Bas S, Perneger T V, Mikhnevitch E, Seitz M, Tiercy J M, Roux-Lombard P, Guerne P A
Division of Rheumatology, Department of Internal Medicine, University Hospital, Geneva, Switzerland.
Rheumatology (Oxford). 2000 Oct;39(10):1082-8. doi: 10.1093/rheumatology/39.10.1082.
To evaluate and to compare the association of two types of autoantibodies-rheumatoid factors (RF) and anti-filaggrin antibodies (AFA)-with clinical severity and joint damage progression in rheumatoid arthritis (RA) patients.
In a cross-sectional study, we determined RF and AFA titres in 199 RA patients and 65 controls. Erosions apparent on X-rays were quantified using the Larsen score in 143 patients, and the distribution of these scores was studied according to disease duration in patients who were positive and negative for RF and AFA.
RF were detected in 72% and AFA in 47% of RA patients. AFA were highly specific for RA (100%). RF positivity was correlated with the presence of subcutaneous nodules, sicca syndrome and the severity of erosions for a given disease duration. AFA positivity was correlated only with the presence of the HLA-DRB1 shared epitope.
Since no significant correlation was observed between joint damage progression and AFA positivity, the determination of AFA does not appear to be useful in assessing the prognosis of RA. However, AFA, which appear early in RA, could be helpful for the diagnosis of RA in patients who do not fulfil four American College of Rheumatology criteria.
评估并比较类风湿关节炎（RA）患者中两种自身抗体——类风湿因子（RF）和抗聚角蛋白微丝蛋白抗体（AFA）——与临床严重程度及关节损伤进展之间的关联。
在一项横断面研究中，我们测定了199例RA患者和65例对照者的RF和AFA滴度。对143例患者的X线片上可见的侵蚀情况用Larsen评分进行量化，并根据RF和AFA阳性及阴性患者的病程研究这些评分的分布情况。
72%的RA患者检测出RF，47%检测出AFA。AFA对RA具有高度特异性（100%）。在给定病程中，RF阳性与皮下结节、干燥综合征及侵蚀严重程度相关。AFA阳性仅与HLA - DRB1共享表位的存在相关。
由于未观察到关节损伤进展与AFA阳性之间存在显著相关性，因此测定AFA似乎对评估RA预后并无用处。然而，在RA早期出现的AFA，可能有助于对不符合美国风湿病学会四条标准的患者进行RA诊断。
