Shaikh Y, Krantz A, El-Farra Y
J Prev Med Hyg. 2013 Sep;54(3):175-80.
The anti-Rods and Rings autoantibody recently described in clinical populations is thought to occur in the setting of hepatitis C treatment, specifically in the context of cytidine triphosphate (CTP) and guanosine triphosphate (GTP) synthetic pathway inhibitors, and is important in its potential impact on response to therapy. This study asks the question: what is the epidemiology of anti-RR autoantibody in the general, non-clinical population?
This is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). Immunofluorescence assay for anti-Rods and Rings autoantibody were performed by NHANES labs and the results made publically available. Sample weights were used to calculate the prevalence and distribution of the autoantibody across demographics. A medication profile of the autoantibody positive population was also constructed
The study sample consisted of 4738 persons over the age of 12 years. Anti-Rods and Rings autoantibodies were found in 39 persons representing 1.3 million persons in the United States population. 38 of 39 persons with anti-Rods and Rings autoantibody had no prior history of hepatitis C virus infection. A majority of these persons were found to have poly-pharmacy.
This is the first study to show that anti-RR can occur in the general population without evidence of hepatits C virus infection, and that the majority of persons with anti-RR in the population have no evidence of prior hepatitis C infection. This indicates that there may be another undetermined etiology for anti-rods and rings autoantibodies besides the currently accepted exposure etiology of hepatitis C virus infection and treatment found in clinical studies.
最近在临床人群中发现的抗杆状和环状抗体被认为出现在丙型肝炎治疗过程中,特别是在三磷酸胞苷(CTP)和三磷酸鸟苷(GTP)合成途径抑制剂的背景下,并且其对治疗反应的潜在影响具有重要意义。本研究提出了一个问题:在普通非临床人群中,抗RR自身抗体的流行病学情况是怎样的?
这是一项使用美国国家健康与营养检查调查(NHANES)的横断面研究。NHANES实验室对抗杆状和环状自身抗体进行了免疫荧光测定,并公开了结果。样本权重用于计算该自身抗体在不同人口统计学特征中的患病率和分布情况。还构建了自身抗体阳性人群的用药情况简介。
研究样本包括4738名12岁以上的人。在美国人群中,有39人检测出抗杆状和环状自身抗体,相当于130万人。39名抗杆状和环状自身抗体阳性者中,有38人既往无丙型肝炎病毒感染史。这些人中大多数被发现使用多种药物。
这是第一项表明抗RR可在无丙型肝炎病毒感染证据的普通人群中出现的研究,并且该人群中大多数抗RR者无既往丙型肝炎感染证据。这表明,除了临床研究中目前公认的丙型肝炎病毒感染和治疗暴露病因外,抗杆状和环状自身抗体可能还有另一种未确定的病因。