Gilliam B E, Chauhan A K, Low J M, Moore T L
Division of Adult and Pediatric Rheumatology, Department of Internal Medicine and Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Clin Exp Rheumatol. 2008 May-Jun;26(3):492-7.
To evaluate in juvenile idiopathic arthritis (JIA) patients a biomarker panel of anti-cyclic citrullinated peptide (anti-CCP) antibodies, cartilage oligomeric matrix protein (COMP), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IgM rheumatoid factor (RF), IgG RF, and IgA RF and compare to the presence of joint erosions (JE), joint space narrowing (JSN), and synovitis in order to evaluate aggressive disease.
Sixty-eight JIA patients (19 RF positive polyarthritis, 23 RF negative polyarthritis, 17 persistent oligoarthritis, and 9 systemic-onset) were evaluated using the biomarker panel and compared to 18 healthy controls. All RF isotypes, anti-CCP antibodies, and COMP were measured by enzyme-linked immunosorbent assays (ELISA). Statistically significant differences and associations were assessed for each biomarker in relation to JE, JSN, and synovitis. Multiple regression analysis was used to find the variables associated with joint damage and synovitis.
Patients with JE and JSN had significantly elevated levels of IgA RF, IgM RF, and anti-CCP antibodies. COMP levels were higher in early disease, but also later in disease in patients with no JE or JSN. ESR, CRP, and IgA RF were significantly elevated in patients with active synovitis. Regression analysis showed IgM RF and disease duration to be associated with JE and JSN. Anti-CCP antibodies and COMP were also associated with JSN. CRP and IgA RF were associated with synovitis.
Our findings demonstrate the importance of measuring IgM RF and IgA RF by ELISA and anti-CCP antibodies by ELISA, in addition to COMP in the assessment of JIA patients to determine severity of disease.
评估青少年特发性关节炎（JIA）患者中抗环瓜氨酸肽（anti-CCP）抗体、软骨寡聚基质蛋白（COMP）、C反应蛋白（CRP）、红细胞沉降率（ESR）、IgM类风湿因子（RF）、IgG RF和IgA RF的生物标志物组合，并与关节侵蚀（JE）、关节间隙变窄（JSN）和滑膜炎的存在情况进行比较，以评估侵袭性疾病。
使用该生物标志物组合对68例JIA患者（19例RF阳性多关节炎、23例RF阴性多关节炎、17例持续性寡关节炎和9例全身发病型）进行评估，并与18名健康对照者进行比较。所有RF亚型、anti-CCP抗体和COMP均通过酶联免疫吸附测定（ELISA）进行检测。评估每种生物标志物与JE、JSN和滑膜炎相关的统计学显著差异和关联。采用多元回归分析来寻找与关节损伤和滑膜炎相关的变量。
患有JE和JSN的患者中，IgA RF、IgM RF和anti-CCP抗体水平显著升高。在疾病早期，COMP水平较高，但在没有JE或JSN的患者中，疾病后期COMP水平也较高。活动性滑膜炎患者的ESR、CRP和IgA RF显著升高。回归分析显示，IgM RF和病程与JE和JSN相关。anti-CCP抗体和COMP也与JSN相关。CRP和IgA RF与滑膜炎相关。
我们的研究结果表明，在评估JIA患者以确定疾病严重程度时，除了COMP之外，通过ELISA检测IgM RF和IgA RF以及通过ELISA检测anti-CCP抗体具有重要意义。
