Yalçinkaya F, Ince E, Uçar T, Ozkaya N, Tekin M, Elhan A H, Tutar E, Güriz D H, Aysev D, Gökdemir R, Doğru U, Tümer N
Ankara University School of Medicine, Ankara, Turkey.
Clin Rheumatol. 2002 Sep;21(5):378-81. doi: 10.1007/s100670200101.
Familial Mediterranean fever (FMF) is an autosomal recessive disorder. Although the pathogenesis of the disease is not yet completely understood, enhanced acute-phase responsiveness is considered to be one of the most important mechanisms. The presence of high levels of antistreptolysin O (ASO) antibodies and streptococcus-associated diseases, such as acute poststreptococcal glomerulonephritis (AGN) and acute rheumatic fever (ARF), has been reported in patients with FMF. In order to better understand the effect of FMF on antistreptococcal antibody response, we measured ASO and antideoxyribonuclease B (anti-DNAse B) levels in patients with FMF and compared them with those in healthy controls. The study consisted of two parts. In the first step, antistreptococcal antibody levels were analysed in 44 patients with FMF and 165 healthy children who had no history or clinical evidence of upper respiratory tract infection (URTI) for the last 4 months. In the second step, antistreptococcal antibody levels were measured in 15 patients with FMF and 22 healthy controls in response to documented group A beta-haemolytic streptococcal pharyngitis. In the first part of the study, ASO and anti-DNAse B levels in patients with FMF were found to be significantly higher than those in healthy controls (P<0.001). In the second part, ASO and anti-DNAse B titres were found to be significantly higher in patients with FMF than in controls (P<0.001 and <0.05, respectively) 4 weeks after a positive throat culture. We concluded that patients with FMF have an exaggerated response to streptococcal antigens and might be prone to poststreptococcal non-suppurative complications, such as ARF.
家族性地中海热（FMF）是一种常染色体隐性疾病。尽管该疾病的发病机制尚未完全明确，但急性期反应增强被认为是最重要的机制之一。有报道称，FMF患者体内存在高水平的抗链球菌溶血素O（ASO）抗体以及与链球菌相关的疾病，如急性链球菌感染后肾小球肾炎（AGN）和急性风湿热（ARF）。为了更好地了解FMF对抗链球菌抗体反应的影响，我们检测了FMF患者的ASO和抗脱氧核糖核酸酶B（抗DNAse B）水平，并将其与健康对照者进行比较。该研究包括两个部分。第一步，分析了44例FMF患者和165名健康儿童的抗链球菌抗体水平，这些健康儿童在过去4个月内无上呼吸道感染（URTI）病史或临床证据。第二步，检测了15例FMF患者和22名健康对照者在确诊为A组β溶血性链球菌咽炎后的抗链球菌抗体水平。在研究的第一部分中，发现FMF患者的ASO和抗DNAse B水平显著高于健康对照者（P<0.001）。在第二部分中，咽喉培养结果呈阳性4周后，发现FMF患者的ASO和抗DNAse B滴度显著高于对照组（分别为P<0.001和<0.05）。我们得出结论，FMF患者对链球菌抗原反应过度，可能易患链球菌感染后非化脓性并发症，如ARF。
