Das Hemlata, Atsumi Tatsuya, Fukushima Yukari, Shibuya Hitoshi, Ito Keiko, Yamada Yuji, Amasaki Yoshiharu, Ichikawa Kenji, Amengual Olga, Koike Takao
Department of Medicine II, Hokkaido University Graduate School of Medicine, N15 W7, Kitaku, 060-8638 Sapporo, Japan.
Clin Rheumatol. 2004 Jun;23(3):218-22. doi: 10.1007/s10067-003-0860-9. Epub 2004 Feb 26.
Our objective in this study was to explore the diagnostic value of antiagalactosyl IgG antibodies in rheumatoid arthritis (RA). The study comprised 266 Japanese patients with systemic autoimmune diseases, including 60 with RA. Human agalactosyl IgG was prepared enzymatically, and the serum levels of antiagalactosyl IgG antibodies were determined using a lectin enzyme immunoassay. Serum IgG and IgM rheumatoid factors (RF) were measured using laser nephelometry for IgM (LN-RF) and an enzyme-linked immunosorbent assay for IgG (IgG-RF). Antiagalactosyl IgG antibodies were significantly more common in patients with RA than in those without (78% vs. 18%, odds ratio (OR) 16.51, 95% confidence interval (CI) 8.12-33.58, p<0.0001). Patients with RA also had a higher frequency of LN-RF than those without RA (75% vs. 28%, OR 7.81, 95% CI 3.91-15.58, p< 0.001). The specificity of antiagalactosyl IgG antibodies for RA was significantly higher than that of LN-RF (82% vs. 72%, p<0.0011). There was a significant correlation between titers of antiagalactosyl IgG antibodies and C-reactive protein levels. Antiagalactosyl IgG antibodies are more specific markers for RA than conventional LN-RF, and may provide useful information for the diagnosis of RA.
本研究的目的是探讨抗半乳糖基IgG抗体在类风湿关节炎(RA)中的诊断价值。该研究纳入了266例患有全身性自身免疫性疾病的日本患者,其中60例为RA患者。通过酶法制备人去半乳糖基IgG,并使用凝集素酶免疫测定法测定抗半乳糖基IgG抗体的血清水平。使用激光散射比浊法检测血清IgM类风湿因子(RF)(LN-RF),并使用酶联免疫吸附测定法检测血清IgG类风湿因子(IgG-RF)。与无RA的患者相比,抗半乳糖基IgG抗体在RA患者中更为常见(78%对18%,优势比(OR)16.51,95%置信区间(CI)8.12-33.58,p<0.0001)。与无RA的患者相比,RA患者中LN-RF的频率也更高(75%对28%,OR 7.81,95%CI 3.91-15.58,p<0.001)。抗半乳糖基IgG抗体对RA的特异性显著高于LN-RF(82%对72%,p<0.0011)。抗半乳糖基IgG抗体滴度与C反应蛋白水平之间存在显著相关性。与传统的LN-RF相比,抗半乳糖基IgG抗体是RA更具特异性的标志物,可能为RA的诊断提供有用信息。