类风湿性关节炎患者自身抗体三重阳性与严重病程相关,但与骨转换标志物无关。

IF 1.7 Q3 RHEUMATOLOGY
Reumatologia Pub Date : 2025-04-30 eCollection Date: 2025-01-01 DOI:10.5114/reum/200527
Tomasz Budlewski, Joanna Sarnik, Olga Brzezińska, Anna Lewandowska-Polak, Tomasz Popławski, Joanna Makowska
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引用次数: 0

摘要

类风湿性关节炎(RA)是一种常见的自身免疫性疾病,以慢性关节炎症和进行性骨侵蚀为特征。传统的自身抗体,如抗瓜氨酸肽抗体(ACPAs)和类风湿因子(RF),是与疾病严重程度相关的既定标志物。最近的研究已经确定抗氨基甲酰化蛋白(anti-CarP)抗体是疾病进展的潜在指标。此外,骨转换标志物和特定的单核苷酸多态性(snp)可能影响RA的发病机制。本研究旨在评估波兰RA患者队列中自身抗体谱、疾病活动性、骨转换标记物和选定snp之间的相关性。材料和方法:来自罗兹医科大学风湿病学系的138例RA患者被纳入研究。采用c反应蛋白(DAS28-CRP)对28个关节的疾病活动性进行评估。采用免疫分析法测定血清RF、ACPAs、抗鲤鱼抗体和骨转换标志物(硬化蛋白、骨膜蛋白和Dickkopf-1)水平。对PADI4 (rs2240340)、STAT4 (rs7574865)和PTPN22 (rs2476601)基因的snp进行基因分型。患者分为两组:抗鲤鱼抗体、RF和ACPA阳性(三阳性,n = 27)和其他抗体组合阳性(n = 111)。结果:人口统计学特征,包括年龄(平均约。61岁),性别分布(约61岁)。75%为女性),治疗率(约为。75%)和糖皮质激素的使用(约占75%)。40%),组间具有可比性。三阳性组表现出更高的疾病活动性,有更多的关节疼痛(平均10.07比7.72;p = 0.017),疼痛的视觉模拟评分(VAS)更高(平均6.26比5.06;p = 0.018), DAS28-CRP评分升高(平均4.75比4.07;p = 0.037),红细胞沉降率(ESR)升高(平均32.92 mm/h vs. 22.82 mm/h;P = 0.019)。血清学上,三阳性组抗鲤鱼水平显著升高(平均29.19 ng/ml vs. 16.29 ng/ml;p < 0.0001)和acpa(平均395.45比368.70;p < 0.0001),但RF水平较低(平均164.01 vs. 453.40;P = 0.004)。骨转换标志物组间无显著差异,但硬化蛋白水平差异接近统计学意义(p = 0.085),提示骨形成抑制程度较高可能与三阳性状态有关。在自身抗体谱和选择的snp之间没有发现显著的关联。结论:抗鲤鱼抗体、RF和ACPA的存在与RA患者疾病活动性增加有关。然而,在这个波兰队列中,这些自身抗体谱与骨转换标记物或选定的遗传多态性没有显著相关性。需要进一步的研究来阐明RA中自身抗体、骨代谢和遗传因素之间复杂的相互作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Triple positivity for autoantibodies in patients with rheumatoid arthritis is associated with a severe course of the disease but not with bone turnover markers.

Introduction: Rheumatoid arthritis (RA) is a prevalent autoimmune disorder characterized by chronic joint inflammation and progressive bone erosion. Traditional autoantibodies, such as anti-citrullinated peptide antibodies (ACPAs) and rheumatoid factor (RF), are established markers associated with disease severity. Recent studies have identified anti-carbamylated protein (anti-CarP) antibodies as potential indicators of disease progression. Additionally, bone turnover markers and specific single nucleotide polymorphisms (SNPs) may influence RA pathogenesis. This study aimed to evaluate the correlation between autoantibody profiles, disease activity, bone turnover markers, and selected SNPs in a cohort of Polish RA patients.

Material and methods: A total of 138 RA patients from the Department of Rheumatology, Medical University of Lodz, were enrolled. Disease activity was assessed using the Disease Activity Score in 28 joints by C-reactive protein (DAS28-CRP). Serum levels of RF, ACPAs, anti-CarP antibodies, and bone turnover markers (sclerostin, periostin, and Dickkopf-1) were measured using immunoassays. Genotyping for SNPs in PADI4 (rs2240340), STAT4 (rs7574865), and PTPN22 (rs2476601) genes was performed. Patients were categorized into two groups: those positive for anti-CarP antibodies, RF, and ACPA (triple-positive, n = 27) and those with other antibody combinations (n = 111).

Results: Demographic characteristics, including age (mean approx. 61 years), gender distribution (approx. 75% female), treatment rates (approx. 75%), and glucocorticosteroid use (approx. 40%), were comparable between groups. The triple-positive group exhibited higher disease activity, with a greater number of painful joints (mean 10.07 vs. 7.72; p = 0.017), higher Visual Analogue Scale (VAS) scores for pain (mean 6.26 vs. 5.06; p = 0.018), elevated DAS28-CRP scores (mean 4.75 vs. 4.07; p = 0.037), and increased erythrocyte sedimentation rate (ESR) (mean 32.92 mm/h vs. 22.82 mm/h; p = 0.019). Serologically, the triple-positive group had significantly higher levels of anti-CarP (mean 29.19 ng/ml vs. 16.29 ng/ml; p < 0.0001) and ACPAs (mean 395.45 vs. 368.70; p < 0.0001), but lower RF levels (mean 164.01 vs. 453.40; p = 0.004). Bone turnover markers showed no significant differences between groups, though the difference in sclerostin levels approached statistical significance (p = 0.085), suggesting a possible association of higher bone formation inhibition with triple-positive status. No significant associations were found between the autoantibody profiles and the selected SNPs.

Conclusions: The presence of anti-CarP antibodies, RF, and ACPA is associated with increased disease activity in RA patients. However, these autoantibody profiles do not significantly correlate with bone turnover markers or the selected genetic polymorphisms in this Polish cohort. Further research is warranted to elucidate the complex interactions between autoantibodies, bone metabolism, and genetic factors in RA.

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来源期刊
Reumatologia
Reumatologia Medicine-Rheumatology
CiteScore
2.70
自引率
0.00%
发文量
44
审稿时长
10 weeks
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