Department of Family Medicine, Medical University of Lublin, ul. Staszica 11, 20-081 Lublin, Poland.
Rheumatol Int. 2011 Nov;31(11):1439-43. doi: 10.1007/s00296-010-1509-z. Epub 2010 May 15.
Anti-citrullinated peptide antibodies (ACPA) and the rheumatoid factor (RF) are well-established serological markers for rheumatoid arthritis (RA). ACPA are very useful in the diagnosis of RA, especially at the early stages of the disease when ACPA have a greater diagnostic value than RF. The aim of the study was to assess the influence of infliximab treatment on RF IgM and ACPA serum levels and RA activity during 6 months of treatment. Thirty-two patients with refractory RA were treated with infliximab during a 6-month period. At baseline, 3 and 6 months of treatment the patients were examined for the number swollen and tender joints out of 28 (SJC, TJC) and the visual analogue scale of arthritis activity according to the patient (VAS). Serum samples were tested for erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), ACPA and RF IgM. The disease activity score (DAS-28) parameter was also calculated at the same time. During the course of our study, we observed statistically significant improvement in ESR, CRP, TJC, SJC, VAS DAS-28, and RF IgM after 3 and 6 months of infliximab treatment when compared to the baseline, whereas the ACPA level remained unchanged after 3 and 6 months of treatment (P = 0.96 and P = 0.85). The changes in the ACPA level are not a factor for evaluation of successful infliximab treatment but the changes in RF IgM are. According to different behavior of these antibodies during infliximab treatment, we suggest that the roles of ACPA and RF in the pathogenesis of RA are different.
抗瓜氨酸化肽抗体 (ACPA) 和类风湿因子 (RF) 是类风湿关节炎 (RA) 的成熟血清标志物。ACPA 对 RA 的诊断非常有用，尤其是在疾病早期，此时 ACPA 的诊断价值大于 RF。本研究旨在评估英夫利昔单抗治疗对 RF IgM 和 ACPA 血清水平以及治疗 6 个月时 RA 活动度的影响。32 例难治性 RA 患者接受英夫利昔单抗治疗 6 个月。在基线、治疗 3 个月和 6 个月时，检查 28 个关节中肿胀和压痛关节的数量（SJC、TJC）和患者的视觉模拟量表关节炎活动度（VAS）。检测红细胞沉降率（ESR）、C 反应蛋白水平（CRP）、ACPA 和 RF IgM 血清样本。同时还计算了疾病活动评分（DAS-28）参数。在我们的研究过程中，与基线相比，在英夫利昔单抗治疗 3 个月和 6 个月后，ESR、CRP、TJC、SJC、VAS DAS-28 和 RF IgM 均观察到统计学显著改善，而 3 个月和 6 个月后 ACPA 水平保持不变治疗（P = 0.96 和 P = 0.85）。ACPA 水平的变化不是评估英夫利昔单抗治疗成功的因素，但 RF IgM 的变化是。根据英夫利昔单抗治疗期间这些抗体的不同行为，我们认为 ACPA 和 RF 在 RA 发病机制中的作用不同。
