抗氨甲酰蛋白抗体与类风湿性关节炎的相关性分析

doi:10.3969/j.issn.1673-8640.2018.01.005

摘要/Abstract

摘要：

目的分析类风湿性关节炎（RA）患者血清中抗氨甲酰蛋白（Carp）抗体水平,探讨其对RA的诊断和评估意义。方法采用酶联免疫吸附试验（ELISA）检测RA组（102例）、非RA组（55例）及健康对照组（83名）血清抗Carp IgG抗体、抗Carp IgA抗体水平,分析这2个指标在3组间的差异及其与RA患者其他相关实验室指标的关系。结果 RA患者血清抗Carp IgG抗体的水平为（8.60±2.64）U/L,阳性率为42.16%,抗Carp IgA抗体的水平为（6.65±3.09）U/L,阳性率为46.08%,均高于非RA组和健康对照组（P<0.05）。抗环瓜氨酸肽（CCP）阴性的RA患者抗Carp IgG抗体的阳性率为46.67%,抗Carp IgA抗体的阳性率为33.33%。抗Carp IgG抗体阳性组IgG、IgA和IgM水平与抗Carp IgG抗体阴性组比较,差异有统计学意义（P<0.05）;抗Carp IgA抗体阳性组IgG、IgA、IgM和补体（C）4水平明显高于抗Carp IgA抗体阴性组（P<0.05）。抗Carp IgG抗体与抗CCP抗体和类风湿因子（RF）均无明显相关性（P>0.05）,抗Carp IgA抗体与抗CCP抗体和RF也无明显相关性（P>0.05）。结论抗Carp抗体是一种新的对RA有诊断价值的血清学指标,与疾病严重程度相关,特别是其对于抗CCP抗体阴性RA的临床意义值得进一步研究。

关键词: 抗氨甲酰蛋白抗体, 类风湿性关节炎, 自身抗体

Abstract:

Objective To analyze the level of anti-carbamylated protein （Carp） antibody in patients with rheumatoid arthritis （RA）,and to investigate the role of anti-Carp antibody in the diagnosis and evaluation of RA. Methods The levels of serum anti-Carp IgG and anti-Carp IgA antibodies in RA group （102 cases）,non-RA group （55 cases） and healthy control group （83 cases） were determined by enzyme-linked immunosorbent assay（ELISA）. The difference of the 2 indices among the 3 groups and the relationship between anti-Carp antibody and RA were evaluated. Results The level of anti-Carp IgG antibody in serum of RA group was （8.60±2.64）U/L,and the positive rate was 42.16%. The level of anti-Carp IgA antibody in serum of RA group was （6.65±3.09）U/L,and the positive rate was 46.08%,which were higher than those in non-RA group and healthy control group （P<0.05）. The positive rate of anti-Carp IgG antibody was 46.67%,and the positive rate of anti-Carp IgA antibody was 33.33% in anti-cyclic citrullinated peptide （CCP） antibody negative RA patients. The levels of IgG,IgA and IgM in anti-Carp IgG antibody positive group had statistical significance compared with those in anti-Carp IgG antibody negative group （P<0.05）,and the levels of IgG,IgA,IgM and complement （C）4 in anti-Carp IgA antibody positive group were higher than those in anti-Carp IgA antibody negative group （P<0.05）. There was no correlation of anti-Carp IgG antibody with anti-CCP antibody and rheumatoid factor（RF）（P>0.05）,and there was no correlation of anti-Carp IgA antibody with anti-CCP antibody and RF （P>0.05）.Conclusions Anti-Carp antibody is a new serological marker for the diagnosis of RA,and it may be associated with the severity of the disease,which may contribute to the diagnosis of anti-CCP antibody negative RA.

Key words: Anti-carbamylated protein antibody, Rheumatoid arthritis, Autoantibody

中图分类号:

R446.62

陈燚琼, 赵迪, 任方, 邓晓刚, 徐龙, 李智. 抗氨甲酰蛋白抗体与类风湿性关节炎的相关性分析[J]. 检验医学, 2018, 33(1): 26-30.

CHEN Yiqiong, ZHAO Di, REN Fang, DENG Xiaogang, XU Long, LI Zhi. Relationship between anti-carbamylated protein antibody and rheumatoid arthritis[J]. Laboratory Medicine, 2018, 33(1): 26-30.

图/表 4

参考文献 8

[1]	KALLBERG H, PADYUKOV L, PLENGE R M, et al.Gene-gene and gene-environment interactions involving HLA-DRB1, PTPN22, and smoking in two subsets of rheumatoid arthritis[J]. Am J Hum Genet, 2007, 80(5) : 867-875.
[2]	VAN DER HELM-VAN MIL A H, VERPOORT K N, BREEDVELD F C, et al. Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis[J]. Arthritis Res Ther, 2005, 7(5) : R949-R958.
[3]	SHI J, KNEVEL R, SUWANNALAI P, et al.Autoantibodies recognizing carbamylated proteins are present in sera of patients with rheumatoid arthritis and predict joint damage[J]. Proc Natl Acad Sci U S A, 2011, 108(42):17372-17377.
[4]	JAISSON S, PIETREMENT C, GILLERY P.Carbamylation-derived products:bioactive compounds and potential biomarkers in chronic renal failure and atherosclerosis[J]. Clin Chem, 2011, 57(11) : 1499-1505.
[5]	WYNCKEL A, RANDOUX C, MILLART H, et al.Kinetics of carbamylated haemoglobin in acute renal failure[J]. Nephrol Dial Transplant, 2000, 15(8): 1183-1188.
[6]	WANG Z, NICHOLLS S J, RODRIGUEZ E R, et al.Protein carbamylation links inflammation, smoking, uremia and atherogenesis[J]. Nat Med,2007, 13(10): 1176-1184.
[7]	SCINOCCA M, BELL D A, RACAPE M, et al.Antihomocitrullinated fibrinogen antibodies are specific to rheumatoid arthritis and frequently bind citrullinated proteins/peptides[J]. J Rheumatol, 2014, 41(2): 270-279.
[8]	VERHEUL M K, SHIOZAWA K, LEVARHT E W,et al.Anti-carbamylated protein antibodies in rheumatoid arthritis patients of Asian descent[J]. Rheumatology (Oxford), 2015,54(10):1930-1932.

组别	例数	抗Carp IgG抗体（U/L）	抗Carp IgG抗体阳性 [例（%）]
RA组	102	8.60±2.64^*##	43（42.16）^*#
非RA组	55	7.49±2.34^*	12（21.82）^*
健康对照组	83	4.62±1.97	3（3.61）

组别	例数	抗Carp IgG抗体（U/L）	抗Carp IgG抗体阳性 [例（%）]
RA组	102	8.60±2.64^*##	43（42.16）^*#
非RA组	55	7.49±2.34^*	12（21.82）^*
健康对照组	83	4.62±1.97	3（3.61）

组别	例数	抗Carp IgG抗体（U/L）	抗Carp IgG抗体阳性 [例（%）]
RA组	102	6.65±3.09^*##	47（46.08）^*#
非RA组	55	5.05±1.99^*	14（25.45）^*
健康对照组	83	3.29±1.47	4（4.82）

组别	例数	抗Carp IgG抗体（U/L）	抗Carp IgG抗体阳性 [例（%）]
RA组	102	6.65±3.09^*##	47（46.08）^*#
非RA组	55	5.05±1.99^*	14（25.45）^*
健康对照组	83	3.29±1.47	4（4.82）

组别	例数	年龄（岁）		性别（男/女）		IgG（g/L）	IgA（g/L）		IgM（g/L）
抗Carp IgG抗体阳性组	43	59.84±13.16		16/27		16.84±7.13	4.18±1.75		1.83±0.79
抗Carp IgG抗体阴性组	59	62.94±12.06		18/41		13.74±2.18	3.18±1.15		1.26±0.45
统计值		1.082		1.073		2.717	2.887		4.008
P值		0.283		0.058		0.009	0.005		0.000
组别	C3（g/L）		C4（g/L）		RF（IU/mL）			抗CCP抗体（U/mL）
抗Carp IgG抗体阳性组	1.61±0.43		0.32±0.11		105.00（23.10,491.50）			692.97±551.46
抗Carp IgG抗体阴性组	1.65±0.42		0.35±0.12		50.00（23.70,193.00）			639.67±548.65
统计值	0.463		1.394		1 085.000			0.424
P值	0.645		0.167		0.268			0.672