Clinical significance of anti-CCP antibodies in rheumatoid arthritis.
Clinical significance of anti-CCP antibodies in rheumatoid arthritis.
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DOI：
10.2169/internalmedicine.44.1122
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发表时间：
2005-11
影响因子：
1.2
通讯作者：
T. Mimori
中科院分区：
文献类型：
--
作者：
T. Mimori
近年来在类风湿性关节炎（RA）中发现了一些新的自身抗体，并对其临床意义和可能的致病作用进行了讨论。特别是针对瓜氨酸化蛋白的新自身抗体，如聚丝蛋白及其环状形式（环瓜氨酸肽：CCP），因其高敏感性和高特异性而特别值得注意。许多研究表明，抗ccp抗体可作为RA早期诊断和关节破坏预后的有力血清学标志物。抗瓜氨酸化蛋白抗体在RA关节局部产生，瓜氨酸化蛋白（大多数是纤维蛋白）定位于RA滑膜组织。这一发现强烈提示关节内蛋白的局部瓜氨酸化可能是导致RA自身抗体产生的初始事件。遗传因素，如瓜氨酸化酶基因多态性，可能与瓜氨酸化蛋白自我耐受性的破坏和自身免疫的诱导有关。
A number of novel autoantibodies have been recently described in rheumatoid arthritis (RA), and their clinical significance and possible pathogenic roles have been discussed. In particular, new autoantibodies to citrullinated proteins such as filaggrin and its circular form (cyclic citrullinated peptide: CCP) are especially noteworthy because of their high sensitivity and high specificity. There are many studies that anti-CCP antibodies may serve as a powerful serologic marker for early diagnosis of RA and prognostic prediction of joint destruction. Anti-citrullinated protein antibodies are locally produced in RA joints, and citrullinated proteins (most are fibrins) are localized in RA synovial tissue. This finding strongly suggests a possibility that local citrullination of intraarticular proteins might be the initial event leading to autoantibody production in RA. Genetic factors such as a gene polymorphism of the citrullinating enzyme, PADI, might be associated with the breakage of self-tolerance and induction of autoimmunity against citrullinated proteins.