在早期炎症性关节炎患者中,抗碳amylated 蛋白抗体与长期残疾和疾病活性增加的关联:来自诺福克关节炎登记册的结果
Jennifer Humphreys1, Marije Verheul2, Anne Barton3
1Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK.
Lancet (London, England)
|August 28, 2015
概括
抗碳amylated (抗CarP) 抗体与炎症性关节炎患者的残疾和疾病活动增加有关. 这些抗体可能提供除了抗蛋白抗体 (ACPA) 之外的额外预后信息,特别是对于ACPA阴性个体.
科学领域:
- 关节病学
- 免疫学
- 临床诊断
背景情况:
- 抗林蛋白抗体 (ACPA) 是已确定的类风湿性关节炎 (RA) 疾病活动和残疾的生物标志物.
- 然而,ACPA阴性患者仍然可能出现严重的疾病负担,这表明需要额外的预后标志物.
- 抗碳amylated蛋白 (抗CarP) 抗体代表了RA中新发现的抗体子集.
研究的目的:
- 研究抗CarP抗体与炎症性关节炎患者的长期残疾和疾病活动之间的关联.
- 为了确定抗CarP抗体是否提供独立于ACPA状态的预后信息.
主要方法:
- 从诺福克关节炎登记处 (NOAR) 招募了患有炎症性关节炎的成年人.
- 在28个关节 (DAS28) 收集了残疾和疾病活动评分的健康评估问卷 (HAQ) 的基线和纵向数据.
- 测量了抗碳amylated 蛋白 (anti- CarP) 和抗素蛋白抗体 (ACPA),并使用了一般估计方程 (GEE) 进行分析.
主要成果:
- 在1995年的患者中,检测到23%的抗CarP抗体.
- 与抗CarP阴性患者相比,抗CarP抗体阳性患者的长期残疾 (HAQ) 和疾病活性 (DAS28) 显著增加.
- 这些关联在ACPA阴性患者中仍然显著,这表明抗CarP抗体识别出预后不佳的亚组.
结论:
- 在炎症性关节炎中,抗CarP抗体的存在与更大的残疾负担和更高的疾病活性有关.
- 抗CarP抗体提供有价值的预后信息,特别是对于ACPA阴性患者,补充现有的生物标志物.
- 这些发现突显了抗CarP抗体在治疗炎症性关节炎方面的潜在临床效用.
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