da Mota Licia Maria Henrique, Santos Neto Leopoldo Luiz Dos, Pereira Ivânio Alves, Burlingame Rufus, Ménard Henri A, Laurindo Ieda Maria Magalhães
Serviço de Reumatologia Clínica Médica, Universidade de Brasília.
Rev Bras Reumatol. 2011 Dec;51(6):564-71.
The diagnostic and prognostic value of the serial measurement of antibodies, such as rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), and anti-citrullinated vimentin (anti-Sa) antibodies, has not been defined in early rheumatoid arthritis (ERA).
To prospectively assess the presence of RF, anti-CCP, and anti-Sa in ERA patients.
Forty ERA (less than 12 months) patients of the Brasília cohort were evaluated and followed up for three years. Both clinical and demographic data were recorded, in addition to the results (ELISA) of RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1), and anti-Sa at the baseline assessment and after 3, 6, 12, 18, 24 and 36 months of follow-up. The results were compared by use of Student t test and paired t test.
The patients' mean age was 45 years, and 90% of them were female. At the time of diagnosis, RF was identified in 50% of the patients (RF IgA, 42%; RF IgG, 30%; and RF IgM, 50%), anti-CCP in 52.5% (no difference between CCP2, CCP3, and CCP3.1), and anti-Sa in 10%. After three years, no difference was observed in RF and anti-CCP prevalence, but anti-Sa increased to 17.5% (P = 0.001).
Repeated RF and anti-CCP measurement, including different isotypes, during three years of follow-up showed no significant changes. The third generation of anti-CCP assays did not increase the diagnostic value of the second-generation assays.
类风湿因子（RF）、抗环瓜氨酸肽（抗CCP）和抗瓜氨酸波形蛋白（抗Sa）抗体等抗体的系列检测在早期类风湿关节炎（ERA）中的诊断和预后价值尚未明确。
前瞻性评估ERA患者中RF、抗CCP和抗Sa的存在情况。
对巴西利亚队列中的40例ERA患者（病程小于12个月）进行评估并随访3年。记录临床和人口统计学数据，以及基线评估时和随访3、6、12、18、24和36个月时RF（IgM、IgG和IgA）、抗CCP（CCP2、CCP3和CCP3.1）和抗Sa的检测结果（ELISA法）。采用学生t检验和配对t检验比较结果。
患者平均年龄45岁，其中90%为女性。诊断时，50%的患者检测到RF（RF IgA为42%；RF IgG为30%；RF IgM为50%），52.5%的患者检测到抗CCP（CCP2、CCP3和CCP3.1之间无差异），10%的患者检测到抗Sa。3年后，RF和抗CCP的患病率无差异，但抗Sa增加至17.5%（P = 0.001）。
在3年随访期间重复检测RF和抗CCP，包括不同亚型，未显示出显著变化。抗CCP检测的第三代方法未增加第二代方法的诊断价值。
