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类风湿关节炎中瓜氨酸化蛋白的抗体

[Antibodies to citrullinated proteins in rheumatoid arthritis].

作者信息

Matsui Toshihiro

机构信息

Department of Rheumatology, Sagamihara National Hospital, National Hospital Organization.

出版信息

Nihon Rinsho Meneki Gakkai Kaishi. 2006 Apr;29(2):49-56. doi: 10.2177/jsci.29.49.

Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown etiology, characterized by chronic joint inflammation that often leads to joint destruction. Diagnosis of RA is currently based on the revised classification criteria of the American College of Rheumatology (ACR); however, it remains imprecise, especially early in the course of disease. Rheumatoid factor (RF) has been widely used in clinical practice as a useful serological marker for diagnosis of RA. Although RF is the only serological test in the criteria of the ACR, its specificity is limited since RF can be also detected in other rheumatic diseases. Because the current therapeutic strategies in RA employ increasingly aggressive regimens from early stage of the disease, more specific serological markers than RF are desirable. Recently, anti-cyclic citrullinated peptide (anti-CCP) antibodies have attracted attention as a useful marker for the diagnosis of RA with high specificity. In addition to the diagnostic properties, anti-CCP antibodies showed to be a good prognostic marker for joint destructions. In this review, we will explain about the clinical usefulness of anti-CCP antibodies for the daily practice of RA.

摘要

类风湿关节炎(RA)是一种病因不明的全身性自身免疫性疾病,其特征为慢性关节炎症,常导致关节破坏。目前RA的诊断基于美国风湿病学会(ACR)修订的分类标准;然而,该诊断仍不准确,尤其是在疾病早期。类风湿因子(RF)作为诊断RA的一种有用的血清学标志物,已在临床实践中广泛应用。虽然RF是ACR标准中唯一的血清学检测项目,但其特异性有限,因为在其他风湿性疾病中也可检测到RF。由于目前RA的治疗策略在疾病早期采用了越来越积极的治疗方案,因此需要比RF更具特异性的血清学标志物。最近,抗环瓜氨酸肽(抗CCP)抗体作为诊断RA的一种具有高特异性的有用标志物而受到关注。除了诊断特性外,抗CCP抗体还被证明是关节破坏的良好预后标志物。在这篇综述中,我们将阐述抗CCP抗体在RA日常诊疗中的临床应用价值。

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