抗纤聚蛋白抗体检测及其在类风湿关节炎中的意义

Antifilaggrin autoantibodies in rheumatoid arthritis

目的 了解抗纤聚蛋白抗体 (AFA)的临床意义。方法 从乳腺癌患者切除乳房皮肤中提取纤聚蛋白 (filaggrin) ,应用免疫印迹法检测类风湿关节炎 (RA)及其他风湿病患者血清AFA ,结合临床资料进行分析。结果 178例RA中AFA阳性 71例 ,对RA诊断敏感性 39 9% ,特异性 96 9%。31例早期RA阳性率 4 8 4 % ,4 8例RF阴性患者AFA阳性率 2 9 2 %。AFA阳性者平均年龄、平均发病年龄、继发Sj gren综合征、RF阳性率、平均滴度较阴性者高 ,AFA与年龄、类风湿因子 (RF)相关。AFA与抗角蛋白抗体 (AKA)、抗核周因子抗体 (APF)相关。结论 AFA检测对RA有诊断价值 ,特别有利于RF阴性及早期RA诊断。AFA与AKA和APF相关 ,但并不完全重叠 ,其所识别抗原 ,无一包含所有抗原决定簇 ,免疫印迹法检测AFA方法简单可靠 ,可能补充间接免疫荧光法检测AKA、APF。

Objective To investigate the significance of antifilaggrin autoantibodies (AFA) in rheumatoid arthritis (RA).Methods Filaggrin was extracted from the skin of the patients who had breast cancer undergoing mammectomy.AFA were detected at the sera titer 1∶10 with Western blotting,and its clinical significance was investigated with the corresponding clinical materials.Results Antifilaggrin autoantibodies (AFA) were detected in 39 9%(71/178) of RA patients,and 6 cases of control group,with a specificity of 0 969.AFA were present in 48 4%(15/31) of the early and 29 2% of seronegative RA.AFA positive patients exhibited higher frequency of Sjgren′s syndrome;The average and onset ages of AFA positive patients were older than those of the negative ones,and there was correlation between AFA and age.The frequency and average titer of RF patients were higher in AFA positive than in negative ones.AFA was significantly correlated to RF,AKA and APF.Conclusion AFA are valuable diagnostic parameter for RA,especially in the early and seronegative RA.AFA is significantly correlated to AKA and APF,but they are not totally overlapped,None of the three antigens used bear all the epitopes recognised by antifilaggrin autoantibodies.Immunoblot detection of AFA,a simple and reliable test,may be complement to conventional IIF detection of AKA and APF.