抗 CCP 抗体的 RA 患者的表型在临床表现方面相似，但在病程方面有所不同。
Antibodies to citrullinated proteins (anti-cyclic-citrullinated peptide [anti-CCP] antibodies) are highly specific for rheumatoid arthritis (RA) and precede the onset of disease symptoms, indicating a pathogenetic role for these antibodies in RA. We recently showed that distinct genetic risk factors are associated with either anti-CCP-positive disease or anti-CCP-negative disease. These data are important as they indicate that distinct pathogenic mechanisms are underlying anti-CCP-positive disease or anti-CCP-negative disease. Likewise, these observations raise the question of whether anti-CCP-positive RA and anti-CCP-negative RA are clinically different disease entities. We therefore investigated whether RA patients with anti-CCP antibodies have a different clinical presentation and disease course compared with patients without these autoantibodies. In a cohort of 454 incident patients with RA, 228 patients were anti-CCP-positive and 226 patients were anti-CCP-negative. The early symptoms, tender and swollen joint count, and C-reactive protein level at inclusion, as well as the swollen joint count and radiological destruction during 4 years of follow-up, were compared for the two groups. There were no differences in morning stiffness, type, location and distribution of early symptoms, patients' rated disease activity and C-reactive protein at inclusion between RA patients with and without anti-CCP antibodies. The mean tender and swollen joint count for the different joints at inclusion was similar. At follow-up, patients with anti-CCP antibodies had more swollen joints and more severe radiological destruction. Nevertheless, the distribution of affected joints, for swelling, bone erosions and joint space narrowing, was similar. In conclusion, the phenotype of RA patients with or without anti-CCP antibodies is similar with respect to clinical presentation but differs with respect to disease course.
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影响因子：
27.4
作者：
Forslind, K;Ahlmén, M;Svensson, B
通讯作者：
Svensson, B
影响因子：
2.1
作者：
Söderlin, MK;Kastbom, A;Skogh, T
通讯作者：
Skogh, T
影响因子：
--
作者：
Vossenaar, ER;Smeets, TJM;Tak, PP
通讯作者：
Tak, PP
影响因子：
--
作者：
Rantapää-Dahlqvist, S;de Jong, BAW;van Venrooij, WJ
通讯作者：
van Venrooij, WJ
影响因子：
27.4
作者：
Kastbom, A;Strandberg, G;Skogh, T
通讯作者：
Skogh, T