AUTOANTIBODY REACTIVE WITH RNA POLYMERASE-III IN SYSTEMIC-SCLEROSIS
AUTOANTIBODY REACTIVE WITH RNA POLYMERASE-III IN SYSTEMIC-SCLEROSIS
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DOI：
10.7326/0003-4819-119-10-199311150-00007
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发表时间：
1993-11-15
影响因子：
39.2
通讯作者：
MEDSGER, TA
中科院分区：
文献类型：
--
作者：
OKANO, Y;STEEN, VD;MEDSGER, TA
目的：探讨抗rna聚合酶III抗体在系统性硬化症（SSc）中的临床意义。设计：对SSc患者和对照组的RNA聚合酶III自身抗体的点流行率进行研究，并对其临床意义进行纵向检验。地点：大学医学中心风湿病科实习。患者：连续新增SSc患者252例，对照组170例（其他结缔组织疾病患者150例，正常志愿者20例）。检测方法：通过免疫沉淀、免疫印迹和免疫消耗研究确定抗rna聚合酶III抗体的存在。主要结果：252例SSc患者中57例（23%,95% CI, 18% - 28%）的血清标本与RNA聚合酶III反应，而170例对照患者的血清标本没有反应（0%,95% CI, 0% - 2%）。在这57个标本中的40个中，免疫沉淀研究也显示存在RNA聚合酶I或II，或两者兼有。111例SSc弥漫性皮肤受累（dcSSc）患者中有50例（45%）血清检测到抗rna聚合酶III抗体，114例SSc有限皮肤受累患者中有7例（6%）血清检测到抗rna聚合酶III抗体，27例SSc重叠综合征患者中没有检测到抗rna聚合酶III抗体（P < 0.001）。在dcSSc患者中，抗rna聚合酶III抗体比抗拓扑异构酶I抗体更常见（45%比27%，P = 0.008）。抗rna聚合酶III抗体患者的平均最大皮肤厚度评分高于抗拓扑异构酶I抗体患者，但毛细血管扩张、炎症性肌病、限制性肺病和严重心脏异常的发生率低于抗拓扑异构酶I抗体患者。结论：抗rna聚合酶ⅲ抗体是许多伴有弥漫性或广泛皮肤受累的SSc患者的一种新的标记性自身抗体。
Objective: To determine the clinical significance of anti-RNA polymerase III antibody in systemic sclerosis (SSc).Design: A point prevalence study of autoantibody to RNA polymerase III and longitudinal examination of its clinical significance in patients with SSc and in controls.Setting: University medical center rheumatology practice.Patients: Two hundred fifty-two consecutive new patients with SSc and 170 controls (150 patients with other connective tissue diseases and 20 normal volunteers).Measurements: The presence of anti-RNA polymerase III antibody was determined by immunoprecipitation, immunoblotting, and immunodepletion studies.Main Results: Serum specimens from 57 of the 252 patients with SSc (23%; 95% CI, 18% to 28%) reacted with RNA polymerase III, compared with none of the specimens from 170 controls (0%; 95% CI, 0% to 2%). In 40 of these 57 specimens, immunoprecipitation studies also showed the presence of RNA polymerase I or II, or both. Anti-RNA polymerase III antibody was detected in sera from 50 of the 111 patients (45%) who had SSc with diffuse cutaneous involvement (dcSSc), 7 of 114 patients (6%) who had SSc with limited cutaneous involvement, and none of 27 patients with an SSc overlap syndrome (P < 0.001). Among patients with dcSSc, anti-RNA polymerase III antibody was more common than antitopoisomerase I antibody (45% compared with 27%; P = 0.008). Patients with anti-RNA polymerase III antibody had a statistically significant higher mean maximum skin thickness score but statistically significant lower frequencies of telangiectasias, inflammatory myopathy, restrictive lung disease, and serious cardiac abnormalities than did patients with antitopoisomerase I antibody.Conclusion: Anti-RNA polymerase III antibody is a new marker autoantibody for many patients who have SSc with diffuse or extensive cutaneous involvement.