Ingegnoli Francesca, Galbiati Valentina, Zeni Silvana, Meani Laura, Zahalkova Lenka, Lubatti Chiara, Soldi Amedeo, Paresce Erberto, Murgo Antonella, Crapanzano Calogero, Fantini Flavio
Department of Rheumatology, Istituto Gaetano Pini, University of Milan, Piazza Cardinal Ferrari, 1- 20122 Milan, Italy.
Clin Rheumatol. 2007 Apr;26(4):510-4. doi: 10.1007/s10067-006-0313-3. Epub 2006 May 3.
To determine the prevalence of anti-cyclic citrullinated peptide (CCP) antibodies in systemic sclerosis (SSc) and to assess any association between the presence of anti-CCP, radiographic features, and clinical manifestations.
Anti-CCP antibodies and rheumatoid factor (RF) were tested in serum samples from 75 patients with SSc (64 women and 11 men), with a mean age of 59.4 years (range 24-85) with either diffuse (dcSSc) and limited (lcSSc) cutaneous involvement. As a control group, 22 age- and sex-matched healthy controls (HCs) were examined. Standard radiographs of the hands and wrists were examined in each patient.
The presence of anti-CCP was found in sera of 10.6% (8/75) patients with SSc (lcSSc 3 of 44, 6.8%; dcSSc 5 of 31, 16.1%). None of the HCs was positive for anti-CCP. The positivity of RF was observed in 19 of 75 (25.3%) SSc patients (lcSSc 10 of 44, 22.7%; dcSSc 9 of 31, 29%). Statistically significant association was found between anti-CCP positivity and the presence of arthritis (p<0.0001) and marginal erosions (p=0.001).
Our data show that joint involvement is a common presenting feature of SSc. In this report, we show that anti-CCP antibodies can be detected also in patients with SSc, but they are generally less commonly present than in adults with rheumatoid arthritis (RA). Thus, the finding of high titers of anti-CCP antibodies may help to define the diagnosis of overlap syndrome SSc/RA and facilitate diagnosis and appropriate treatment.
确定抗环瓜氨酸肽（CCP）抗体在系统性硬化症（SSc）中的患病率，并评估抗CCP抗体的存在与影像学特征及临床表现之间的任何关联。
对75例SSc患者（64例女性和11例男性）的血清样本进行抗CCP抗体和类风湿因子（RF）检测，这些患者平均年龄为59.4岁（范围24 - 85岁），有弥漫性（dcSSc）和局限性（lcSSc）皮肤受累情况。作为对照组，检查了22例年龄和性别匹配的健康对照者（HCs）。对每位患者的双手和腕部进行标准X线片检查。
在75例SSc患者中，10.6%（8/75）的患者血清中存在抗CCP抗体（lcSSc组44例中有3例，6.8%；dcSSc组31例中有5例，16.1%）。HCs中无抗CCP抗体阳性者。75例SSc患者中有19例（25.3%）RF呈阳性（lcSSc组44例中有10例，22.7%；dcSSc组31例中有9例，29%）。抗CCP抗体阳性与关节炎的存在（p<0.0001）和边缘侵蚀（p = 0.001）之间存在统计学显著关联。
我们的数据表明关节受累是SSc常见的表现特征。在本报告中，我们表明SSc患者中也可检测到抗CCP抗体，但与类风湿关节炎（RA）成人患者相比，其普遍存在的情况较少。因此，高滴度抗CCP抗体的发现可能有助于明确重叠综合征SSc/RA的诊断，并有助于诊断和适当治疗。
