Steiner G, Smolen J S
Klinische Abteilung für Rheumatologie, Universitätsklinik für Innere Medizin III, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20 1090 Vienna, Austria.
Z Rheumatol. 2002 Dec;61(6):667-73. doi: 10.1007/s00393-002-0470-y.
The diagnosis of rheumatoid arthritis has been hampered by the lack of a truly disease-specific serologic marker. Thus, despite its moderate specificity rheumatoid factor (RF) is still the only established marker antibody for RA and among the diagnostic criteria of the American College of Rheumatology the only serologic one. However, in recent years, several newly characterized autoantibodies have been described that may have the potential to become diagnostic indicators for RA. In particular, antibodies to citrullinated targets (anti-keratin or anti-filaggrin antibodies, respectively, antibodies to synthetic citrullinated peptides) appear to be highly specific for RA. Other potentially useful antibodies include anti-RA33 autoantibodies and antibodies to the stress protein BiP which seem to have higher specificity for RA than RF. Apart from being promising diagnostic markers these autoantibodies or the underlying cellular autoimmune reactions, respectively, may also play a role in the pathogenesis of RA.
类风湿性关节炎的诊断因缺乏真正疾病特异性的血清学标志物而受到阻碍。因此,尽管类风湿因子(RF)具有一定的特异性,但它仍然是类风湿关节炎唯一已确立的标志物抗体,并且是美国风湿病学会诊断标准中唯一的血清学指标。然而,近年来,已描述了几种新鉴定的自身抗体,它们可能有潜力成为类风湿关节炎的诊断指标。特别是,针对瓜氨酸化靶标的抗体(分别为抗角蛋白或抗丝集蛋白抗体、抗合成瓜氨酸化肽抗体)似乎对类风湿关节炎具有高度特异性。其他可能有用的抗体包括抗RA33自身抗体和抗应激蛋白BiP抗体,它们对类风湿关节炎的特异性似乎高于RF。除了有望成为诊断标志物外,这些自身抗体或潜在的细胞自身免疫反应可能在类风湿关节炎的发病机制中也起作用。