Liu Feng-Cheng, Chao You-Chen, Hou Tsung-Yun, Chen Hsiang-Cheng, Shyu Rong-Yaun, Hsieh Tsai-Yuan, Chen Chen-Hung, Chang Deh-Ming, Lai Jenn-Haung
Division of Rheumatology/Immunology/Allergy, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Clin Rheumatol. 2008 Apr;27(4):463-7. doi: 10.1007/s10067-007-0729-4. Epub 2007 Sep 18.
The presence of antibodies to cyclic citrullinated peptide (CCP) has high specificity in the diagnosis of rheumatoid arthritis (RA). Hepatitis C virus (HCV) infection may induce extra-hepatic manifestations, such as polyarthritis that mimic RA. The aim of this study was to determine the prevalence of anti-CCP antibodies in HCV-infected patients with or without arthritis, rheumatoid factor (RF), or cryoglobulinemia and to investigate whether anti-CCP antibodies may be helpful in discriminating patients with RA from patients with HCV-associated arthropathy. A total of 44 patients with RA, 34 patients with HCV infections, and 42 control patients with non-RA rheumatic diseases were recruited for the study. Anti-CCP antibody levels were determined by enzyme-linked immunosorbent assay. We found that, consistent with other reports, patients with RA were more likely to have high titers of anti-CCP antibody than HCV-infected or control patients. A significant number of HCV-infected patients with neither RF nor cryoglobulinemia were also positive for anti-CCP antibodies (the three positive values were 36.10, 8.65, and 5.83 U/ml, P < 0.01 compared with the control patients). The presence of cryoglobulinemia and/or RF in HCV-infected patients did not affect the anti-CCP outcomes. Although anti-CCP antibodies remain to be a very useful tool in discriminating RA from non-RA, HCV-infected patients with neither RF nor cryoglobulinemia may have anti-CCP antibodies. Because of limited patient numbers, this tentative conclusion may need further confirmation with inclusion of more patient population.
抗环瓜氨酸肽（CCP）抗体的存在对类风湿关节炎（RA）的诊断具有高度特异性。丙型肝炎病毒（HCV）感染可能诱发肝外表现，如类似RA的多关节炎。本研究的目的是确定有无关节炎、类风湿因子（RF）或冷球蛋白血症的HCV感染患者中抗CCP抗体的患病率，并研究抗CCP抗体是否有助于区分RA患者和HCV相关性关节病患者。共招募了44例RA患者、34例HCV感染患者和42例非RA风湿性疾病对照患者进行研究。通过酶联免疫吸附测定法测定抗CCP抗体水平。我们发现，与其他报告一致，RA患者比HCV感染患者或对照患者更有可能具有高滴度的抗CCP抗体。相当数量既无RF也无冷球蛋白血症的HCV感染患者抗CCP抗体也呈阳性（三个阳性值分别为36.10、8.65和5.83 U/ml，与对照患者相比P<0.01）。HCV感染患者中冷球蛋白血症和/或RF的存在不影响抗CCP结果。虽然抗CCP抗体仍然是区分RA与非RA的非常有用的工具，但既无RF也无冷球蛋白血症的HCV感染患者可能有抗CCP抗体。由于患者数量有限，这一初步结论可能需要纳入更多患者群体进行进一步证实。
