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抗II型胶原IgG抗体反映类风湿性关节炎患者的炎症活动。

IgG antibodies to type II collagen reflect inflammatory activity in patients with rheumatoid arthritis.

作者信息

Kim W U, Yoo W H, Park W, Kang Y M, Kim S I, Park J H, Lee S S, Joo Y S, Min J K, Hong Y S, Lee S H, Park S H, Cho C S, Kim H Y

机构信息

Catholic Research Institutes of Medical Science, Department of Internal Medicine, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, Seoul.

出版信息

J Rheumatol. 2000 Mar;27(3):575-81.

PMID:10743792

Abstract

OBJECTIVE

To determine the clinical significance of IgG antibodies to type II collagen (CII) and to define any correlation of antibodies to CII with the inflammatory response in patients with rheumatoid arthritis (RA).

METHODS

IgG antibodies to native human type II collagen (IgG anti-CII) were measured in sera and synovial fluid (SF) from patients with RA, patients with osteoarthritis (OA), and healthy controls by an improved ELISA. Demographic, clinical, and laboratory data including tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6) levels were also obtained at the time of sampling in patients with RA.

RESULTS

The median level and positivity for circulating IgG anti-CII were higher in patients with RA (n = 297) than patients with OA (n = 34) and healthy controls (n = 50) (p < 0.001). The titers of IgG anti-CII in SF were also higher in RA (n = 45) than in OA (n = 16) (p < 0.001). In paired samples, the levels of IgG anti-CII were significantly higher in SF compared to the sera in patients with RA (n = 45) (p < 0.001), but levels were not different in patients with OA (n = 16). Circulating IgG anti-CII converted from positive to negative in 13 patients (10.7%) and from negative to positive in 18 patients (14.8%) among 122 patients with RA in whom IgG anti-CII were monitored sequentially at a mean interval of 12.2 months. IgG anti-CII positive patients (n = 98) had shorter disease duration (p = 0.04) and less frequent deformity (p = 0.013), and higher median erythrocyte sedimentation rate (ESR) (p = 0.001) and C-reactive protein (CRP) (p < 0.001) than IgG anti-CII negative patients (n = 120). The levels of IgG anti-CII correlated with CRP (r = 0.270) and ESR (r = 0.253). CRP decreased significantly in patients (n = 13) who converted from IgG anti-CII positive to negative (p = 0.013). IgG anti-CII positive patients (n = 40) had higher levels of TNF-alpha and IL-6 than negative patients (n = 40) (p < 0.001). Levels of IgG anti-CII correlated well with TNF-alpha (r = 0.617) and IL-6 (r = 0.347).

CONCLUSION

Increased IgG anti-CII in sera and SF in RA correlated directly with acute phase reactants and the proinflammatory cytokines TNF-alpha and IL-6. Our data suggest that IgG anti-CII could reflect inflammatory activity with a potential to destroy cartilage in the early stages of RA.

摘要

目的

确定抗II型胶原（CII）IgG抗体的临床意义，并明确类风湿关节炎（RA）患者中抗CII抗体与炎症反应之间的相关性。

方法

采用改良的酶联免疫吸附测定法（ELISA）检测RA患者、骨关节炎（OA）患者及健康对照者血清和滑液（SF）中抗天然人II型胶原IgG抗体（IgG抗-CII）。同时收集RA患者采样时的人口统计学、临床和实验室数据，包括肿瘤坏死因子-α（TNF-α）和白细胞介素6（IL-6）水平。

结果

RA患者（n = 297）血清中循环IgG抗-CII的中位数水平及阳性率高于OA患者（n = 34）和健康对照者（n = 50）（p < 0.001）。RA患者（n = 45）SF中IgG抗-CII的滴度也高于OA患者（n = 16）（p < 0.001）。在配对样本中，RA患者（n = 45）SF中IgG抗-CII水平显著高于血清（p < 0.001），而OA患者（n = 16）则无差异。在122例接受序贯监测（平均间隔12.2个月）的RA患者中，13例（10.7%）循环IgG抗-CII由阳性转为阴性，18例（14.8%）由阴性转为阳性。IgG抗-CII阳性患者（n = 98）的病程较短（p = 0.04），畸形发生率较低（p = 0.013），红细胞沉降率（ESR）中位数较高（p = 0.001），C反应蛋白（CRP）较高（p < 0.001），均高于IgG抗-CII阴性患者（n = 120）。IgG抗-CII水平与CRP（r = 0.270）和ESR（r = 0.253）相关。从IgG抗-CII阳性转为阴性的患者（n = 13）中，CRP显著下降（p = 0.013）。IgG抗-CII阳性患者（n = 40）的TNF-α和IL-6水平高于阴性患者（n = 40）（p < 0.001）。IgG抗-CII水平与TNF-α（r = 0.617）和IL-6（r = 0.347）相关性良好。