Shibata Sayaka, Tada Yayoi, Komine Mayumi, Hattori Naoko, Osame Satsuki, Kanda Naoko, Watanabe Shinichi, Saeki Hidehisa, Tamaki Kunihiko
Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
J Dermatol Sci. 2009 Jan;53(1):34-9. doi: 10.1016/j.jdermsci.2008.06.008. Epub 2008 Aug 26.
Anti-cyclic citrullinated peptide antibodies (anti-CCP) are reported to be found in 5-13% of patients with psoriatic arthritis (PsA). However, whether anti-CCP-positive PsA patients and rheumatoid arthritis (RA) patients have a similar pathophysiological background still remains uncertain.
To determine the prevalence of anti-CCP antibodies in patients with PsA and characterize these anti-CCP-positive patients of PsA.
We measured the serum levels of the anti-CCP antibodies in patients with PsA (n=16), psoriasis (n=15), RA (n=9) and healthy controls (n=11). Serum levels of rheumatoid factor (RF), matrix metalloproteinase-3 (MMP-3), cartilage oligomeric matrix protein (COMP), interleukin (IL)-23p19 and IL-12p40 were also measured in all the samples.
Two of the 16 PsA patients (13%) were positive for anti-CCP antibodies with high titers of RF. However, the serum IL-23p19 levels were two orders of magnitude higher in the anti-CCP-positive PsA patients as compared with those in the RA patients and anti-CCP-negative PsA patients. No significant elevation of the serum levels of MMP-3, COMP and IL-12p40 was found in these patients.
Thirteen percent of the PsA patients were positive for anti-CCP. These patients do not fulfill the American College of Rheumatology (ACR) classification criteria for RA so far. Furthermore, they showed the typical clinical features of PsA rather than those of RA. Although anti-CCP-positive PsA patients may possibly be have a risk of developing RA, we propose that these patients be classified, for the moment, into a independent subtype of PsA, as a different entity from RA.
据报道，5%至13%的银屑病关节炎（PsA）患者体内可检测到抗环瓜氨酸肽抗体（抗CCP）。然而，抗CCP阳性的PsA患者与类风湿关节炎（RA）患者是否具有相似的病理生理背景仍不确定。
确定PsA患者中抗CCP抗体的患病率，并对这些抗CCP阳性的PsA患者进行特征描述。
我们检测了PsA患者（n = 16）、银屑病患者（n = 15）、RA患者（n = 9）和健康对照者（n = 11）血清中的抗CCP抗体水平。同时还检测了所有样本中类风湿因子（RF）、基质金属蛋白酶-3（MMP-3）、软骨寡聚基质蛋白（COMP）、白细胞介素（IL）-23p19和IL-12p40的血清水平。
16例PsA患者中有2例（13%）抗CCP抗体呈阳性，且RF滴度较高。然而，抗CCP阳性的PsA患者血清IL-23p19水平比RA患者和抗CCP阴性的PsA患者高出两个数量级。这些患者的血清MMP-3、COMP和IL-12p40水平未发现明显升高。
13%的PsA患者抗CCP呈阳性，但这些患者目前不符合美国风湿病学会（ACR）的RA分类标准。此外，他们表现出PsA的典型临床特征，而非RA的特征。尽管抗CCP阳性的PsA患者可能有发展为RA的风险，但我们建议目前将这些患者归为PsA的一个独立亚型，作为与RA不同的实体。
