Unidad de Investigación en Epidemiologia Clínica, UMAE HE CMNO, IMSS, Av. Juan Palomar y Arias (Antes Yaquis) #658, Col. Providencia, 44670 Guadalajara, Jalisco, Mexico.
Rheumatol Int. 2012 Nov;32(11):3531-6. doi: 10.1007/s00296-011-2224-0. Epub 2011 Nov 15.
Leprosy offers a broad spectrum of altered immunological sceneries, ranging from strong cell-mediated immune responses seen in tuberculoid leprosy (TT), through borderline leprosy (BB), to the virtual absence of T cell responses characteristic in lepromatous leprosy (LL). The exact mechanism of autoantibodies production remains unknown in leprosy and other chronic inflammatory diseases and also the contribution of these antibodies to the pathogenesis of the disease. The aim of this study is to evaluate the frequency and profiles of serum anti-cyclic citrullinated peptide antibodies (a-CCP), rheumatoid factor (RF) and its relationship with leprosy spectrum. Serum samples from 67 leprosy patients (54 LL, 5 TT and 8 BB) and 46 clinically healthy subjects (CHS) from the same endemic region were investigated. The clinical chart and questionnaire were used to obtain clinical information. Anti-cyclic citrullinated peptide antibodies (a-CCP) were measured by enzyme-linked immunosorbent assay, whereas the rheumatoid factor (RF) levels were measured by nephelometric method. The mean age of patients was 51.5 ± 13 years. Sera levels of a-CCP where higher in leprosy patients than in CHS (5.9 ± 11.6 vs. 0.3 ± 0.29) (P < 0.0001); the same pattern was found for RF sera titers without reaching statistical significance (16.8 ± 22.5 vs. 9.9 ± 3) (P = NS). We did not find a correlation between a-CCP and RF Rho =0.02786 (IC 95%) P = 0.8229. However, LL patients had higher a-CCP and RF levels than TT patients. Although an absence in correlation was observed, the serum levels of a-CCP antibodies and RF appeared to be useful in distinguishing LL from TT patients with a limited significance in detecting reactional leprosy patients.
麻风病提供了广泛的免疫改变景观,从结核样型麻风(TT)中所见的强烈细胞介导免疫反应,到边界型麻风(BB),再到麻风杆菌病(LL)中特征性的 T 细胞反应几乎缺失。麻风病和其他慢性炎症性疾病中自身抗体产生的确切机制仍不清楚,以及这些抗体对疾病发病机制的贡献。本研究旨在评估血清抗环瓜氨酸肽抗体(a-CCP)、类风湿因子(RF)的频率和谱型及其与麻风病谱的关系。来自同一流行地区的 67 例麻风病患者(54 例 LL、5 例 TT 和 8 例 BB)和 46 例临床健康对照者(CHS)的血清样本进行了研究。使用临床图表和问卷获得临床信息。通过酶联免疫吸附试验测量抗环瓜氨酸肽抗体(a-CCP),通过比浊法测量类风湿因子(RF)水平。患者的平均年龄为 51.5±13 岁。麻风病患者的血清 a-CCP 水平高于 CHS(5.9±11.6 与 0.3±0.29)(P<0.0001);RF 血清滴度也呈现出相同的模式,但没有达到统计学意义(16.8±22.5 与 9.9±3)(P=NS)。我们没有发现 a-CCP 与 RF 之间存在相关性(Rho=0.02786[95%CI],P=0.8229)。然而,LL 患者的 a-CCP 和 RF 水平高于 TT 患者。尽管观察到缺乏相关性,但血清 a-CCP 抗体和 RF 水平似乎有助于区分 LL 和 TT 患者,在检测反应性麻风病患者方面具有有限的意义。