Absence of antibodies to cyclic citrullinated peptide in sera of patients and with hepatitis C virus infection cryoglobulinemia
Absence of antibodies to cyclic citrullinated peptide in sera of patients and with hepatitis C virus infection cryoglobulinemia
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DOI：
10.1002/art.20355
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发表时间：
2004-07-01
影响因子：
--
通讯作者：
Gretch, DR
中科院分区：
文献类型：
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作者：
Wener, MH;Hutchinson, K;Gretch, DR
目标。目的：探讨慢性丙型肝炎病毒（HCV）感染中是否存在环瓜氨酸肽（anti-CCP）抗体。对50例HCV感染但无冷球蛋白血症患者、29例混合冷球蛋白血症患者（其中13例有风湿病症状，5例有关节炎）和20例正常献血者的血清进行类风湿因子（RF）和抗ccp检测。采用第二代酶联免疫吸附试验（ELISA）检测抗ccp抗体。在无冷球蛋白血症的HCV感染患者中未发现血清中抗ccp升高，在该人群中，最高抗ccp为10单位，远低于阳性临界值20单位。22例（44%）HCV患者RF检测呈阳性，>为50 IU/ml， 8例（16%）患者RF检测呈阳性，最大RF为526 IU/ml。在冷球蛋白血症患者中，22例（76%）的RF检测结果呈阳性，其中18例（62%）的RF值为50 IU/ml，最大RF值为5540 IU/ml。2例（6.9%）冷球蛋白血症患者在抗ccp检测（25单位和37单位）中呈边缘阳性，这是ELISA非特异性结合引起的假阳性结果。RF与抗ccp浓度无相关性。尽管RF在伴有或不伴有冷球蛋白血症的HCV感染患者中很常见，但在无并发症的HCV感染患者中未观察到抗ccp。在混合冷球蛋白血症患者中很少观察到边缘阳性的抗ccp结果，这是由非特异性结合塑料引起的。检测抗ccp可能有助于诊断慢性HCV感染患者的RA。
Objective. To determine if antibodies to cyclic citrullinated peptide (anti-CCP) are found in chronic hepatitis C virus (HCV) infection.Methods. Rheumatoid factor (RF) and anti-CCP were measured in sera from 50 patients with HCV infection but without cryoglobulinemia, sera from 29 patients with mixed cryoglobulinemia (including 13 with rheumatic symptoms and 5 with arthritis), and sera from 20 normal blood donors. Anti-CCP was measured by second-generation enzyme-linked immunosorbent assay (ELISA).Results. No sera with elevated anti-CCP were found in patients with HCV infection without cryoglobulinemia, and in that population, the maximum anti-CCP was 10 units, well below the positive cutoff of 20 units. Positive findings on RF testing >13 IU/ml were present in 22 (44%) of the HCV patients, with RF >50 IU/ml in 8 (16%) and a maximum RF of 526 IU/ml. Of the cryoglobulinemia patients, 22 (76%) had positive results on tests for RF, including 18 (62%) with RF >50 IU/ml and a maximum RF of 5,540 IU/ml. Two (6.9%) of the cryoglobulinemia patients had borderline-positive findings on tests for anti-CCP (25 units and 37 units), which were false-positive results caused by nonspecific binding in the ELISA. No association between the RF and the anti-CCP concentrations was found.Conclusion. Whereas RF was frequent in patients with HCV infection with and without cryoglobulinemia, anti-CCP was not observed in patients with uncomplicated HCV infection. Borderline-positive anti-CCP results were observed infrequently in patients with mixed cryoglobulinemia and were caused by nonspecific binding to plastic. Measurement of anti-CCP may help in diagnosing RA in patients with chronic HCV infection.