Skogh Thomas
Division of Rheumatology/AIR, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden.
Arthritis Res Ther. 2005;7(6):230-2. doi: 10.1186/ar1836. Epub 2005 Sep 16.
The introduction of tests recognizing 'anti-citrullinated protein antibodies' (ACPA) has caused a revolution in rheumatology. Immunization against citrullinated proteins is a feature almost unique for rheumatoid arthritis, although ACPA may occur long before the onset of symptoms. Even if the presence of ACPA does not seem to reveal a distinct arthritis phenotype at symptom onset, it predicts an aggressive disease course with unfavourable outcome. Despite the very high diagnostic specificity for rheumatoid arthritis, ACPA-positivity does not always accord with a traditional diagnosis of rheumatoid arthritis at clinical presentation. However, even when these patients are judged to suffer from mild undifferentiated arthritis, they call for follow-up and special attention by rheumatologists.
识别“抗瓜氨酸化蛋白抗体”（ACPA）的检测方法的引入引发了风湿病学的一场革命。针对瓜氨酸化蛋白的免疫反应几乎是类风湿关节炎所独有的特征，尽管ACPA可能在症状出现前很久就已出现。即使在症状发作时ACPA的存在似乎并未揭示出明显的关节炎表型，但它预示着疾病进程具有侵袭性且预后不良。尽管ACPA对类风湿关节炎具有很高的诊断特异性，但在临床表现时ACPA阳性并不总是与类风湿关节炎的传统诊断相符。然而，即使这些患者被判定患有轻度未分化关节炎，他们也需要风湿病学家进行随访和特别关注。
