Hirohata Shunsei, Kasama Tsuyoshi, Kawahito Yutaka, Takabayashi Katsuhiko
Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine , Kanagawa , Japan.
Mod Rheumatol. 2014 Nov;24(6):939-44. doi: 10.3109/14397595.2014.884529. Epub 2014 Mar 26.
Anti-ribosomal P protein antibody (anti-P) is detected in a fraction of systemic lupus erythematosus (SLE) patients, especially with lupus psychosis, lupus nephritis, and lupus hepatitis. However, it has been unclear whether anti-P testing is specific for SLE. The current studies were designed to examine the efficacy of serum anti-P testing in diagnosis of SLE.
Multicenter retrospective study was performed with 102 SLE patients, 102 patients with non-SLE rheumatic diseases, and 100 normal healthy subjects, who gave informed consents. The diagnosis of SLE was confirmed according to the 1982 ACR revised criteria. Serum IgG anti-P was determined by ELISA using the C-terminal 22 amino-acids of ribosomal P protein conjugated to human serum albumin. The specificity and sensitivity of anti-P were compared with those of anti-DNA, anti-Sm, and anti-cardiolipin (CL) antibodies.
Serum anti-P was positive in 38 of 102 SLE patients (37.3%), in 4 of 102 patients with non-SLE rheumatic diseases (3.9%), and in none of 100 normal subjects. Receiver operating characteristic (ROC) curve analysis revealed that anti-P provided higher AUC (area under the curve) than anti-Sm or anti-CL. Consistently, the sensitivity of anti-P (37.3%) was superior to that of anti-Sm (27.5%) and anti-CL (24.5%), but inferior to that of anti-DNA (51.0%), whereas the specificity of anti-P (96.1%) was superior to that of anti-CL (86.3%) and comparable to that of anti-DNA (96.1%) and anti-Sm (96.1%).
These results indicate that serum anti-P testing might be an effective measure in diagnosing SLE, providing better diagnostic efficiency than anti-Sm and anti-CL.
在一部分系统性红斑狼疮（SLE）患者中可检测到抗核糖体P蛋白抗体（抗P），尤其是伴有狼疮性精神病、狼疮性肾炎和狼疮性肝炎的患者。然而，抗P检测是否对SLE具有特异性尚不清楚。当前研究旨在检验血清抗P检测在SLE诊断中的效能。
对102例SLE患者、102例非SLE风湿性疾病患者和100例正常健康受试者进行多中心回顾性研究，所有受试者均签署知情同意书。SLE的诊断根据1982年美国风湿病学会（ACR）修订标准确定。采用与人类血清白蛋白偶联的核糖体P蛋白C末端22个氨基酸，通过酶联免疫吸附测定（ELISA）法测定血清IgG抗P。将抗P的特异性和敏感性与抗DNA、抗Sm和抗心磷脂（CL）抗体的特异性和敏感性进行比较。
102例SLE患者中有38例（37.3%）血清抗P呈阳性，102例非SLE风湿性疾病患者中有4例（3.9%）血清抗P呈阳性，100例正常受试者中血清抗P均为阴性。受试者工作特征（ROC）曲线分析显示，抗P的曲线下面积（AUC）高于抗Sm或抗CL。同样，抗P的敏感性（37.3%）优于抗Sm（27.5%）和抗CL（24.5%），但低于抗DNA（51.0%）；而抗P的特异性（96.1%）优于抗CL（86.3%），与抗DNA（96.1%）和抗Sm（96.1%）相当。
这些结果表明，血清抗P检测可能是诊断SLE的有效手段，其诊断效率优于抗Sm和抗CL。
