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对抗素蛋白抗体阳性类风湿性关节炎的早期风险因素的识别 - 一项前性队列研究
Alexandra Cîrciumaru1,2, Yogan Kisten1, Monika Hansson1,3
1Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Rheumatology (Oxford, England)
|March 8, 2024
概括
患有抗CCP抗体和肌肉骨疾病的个体,具有ACPA反应性,肌炎,IL-6和IL-15Rα的个体,风湿性关节炎进展的风险很高. 这些因素可以帮助识别患关节炎的高风险或低风险的人.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 生物标志物 生物标志物
背景情况:
- 患有反循环抗体 (anti-CCP) 和肌肉骨疾病 (MSK-C) 的个体患有类风湿性关节炎 (RA) 的风险较高.
- 早期识别进展到RA的个体对于及时干预和改善患者结果至关重要.
研究的目的:
- 调查预测MSK-C.抗CCP阳性个体关节炎进展的因素.
- 确定RA发展的独特高风险阶段.
主要方法:
- 招募抗CCP2阳性个体,在基线时缺乏关节炎的MSK-C.
- 长度随访 (≥3年) 临床和超声波评估.
- 使用考克斯回归分析对自身抗体 (ACPA反应性),与炎症相关的蛋白质 (IL-6,IL-15Rα) 和HLA等位基因的分析.
主要成果:
- 在267名参与者中,有101人 (38%) 患有关节炎.
- 关节炎进展的重要独立预测因素包括:ACPA反应的存在 (HR 8.0),超声波检测到的肌炎 (HR 3.4),IL-6水平的升高 (HR 1.5),和IL-15受体α (IL-15Rα) 水平 (HR 0.6).
- 预测模型表现良好 (AUC为0.82).
结论:
- 高风险的RA阶段的特点是ACPA反应性,肌炎,IL-6和IL-15Rα.
- 这些因素需要进一步研究,以确定它们在按关节炎进展风险对个体进行分层的临床有用性.
- 这可以实现个性化的风险评估和管理策略.
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