Increased levels of C-reactive protein in serum from blood donors before the onset of rheumatoid arthritis
Increased levels of C-reactive protein in serum from blood donors before the onset of rheumatoid arthritis
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DOI：
10.1002/art.20431
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发表时间：
2004-08-01
影响因子：
--
通讯作者：
Dijkmans, BAC
中科院分区：
文献类型：
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作者：
Nielen, MMJ;van Schaardenburg, D;Dijkmans, BAC
客观的。我们之前报道过，大约一半的类风湿性关节炎 (RA) 患者在症状出现前几年就出现了特定的血清学异常（IgM 类风湿因子和/或抗环瓜氨酸肽抗体的血清浓度升高）。在本研究中，通过连续测量 C 反应蛋白 (CRP) 来研究临床前 RA 患者炎症血清学体征的存在。方法。确定了 79 名在 RA 发病前曾献血的患者（61% 为女性；出现症状的平均年龄 51 岁）。取回每位捐献者的冷冻血清样本，以及来自与年龄、性别和捐献日期相匹配的对照捐献者的样本。使用高度灵敏的乳胶增强测定法测量 CRP。捐赠日期被分为 RA 症状出现前的 15 个 I 年时期。对于每个时期，使用 Mann-Whitney U 检验比较患者组和对照组的中位 CRP 水平。通过随机系数分析估计患者组中 CRP 浓度随时间的变化。结果。每个患者平均有 13 个样本（范围 1-51）；最早的捐赠是在症状出现前 7.5 年（范围 0.4-14.5 年）进行的。总共测试了 1,078 份患者样本和 1,071 份对照样本。在所有 I 年期间，与对照组相比，患者组的中位 CRIP 浓度有所增加，但这种差异仅在症状出现前的 0-1 年、1-2 年和 4-5 年期间具有统计学意义。临床前 RA 患者的 CRIP 浓度随时间显着增加；在症状出现前有血清学异常的患者组中，其水平略高于没有血清学异常的患者。结论。在观察 RA 症状出现前 5 年的特定血清学异常后，我们现在报告后来出现 RA 的献血者的 CRP 水平升高；这些增加在症状出现前的两年内最为常见。在有和没有血清学异常的供体中都观察到 CRP 水平的临床前升高。
Objective. We previously reported that approximately half of the patients with rheumatoid arthritis (RA) have specific serologic abnormalities (elevated serum concentrations of IgM rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies) starting several years before the onset of symptoms. In this study, the presence of serologic signs of inflammation in patients with preclinical RA was investigated with serial measurements of C-reactive protein (CRP).Methods. Seventy-nine patients (61% female; mean age at onset of symptoms 51 years) who had been blood donors before the onset of RA were identified. Frozen serum samples from each donor were retrieved, together with I sample from a control donor matched for age, sex, and date of donation. CRP was measured using a highly sensitive latex-enhanced assay. The dates of donation were categorized into 15 I-year periods preceding the onset of RA symptoms. For each period, the median CRP levels in the patient and control groups were compared using the Mann-Whitney U test. The course of CRP concentrations over time in the patient group was estimated with random coefficient analysis.Results. A median of 13 samples (range 1-51) per patient were available; the earliest donation was made a median of 7.5 years (range 0.4-14.5 years) before the onset of symptoms. A total of 1,078 patient samples and 1,071 control samples were tested. For all I-year periods, the median CRIP concentration was increased in the patient group compared with the control group, but this difference was statistically significant only for the periods 0-1 year, 1-2 years, and 4-5 years before the onset of symptoms. The CRIP concentration increased significantly over time in patients with preclinical RA; levels were slightly higher in the group of patients who had serologic abnormalities before the onset of symptoms than in those without such serologic abnormalities.Conclusion. After observing specific serologic abnormalities 5 years before the onset of RA symptoms, we now report increased levels of CRP in blood donors in whom RA later developed; these increases were most common within the 2 years before the onset of symptoms. The preclinical increase in CRP levels was observed both in donors with and in those without serologic abnormalities.