检测抗聚丝蛋白抗体在类风湿关节炎诊断中的意义

Significance of antibodies to filaggrin in diagnosis of rheumatoid arthritis

目的探讨抗聚丝蛋白抗体(AFA)对类风湿关节炎(RA)诊断的价值,并比较与RA的其他早期诊断指标的相关性。方法从人表皮细胞中提取并部分纯化聚丝蛋白(filaggrin)抗原,用于免疫印迹检测(Western blot)103例RA血清标本和140例对照血清,包括系统性红斑狼疮(SLE)、干燥综合征(SS)、骨性关节炎(OA)95份及正常人45份。APF和AKA用间接免疫荧光法检测。结果103例RA病人的AFA阳性率、特异性分别为35.9%,93.7%,显著高于疾病对照组和正常人(P<0.001)。在AFA阳性的37例中,AKA也阳性的为26例,重叠率为70.3%;APF亦阳性的为31例,重叠率为83.8%,AFA与AKA、APF之间存在相关性。结论AFA对RA具有很高的特异性。AFA的检测可用于RA的临床诊断。AFA与APF及AKA有相关性,但不能完全取代它们的检测。

Objective To determine the diagnostic value of antifilaggrin antibodies （AFA） in rheumatoid arthritis （RA） and to compare the correlation among AFA, anti-perinuclear factor （APF） and anti-keratin antibodies （AKA）. Methods Filaggrin was extracted from human epidermis and then partially purified. AFA in 103 cases of RA and 140 cases of controls were detected by western blot. APF and AKA were detected using indirect immunofluorescence. Results AFA test resulted in diagnosis of 35.9% of 103 RA samples, with a specificity of 93.7%. The result was significantly higher than the controls （P 〈0. 001 ）. Tweenty six（70. 3% ） samples out of 37 AFA positive sera were positive in the AKA test and 31 samples out of 37 AFA positive were positive in APF test. The data show that there is a positive correlation among AFA, APF and AKA tests. Conclusion AFA has diagnostic value in rheumatoid arthritis. Although there is a positive correlation among AFA, APF and AKA, AFA can＇ t replace APF and AKA tests.