Anticyclic citrullinated peptide antibodies in patients with mixed connective tissue disease.
Anticyclic citrullinated peptide antibodies in patients with mixed connective tissue disease.
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DOI：
10.1007/s10165-004-0325-2
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发表时间：
2004-01-01
影响因子：
2.2
通讯作者：
Hashimoto, Hiroshi
中科院分区：
文献类型：
--
作者：
Takasaki, Yoshinari;Yamanaka, Kenjiro;Hashimoto, Hiroshi
目的探讨混合性结缔组织病（MCTD）患者血清抗环瓜氨酸肽（CCP）抗体的临床意义。共检测86例MCTD患者、96例类风湿性关节炎（RA）患者、42例系统性红斑狼疮（SLE）患者、23例系统性硬化症（SSc）患者、21例多发性肌炎/皮肌炎（PM/DM）患者和17例干燥综合征（SjS）患者血清中的抗CCP抗体。96例RA患者抗CCP抗体阳性率为85%，明显高于MCTD、SLE、SSc、PM/DM和SjS患者（分别为9%、14%、13%、14%和18%，P < 0.001）。在符合RA诊断标准的8例MCTD患者中，只有50%的患者有抗CCP抗体，其患病率显著低于所有RA患者（p < 0.01）。所有8例符合RA诊断标准的患者均存在SLE和SSc重叠，但1例除外，而4例不符合RA诊断标准的抗CCP阳性患者的SjS无SLE和SSc重叠特征;此外，大多数患者的抗体滴度较低。这些结果表明，抗CCP抗体与MCTD患者中的RA相关，但如果抗CCP抗体滴度低的患者缺乏重叠的SLE和SSc，则需要仔细诊断RA。
The clinical significance of anticyclic citrullinated peptide (CCP) antibodies in patients with mixed connective tissue disease (MCTD) was assessed. Altogether, 86 sera from MCTD patients, 96 from rheumatoid arthritis (RA) patients, 42 from systemic lupus erythematosus (SLE) patients, 23 from systemic sclerosis (SSc) patients, 21 from polymyositis/dermatomyositis (PM/DM) patients, and 17 from those with Sjogren's syndrome (SjS) were tested for anti-CCP antibodies using an enzyme-lined immunosorbent assay. Among the 96 RA patients, anti-CCP antibodies were detected in 85%, with the frequency being significantly higher than in MCTD, SLE, SSc, PM/DM, and SjS patients (9%, 14%, 13%, 14%, and 18%, respectively; P < 0.001). Among eight MCTD patients who fulfilled the diagnostic criteria for RA, only 50% had anti-CCP antibodies, and the prevalence was significantly lower than for all RA patients (p < 0.01). All eight patients who fulfilled the criteria for RA had overlap of SLE and SSc, except one patient, whereas the four anti-CCP-positive patients who did not fulfill the criteria for RA had SjS without overlapping features of SLE and SSc; moreover, most of their antibody titers were low. These results suggested that anti-CCP antibodies are associated with RA in MCTD patients, but careful diagnosis of RA is required if patients with low titers of anti-CCP antibodies lack overlapping SLE and SSc.