Mattey D L, Dawes P T, Nixon N B, Goh L, Banks M J, Kitas G D
Staffordshire Rheumatology Centre, The Haywood, High Lane, Burslem, Stoke-on-Trent, Staffordshire ST6 7AG, UK.
Ann Rheum Dis. 2004 Apr;63(4):420-5. doi: 10.1136/ard.2003.008011.
To determine whether raised levels of antibodies to CK18 in patients with RA are associated with ischaemic heart disease (IHD).
IgA, IgG, and IgM antibodies to CK18 were measured by enzyme linked immunosorbent assay (ELISA) in patients with RA with (n = 34) or without (n = 28) IHD. The relationship between CK18 antibody levels and markers of inflammatory and/or cardiovascular disease was examined.
Initial analysis showed that IgG antibody levels to CK18 were higher in patients with RA with IHD than in those without (50.1 v 34.5 AU, p = 0.047), although significance was lost after correction for multiple comparisons. Further analysis showed a significant difference (p = 0.015) between patients with IHD and a positive family history, and patients without IHD and a negative family history (53.7 v 29.0 AU, Kruskal-Wallis multiple comparison Z value test). There was also a significant trend of increasing 10 year cardiovascular risk with increasing CK18 IgG antibody levels (p = 0.01). No association was found between CK18 antibody levels and conventional markers of inflammation or cardiovascular disease, but an association was found between levels of CK18 IgG and IgG antibodies to cytomegalovirus (CMV) (Spearman's r(s) = 0.379, p(corr) = 0.04). No evidence for cross reactivity of CK18 antibodies with CMV antigens was found.
Levels of IgG antibodies to CK18 are raised in patients with RA with IHD, particularly if they also have a positive family history. This may reflect damage to CK18 containing cells in the cardiac vasculature and/or in atherosclerotic plaques, and may be a useful additional marker for the identification of patients with, or likely to develop, IHD.
确定类风湿关节炎（RA）患者中细胞角蛋白18（CK18）抗体水平升高是否与缺血性心脏病（IHD）相关。
采用酶联免疫吸附测定（ELISA）法检测有IHD（n = 34）或无IHD（n = 28）的RA患者的CK18 IgA、IgG和IgM抗体。研究了CK18抗体水平与炎症和/或心血管疾病标志物之间的关系。
初步分析显示，有IHD的RA患者的CK18 IgG抗体水平高于无IHD的患者（50.1对34.5 AU，p = 0.047），但在进行多重比较校正后显著性消失。进一步分析显示，有IHD且有阳性家族史的患者与无IHD且有阴性家族史的患者之间存在显著差异（p = 0.015）（53.7对29.0 AU，Kruskal-Wallis多重比较Z值检验）。随着CK18 IgG抗体水平升高，10年心血管风险也有显著增加趋势（p = 0.01）。未发现CK18抗体水平与传统炎症或心血管疾病标志物之间存在关联，但发现CK18 IgG水平与巨细胞病毒（CMV）IgG抗体之间存在关联（Spearman's r(s)= 0.379，p(corr)= 0.04）。未发现CK18抗体与CMV抗原存在交叉反应的证据。
有IHD的RA患者的CK18 IgG抗体水平升高，尤其是那些也有阳性家族史的患者。这可能反映了心脏血管系统和/或动脉粥样硬化斑块中含CK18细胞的损伤，可能是识别患有或可能发生IHD患者的一个有用的附加标志物。
