López-Longo Francisco Javier, Sánchez-Ramón Silvia, Carreño Luis
Department of Rheumatology, University Hospital Gregorio Maranon, Madrid, Spain.
Drug News Perspect. 2009 Nov;22(9):543-8. doi: 10.1358/dnp.2009.22.9.1416992.
Rheumatoid arthritis (RA) is a systemic autoimmune disease that causes chronic inflammation of the joints and several extra-articular manifestations that account for increased morbimortality of these patients. The involvement of B cells in RA pathophysiology was recognized early, with the discovery of rheumatoid factor antibody. Recently, a number of autoantibodies against citrullinated proteins have been described, of which anti-cyclic citrullinated peptide (anti-CCP) is the most specific for RA. A cohort of 937 patients with RA was studied to determine the clinical correlates of anti-CCP antibodies. The presence of anti-CCP antibodies correlated with worse joint involvement and several extra-articular manifestations, i.e., higher incidence of ischemic heart disease independent of classic cardiovascular factors and higher mortality rate. A multivariate logistic regression model showed that only anti-CCP antibodies were independently associated with the development of ischemic heart disease in patients with RA. The clinical value of anti-citrullinated protein antibodies and the relevance of anti-CCP antibodies in daily clinical practice are reviewed.
类风湿关节炎（RA）是一种全身性自身免疫性疾病，可导致关节慢性炎症以及多种关节外表现，这些表现导致了此类患者更高的病残率和死亡率。随着类风湿因子抗体的发现，B细胞在RA病理生理学中的作用很早就被认识到了。最近，已描述了多种针对瓜氨酸化蛋白的自身抗体，其中抗环瓜氨酸肽（抗CCP）对RA最为特异。对937例RA患者进行了一项队列研究，以确定抗CCP抗体的临床相关性。抗CCP抗体的存在与更严重的关节受累和多种关节外表现相关，即与经典心血管因素无关的缺血性心脏病更高的发病率和更高的死亡率。多变量逻辑回归模型显示，在RA患者中，只有抗CCP抗体与缺血性心脏病的发生独立相关。本文综述了抗瓜氨酸化蛋白抗体的临床价值以及抗CCP抗体在日常临床实践中的相关性。
