Clague R B, Morgan K, Collins I, Pattrick M, Doherty M
Department of Rheumatology, University of Manchester Medical School, UK.
Ann Rheum Dis. 1991 Nov;50(11):769-71. doi: 10.1136/ard.50.11.769.
A cardinal feature of generalised nodal osteoarthritis is the loss of articular cartilage. To determine if autoimmunity to these cartilage collagens occurred, serum antibodies to native and denatured type II collagen were measured by enzyme linked immunosorbent assay (ELISA) in 96 patients (90 women, six men, aged 47-91 years) with generalised nodal osteoarthritis. Generalised nodal osteoarthritis was diagnosed by typical clinical and radiological features. Serum samples from 42 blood donors were assayed as controls. No significant difference was found between the patients with generalised nodal osteoarthritis and the controls. Furthermore, the 20 patients who were HLA-A1, B8 positive had similar antibody levels to the group as a whole. One woman patient with generalised nodal osteoarthritis (HLA-A1, B8 negative) had markedly increased antibody levels to native and denatured type II collagen in a pattern similar to that seen in patients with rheumatoid arthritis. This patient did not develop super added rheumatoid arthritis during a three year follow up period. Autoimmunity to type II collagen is therefore rare in generalised nodal osteoarthritis. A lack of collagen antibodies in a condition characterised by hyaline cartilage loss suggests that the presence of such antibodies in rheumatoid arthritis is more than a secondary event to joint damage.
全身性结节性骨关节炎的一个主要特征是关节软骨的丧失。为了确定是否存在针对这些软骨胶原蛋白的自身免疫,采用酶联免疫吸附测定(ELISA)法,对96例(90名女性,6名男性,年龄47 - 91岁)全身性结节性骨关节炎患者血清中针对天然和变性II型胶原蛋白的抗体进行了检测。全身性结节性骨关节炎通过典型的临床和放射学特征进行诊断。以42名献血者的血清样本作为对照。全身性结节性骨关节炎患者与对照组之间未发现显著差异。此外,20名HLA - A1、B8阳性的患者与整个组的抗体水平相似。一名全身性结节性骨关节炎女性患者(HLA - A1、B8阴性),其针对天然和变性II型胶原蛋白的抗体水平显著升高,模式与类风湿关节炎患者相似。该患者在三年随访期内未并发类风湿关节炎。因此,全身性结节性骨关节炎中针对II型胶原蛋白的自身免疫很少见。在以透明软骨丧失为特征的疾病中缺乏胶原蛋白抗体,这表明类风湿关节炎中此类抗体的存在不仅仅是关节损伤的继发事件。