Lowrie M, Penderis J, Eckersall P D, McLaughlin M, Mellor D, Anderson T J
Division of Companion Animal Sciences, Faculty of Veterinary Medicine, Institute of Comparative Medicine, University of Glasgow, Bearsden Road, Glasgow G611QH, UK.
Vet J. 2009 Oct;182(1):125-30. doi: 10.1016/j.tvjl.2008.05.001. Epub 2008 Jun 30.
Acute phase proteins (APPs) have become an important tool in the diagnosis, management and prognosis of inflammatory diseases in humans and are developing a similar utility in domestic species. Steroid-responsive meningitis arteritis (SRMA) is a well-recognised inflammatory disease of the dog, the diagnosis of which remains unsatisfactory based on clinical criteria and non-specific laboratory investigations. In this prospective pilot study the authors examined the acute phase response throughout the course of SRMA in serum and cerebrospinal fluid (CSF) by evaluating three key stages in disease management: presentation, treatment response and putative relapse. Serum APPs were found to be of value in supporting the diagnosis of SRMA and monitoring its treatment. C-reactive protein (CRP), serum amyloid-A (SAA), alpha-1-acid glycoprotein (AGP) and haptoglobin (Hp) all exhibited an increase above our laboratory reference range in nine patients at initial presentation. During treatment APPs decreased significantly compared to presentation except Hp which increased (Wilcoxon-Signed-Rank-test: CRP, SAA and AGP P<0.05). Serum CRP and SAA were also found to be of clinical value in the identification of putative relapse (seven cases), particularly in the light of unperturbed CSF parameters where APP concentrations were elevated. CSF APPs were found to be less reliable markers in the management of this disease. The results indicate that SRMA causes a significant APP response in dogs, which although not disease specific, is of value in supporting the diagnosis of SRMA.
急性期蛋白（APPs）已成为人类炎症性疾病诊断、管理和预后评估的重要工具，并且在家养动物中也逐渐发挥类似作用。类固醇反应性脑膜炎动脉炎（SRMA）是一种广为人知的犬类炎症性疾病，基于临床标准和非特异性实验室检查，其诊断仍不尽人意。在这项前瞻性试点研究中，作者通过评估疾病管理的三个关键阶段：发病、治疗反应和假定复发，研究了SRMA病程中血清和脑脊液（CSF）的急性期反应。发现血清APPs在支持SRMA的诊断和监测其治疗方面具有价值。在9例初诊患者中，C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）、α1酸性糖蛋白（AGP）和触珠蛋白（Hp）均高于我们实验室的参考范围。与发病时相比，治疗期间APPs显著下降，但Hp除外，其有所升高（Wilcoxon符号秩检验：CRP、SAA和AGP，P<0.05）。还发现血清CRP和SAA在识别假定复发（7例）方面具有临床价值，特别是在脑脊液参数未受干扰但APP浓度升高的情况下。发现脑脊液APPs在该疾病的管理中作为标志物可靠性较低。结果表明，SRMA在犬类中引起显著的APP反应，虽然不具有疾病特异性，但在支持SRMA的诊断方面具有价值。
