Laboratorio de Análisis Clínicos e Inmunológicos, La Plata, Argentina.
Autoimmunity. 2013 Feb;46(1):44-9. doi: 10.3109/08916934.2012.722143. Epub 2012 Oct 11.
The objective of this study was to evaluate neopterin plasma concentrations in patients with early Rheumatoid Arthritis (RA) and correlate them with disease activity.
This is a 28-month prospective study carried out on 65 individuals. There were 27 patients with early RA and 38 healthy volunteers as control group. Enzyme immunoassay was used to measure concentrations of neopterin and anti-cyclic citrullinated peptide (CCP) antibodies. Rheumatoid factor (RF) and C-reactive protein (CRP) were measured turbidimetrically, and antinuclear antibodies (ANA) were detected by immunofluorescence. Patients with early RA disease activity were divided into 4 groups according to DAS-28 criteria. Neopterin concentrations in RA patients were compared to conventional RA diagnostic serological markers.
Healthy volunteers had a mean neopterin concentration of 5.63 ± 0.38 [1.36-9.93] nmol. L(- 1). A statistically significant elevation of neopterin mean concentration was found on early RA patients: mean value of 8.92 ± 0.93 [3.94-28.3] nmol. L(- 1) (p < 0.001). Pearson product moment correlation suggests a correlation between neopterin concentrations and DAS-28 (r = 0.208, p = 0.065). The analysis of the mean values grouped according with the DAS-28 criteria showed a correspondence between these means, with a Pearson correlation coefficient r = 0.979, p = 0.021. CRP concentrations also showed a similar trend. Anti-CCP antibodies and RF revealed a positive relationship with RA activity. Such a correlation was not found with ANA results.
The elevation of plasma neopterin concentrations in early RA patients may indicate stimulation of immune response. Good correlation between neopterin concentrations and DAS-28 may facilitate assessing disease activity.
本研究旨在评估早期类风湿关节炎（RA）患者的血浆中新蝶呤浓度，并将其与疾病活动度相关联。
这是一项为期 28 个月的前瞻性研究，共纳入 65 名参与者。其中 27 名患者为早期 RA，38 名健康志愿者为对照组。采用酶联免疫吸附试验测定新蝶呤浓度和抗环瓜氨酸肽（CCP）抗体。采用比浊法测定类风湿因子（RF）和 C 反应蛋白（CRP），采用免疫荧光法检测抗核抗体（ANA）。根据 DAS-28 标准，将早期 RA 患者分为 4 组。比较 RA 患者的新蝶呤浓度与常规 RA 诊断血清学标志物。
健康志愿者的新蝶呤平均浓度为 5.63 ± 0.38 [1.36-9.93] nmol/L。早期 RA 患者的新蝶呤平均浓度明显升高：平均浓度为 8.92 ± 0.93 [3.94-28.3] nmol/L（p<0.001）。Pearson 积矩相关提示新蝶呤浓度与 DAS-28 之间存在相关性（r=0.208，p=0.065）。根据 DAS-28 标准分组后的平均值分析显示，这些平均值之间存在对应关系，Pearson 相关系数 r=0.979，p=0.021。CRP 浓度也表现出类似的趋势。抗 CCP 抗体和 RF 与 RA 活动呈正相关。ANA 结果未发现这种相关性。
早期 RA 患者血浆中新蝶呤浓度升高可能提示免疫反应受到刺激。新蝶呤浓度与 DAS-28 之间的良好相关性可能有助于评估疾病活动度。
