Habeeb Reem A, Mansour Howaida E, Abdeldayem Aya M, Abo-Shady Rania A, Hassan Iman A, Saafan Nazek K, Aly Dalia G
Departments of Internal Medicine.
Clin Med Insights Arthritis Musculoskelet Disord. 2010 Apr 28;3:15-23. doi: 10.4137/cmamd.s4503.
Systemic Sclerosis (SSc) is characterized by skin thickening, fibrosis and vascular obliteration. The onset and course are heterogeneous. Prominent features include autoimmunity, inflammation and vascular damage.
To measure the level of serum Anti-Annexin V antibodies in SSc patients and to study its significance in relation to vascular damage in these patients.
Twenty patients with SSc (12 with diffuse SSc and 8 with the limited form) and 10 healthy age and sex matched volunteers as controls were all subjected to routine laboratory testing and immunological profiling including antinuclear, anti-Scl-70, anticentomere, anticardiolipin antibodies and anti-annexin V antibodies titres. Vascular damage was assessed by clinical examination and assessment of the disease activity score, nailfold capillaroscopy and colour flow Doppler of the renal arteries; Doppler echocardiography was used for assessing pulmonary hypertension.
Anti-annexin V antibodies were detected in 75% of patients. Comparisons between anti-annexin V in diffuse and limited subgroups showed no significance; however a statistically significant positive correlation was found between Anti-annexin V titre and the degree of vascular damage in SSc patients. Anti-annexin V increased significantly in patients with severe vascular damage in comparison with those less affected (15.3 ± 6.6 vs. 11.25 ± 3.6, P < 0.05). A significant positive correlation was found between Anti-annexin V titre and both the ACL titre (r = 0.79, P < 0.001) and the resistive index of the main renal artery (r = 0.42, P < 0.05).
Anti-annexin V antibodies were significantly present in sera of patients with SSc. Patients with more severe forms of vascular damage had higher titres of these antibodies. Anti-annexin V antibodies are a sensitive predictor of vascular damage in SSc and could serve as a useful parameter in discriminating patients with a higher risk of vascular affection from those without.
系统性硬化症（SSc）的特征为皮肤增厚、纤维化和血管闭塞。其发病和病程具有异质性。突出特征包括自身免疫、炎症和血管损伤。
检测系统性硬化症患者血清抗膜联蛋白V抗体水平，并研究其与这些患者血管损伤的相关性。
20例系统性硬化症患者（12例弥漫性SSc和8例局限性SSc）以及10例年龄和性别匹配的健康志愿者作为对照，均接受常规实验室检测和免疫分析，包括抗核抗体、抗Scl - 70抗体、抗着丝点抗体、抗心磷脂抗体及抗膜联蛋白V抗体滴度。通过临床检查、疾病活动评分评估、甲襞毛细血管镜检查以及肾动脉彩色多普勒评估血管损伤；采用多普勒超声心动图评估肺动脉高压。
75%的患者检测到抗膜联蛋白V抗体。弥漫性和局限性亚组中抗膜联蛋白V的比较无显著差异；然而，在系统性硬化症患者中，抗膜联蛋白V滴度与血管损伤程度之间存在统计学显著的正相关。与血管损伤较轻的患者相比，严重血管损伤患者的抗膜联蛋白V显著升高（15.3 ± 6.6对11.25 ± 3.6，P < 0.05）。抗膜联蛋白V滴度与抗心磷脂抗体滴度（r = 0.79，P < 0.001）以及主肾动脉阻力指数（r = 0.42，P < 0.05）之间均存在显著正相关。
系统性硬化症患者血清中显著存在抗膜联蛋白V抗体。血管损伤较严重的患者这些抗体滴度更高。抗膜联蛋白V抗体是系统性硬化症血管损伤的敏感预测指标，可作为区分血管受累风险较高患者与无此风险患者的有用参数。
