Low frequency of anticyclic citrullinated peptide antibodies in psoriatic arthritis but not in cutaneous psoriasis
Low frequency of anticyclic citrullinated peptide antibodies in psoriatic arthritis but not in cutaneous psoriasis
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DOI：
10.1097/rhu.0000242779.73390.51
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发表时间：
2006-10-01
影响因子：
3.4
通讯作者：
Espinoza, Luis R.
中科院分区：
文献类型：
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作者：
Candia, Liliana;Marquez, Javier;Espinoza, Luis R.
背景：抗环瓜氨酸肽(抗CCP)抗体对类风湿关节炎(RA)的诊断具有很高的特异性。类风湿性关节炎和银屑病关节炎(PSA)之间的临床区别通常很难确定；因此，类风湿因子(RF)和抗CCP抗体的存在可能是有用的。7%到40%的长期牛皮癣患者会在某个时候患上PSA。目的：检测银屑病和前列腺炎性关节炎(PSA)患者血清中抗CCP抗体的阳性率，并与其他炎症性、非炎性(骨关节炎)关节炎患者和健康对照组进行比较。方法：采用商品化的第二代酶联免疫吸附试验检测106例皮肤型银屑病患者、72例PSA患者、41例健康对照(HC)、41例未分化或早期炎症性关节炎(UA)患者、41例RA患者和41例骨性关节炎患者的血清抗CCP抗体。我们认为阳性结果为>；20uI/ml，这是制造商的建议。结果：106例PSA患者中，女性55例，男性51例。平均年龄42.87±17.71岁，平均病程5.3±2.10年。抗CCP抗体在无关节炎的银屑病患者中不存在。72例PSA患者中有7例(9.72%)抗CCP抗体阳性，中位滴度为7.16单位。仅1例PSA患者RF阳性。患者多为女性，多关节受累。4例远端指间受累，2例有指炎。当我们比较PSA患者和银屑病患者时，我们发现有明显的差异(P=0.001)。在43例不稳定型心绞痛患者中，4例最初显示低滴度抗CCP抗体阳性，在随访中，另一名患者出现抗CCP抗体，后来发展为类风湿关节炎。UA患者术后5年无1例发生PSA。41例患者中32例抗CCP抗体阳性，抗CCP单位的平均+/-标准差为80.61+/-55.5.2。41例骨关节炎患者中有6例(14.6%)抗CCP抗体阳性，平均滴度为7,388。结论：抗CCP抗体可能存在于PSA患者中，而在我们的单纯皮肤型银屑病患者中则不存在。这些抗体也可能在一些骨关节炎患者中发现，而在不稳定型心绞痛患者中很少发现；这类患者将有兴趣进行前瞻性跟踪。
Background: Anticyclic citrullinated peptide (anti-CCP) antibodies are highly specific for the diagnosis of rheumatoid arthritis (RA). The clinical distinction between RA and psoriatic arthritis (PsA) is often difficult to establish; therefore, the presence of rheumatoid factor (RF) and anti-CCP antibodies could be useful. Seven percent to 40% of patients with longstanding psoriasis will develop PsA at some point. Therefore, it is important to study the positivity of these antibodies in these two interrelated populations.Objective: The aim of this study was to determine the seropositivity of anti-CCP antibodies in patients with psoriasis and PsA and to compare it with that seen in patients with other inflammatory, noninflammatory (osteoarthritis) arthritides and healthy controls.Patients and Methods: Serum anti-CCP antibodies were measured in 106 patients with cutaneous psoriasis, 72 patients with PsA, 41 healthy controls (HC), 41 patients with undifferentiated or early inflammatory arthritis (UA), and 41 patients with RA and 41 with osteoarthritis using a commercial second-generation enzyme-linked immunosorbent assay. We considered a positive result to be >20 UI/mL, as recommended by the manufacturer.Results: Of 106 patients with PsA, 55 were women and 51 men. The mean age was 42.87 +/- 17.71 years and the mean disease duration was 5.3 +/- 2.10 years. Anti-CCP antibodies were not present in patients with psoriasis without arthritis. In contrast, 7 of 72 (9.72%) patients with PsA were positive for anti-CCP antibodies with a median titer of 7.16 units. Only one patient with PsA was positive for RF. Most of these patients were female with polyarticular joint involvement. Distal interphalangeal involvement was present in 4 and 2 had dactylitis. We found clear differences when we compared patients with PsA with patients with psoriasis (P = 0.001). Of the 43 patients with UA studies, 4 initially exhibited a low titer positive anti-CCP antibody, and at follow up, another patient developed anti-CCP antibodies and later developed RA. None of the patients with UA developed PsA at 5-year follow up. Thirty-two of the 41 patients had a positive anti-CCP antibody and the mean +/- standard deviation of the anti-CCP units was 80.61 +/- 55.5.2. Six of the 41 (14.6%) patients with osteoarthritis studied had positive anti-CCP with a mean titer of 7,388. None of the healthy controls exhibited positively for anti-CCP antibodies.Conclusion: Anti-CCP antibodies may be found in patients with PsA and not in our patients with only cutaneous psoriasis. These antibodies may also be found in some patients with osteoarthritis and rarely in patients with UA; such patients will be of interest to follow prospectively.