Autoantibodies to RNA helicase A - A new serologic marker of early lupus
Autoantibodies to RNA helicase A - A new serologic marker of early lupus
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DOI：
10.1002/art.22329
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发表时间：
2007-02-01
影响因子：
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通讯作者：
Satoh, Minoru
中科院分区：
文献类型：
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作者：
Yamasaki, Yoshioki;Narain, Sonali;Satoh, Minoru
Objective.目的探讨抗RNA解旋酶A（RHA）自身抗体在系统性风湿病患者中的临床和免疫学意义。该研究组由2000年至2005年在佛罗里达大学自身免疫疾病中心登记的1,119名个体组成。诊断基于标准标准。通过免疫沉淀和蛋白质印迹法分析自身抗体。结果。276例系统性红斑狼疮（SLE）患者中有17例（6.2%）观察到抗RRA，2例抗磷脂抗体患者和3例其他患者，但在多发性肌炎/皮肌炎、系统性硬化症、类风湿性关节炎或干燥综合征患者中未观察到抗RHA。仅2.9%的非裔美国人患者存在抗RHA，而白色患者为6.0%，其他种族患者为12-25%;这与非裔美国人患者中抗Sm的频率（27.2%）形成鲜明对比。在系统性红斑狼疮患者中，抗-RHA在年轻患者中常见（26%的患者首次就诊时年龄小于20岁，而3-4%的患者首次就诊时年龄为20-49岁）和疾病早期（23%的患者首次就诊是在疾病发作后1年内，而2-8%的患者首次就诊是在疾病发作后至少1年）。在11例患者中，9例患者的抗RHA水平在9-37个月内下降至初始值的10%以下，而共存的抗Ro或抗Su水平保持不变。2例患者出现新的特异性（分别为抗核RNP和抗Sm，以及抗核糖体P）。这些数据表明，抗RHA水平随着时间的推移而降低，抗RHA通过一种不同于其他狼疮相关自身抗体的机制进行调节。抗RHA是SLE的一个新的血清学标志物。它主要在非非洲裔美国人的年轻人中产生，处于疾病的早期阶段。抗RHA具有随时间减少的独特趋势。抗RHA的产生可能依赖于局限于早期SLE的过程，或者可能对治疗高度敏感。
Objective. To investigate the clinical and immunologic significance of autoantibodies to RNA helicase A (RHA) in patients with systemic rheumatic diseases.Methods. The study group comprised 1,119 individuals enrolled in the University of Florida Center for Autoimmune Diseases registry from 2000 to 2005. Diagnoses were based on standard criteria. Autoantibodies were analyzed by immunoprecipitation and Western blot assays.Results. Anti-RRA was observed in 17 (6.2%) of 276 patients with systemic lupus erythematosus (SLE), 2 patients with antiphospholipid antibodies, and 3 other patients, but anti-RHA was not observed in any patient with polymyositis/dermatomyositis, systemic sclerosis, rheumatoid arthritis, or Sjogren's syndrome. Anti-RHA was present in only 2.9% of African American patients, compared with 6.0% of white patients and 12-25% of patients of other races; this was in striking contrast to the frequency of anti-Sm in African American patients (27.2%). Among patients with SLE, anti-RHA was common in young patients (26% of those whose initial visit was at an age younger than 20 years versus 3-4% of those who were initially seen at ages 20-49 years) and at an early stage of disease (23% of those whose first clinic to visit was within 1 year of disease onset versus 2-8% of those whose first visit was at least 1 year after disease onset). In 9 of 11 patients, levels of anti-RHA decreased to < 10% of the initial value within 9-37 months, while levels of coexisting anti-Ro or anti-Su remained the same. New specificities developed in 2 patients (antinuclear RNP and anti-Sm, and anti-ribosomal P, respectively). These data suggest that the level of antiRHA diminishes over time, and that anti-RHA is regulated via a mechanism different from that for other lupus-related autoantibodies.Conclusion. Anti-RHA is a new serologic marker for SLE. It is produced mainly in young non-African Americans at an early stage of their disease. Anti-RHA has a unique tendency to diminish over time. The production of anti-RHA may depend on a process restricted to early SLE, or it may be highly sensitive to treatment.