CARTILAGE AND BONE METABOLISM IN RHEUMATOID-ARTHRITIS - DIFFERENCES BETWEEN RAPID AND SLOW PROGRESSION OF DISEASE IDENTIFIED BY SERUM MARKERS OF CARTILAGE METABOLISM
CARTILAGE AND BONE METABOLISM IN RHEUMATOID-ARTHRITIS - DIFFERENCES BETWEEN RAPID AND SLOW PROGRESSION OF DISEASE IDENTIFIED BY SERUM MARKERS OF CARTILAGE METABOLISM
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DOI：
10.1172/jci117753
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发表时间：
1995-03-01
影响因子：
15.9
通讯作者：
SAXNE, T
中科院分区：
文献类型：
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作者：
MANSSON, B;CAREY, D;SAXNE, T
在两个明确定义的具有明显不同疾病结果的早期类风湿性关节炎患者组中测量反映组织更新的特定软骨和骨分子的血清浓度，以观察其水平的早期差异是否预示关节破坏率。与匹配的正常人群相比，在所有发生快速髋关节破坏的患者中发现软骨寡聚基质蛋白（COMP）浓度增加。相反，软骨聚集蛋白聚糖合成的假定标记物硫酸软骨素表位846的水平仅在缓慢关节破坏的患者中增加。两组患者的骨唾液蛋白（BSP）水平均升高，II型前胶原（CPII）的C-前肽水平也升高，CPII是II型胶原合成的标志物。缓慢关节破坏患者的846表位浓度升高表明聚集蛋白聚糖合成增加。在快速关节破坏患者中846表位的低水平，伴随着CPII水平的升高，表明胶原蛋白合成的选择性增加。升高的BSP水平表明两组的骨转换增加。因此，血清COMP水平升高可能表明快速关节破坏的不良预后，而升高的846表位表明更有利的预后。
Serum concentrations of specific cartilage and bone molecules reflecting tissue turnover were measured in two well-defined patient groups with early rheumatoid arthritis with distinctly different disease outcome to see if early differences in their levels are prognostic of the rate of joint destruction. Compared with a matched normal population, increased concentrations of cartilage oligomeric matrix protein (COMP) were found in all patients who developed rapid hip joint destruction. In contrast, levels of a putative marker of cartilage aggrecan synthesis, the chondroitin sulfate epitope 846, were increased only in patients with slow joint destruction. Levels of bone sialoprotein (BSP) were increased in both groups, as were levels of the C-propeptide of type II procollagen (CPII), a marker of collagen II synthesis.The increased concentrations of the 846 epitope in patients with slow joint destruction suggest increased aggrecan synthesis. The low levels of the 846 epitope in patients with rapid joint destruction, concomitant with elevated levels of CPII, suggest a selective increase in collagen synthesis. The elevated BSP levels indicate an increased bone turnover in both groups. Thus elevated serum levels of COMP may indicate an unfavorable prognosis for rapid joint destruction, whereas elevated 846 epitope indicates a more favorable prognosis.