Rheumatology Unit, Oslo University Hospital Rikshospitalet,
Department of Immunology and Transfusion Medicine, Oslo University Hospital.
Rheumatology (Oxford). 2016 Jan;55(1):103-8. doi: 10.1093/rheumatology/kev300. Epub 2015 Aug 28.
MCTD is a chronic, immune-mediated disorder defined by the combined presence of serum anti-RNP antibodies and distinct clinical features, including progressive lung fibrosis. The aim of the study was to evaluate the potential impact of anti-SSA (i.e. Ro52 and Ro60) and anti-SSB autoantibodies as markers for disease outcomes in MCTD.
Stored serum samples from 113 patients included in the cross-sectional, nationwide Norwegian MCTD cohort were screened for the presence of anti-Ro52, anti-Ro60 and anti-SSB by a commercial line immunoassay. Correlation analyses were carried out with clinical parameters, including quantitative lung fibrosis scores by high-resolution CT. Lung fibrosis was defined by reticular pattern changes according to the Fleischner Society CT criteria for interstitial lung disease.
Anti-Ro52 antibodies were present in 29%, anti-Ro60 in 19% and anti-SSB in 6% of the MCTD sera. High-resolution CT scoring identified lung fibrosis in 38 of 113 (34%) MCTD patients. Anti-Ro52 antibodies were detected in 50% (19 of 38) of the MCTD patients with lung fibrosis and in 19% (14 of 75) without lung fibrosis (P < 0.001). The odds ratio for the presence of anti-Ro52 antibodies in lung fibrosis was 4.4 (95% CI 1.8, 10.3). Anti-Ro52 antibodies were equally frequent in patients with mild to moderate (eight of 17; 44%) and severe fibrosis (11 of 21; 52%). Anti-Ro52 was not associated with any of the other clinical parameters assessed, nor was anti-Ro60 or anti-SSB.
Our cross-sectional data suggest that anti-Ro52 antibodies may serve as a potential marker for lung fibrosis in MCTD.
MCTD 是一种慢性、免疫介导的疾病，其特征是血清中存在抗 RNP 抗体和独特的临床特征，包括进行性肺纤维化。本研究旨在评估抗 SSA（即 Ro52 和 Ro60）和抗 SSB 自身抗体作为 MCTD 疾病结局的潜在标志物。
通过商业线免疫分析法检测 113 例纳入横断面全国挪威 MCTD 队列的患者血清中抗 Ro52、抗 Ro60 和抗 SSB 的存在情况。对临床参数（包括高分辨率 CT 定量肺纤维化评分）进行相关性分析。肺纤维化根据 Fleischner 协会 CT 标准定义为间质性肺疾病的网状模式改变。
在 113 例 MCTD 血清中，抗 Ro52 抗体的存在率为 29%，抗 Ro60 为 19%，抗 SSB 为 6%。高分辨率 CT 评分显示，113 例 MCTD 患者中有 38 例（34%）存在肺纤维化。肺纤维化患者中检测到抗 Ro52 抗体的有 50%（19/38），无肺纤维化患者中检测到抗 Ro52 抗体的有 19%（14/75）（P<0.001）。抗 Ro52 抗体在肺纤维化患者中的存在的比值比为 4.4（95%CI 1.8, 10.3）。在轻度至中度纤维化患者中（17 例中有 8 例，44%）和严重纤维化患者中（21 例中有 11 例，52%），抗 Ro52 抗体的频率相等。抗 Ro52 抗体与评估的任何其他临床参数均无相关性，抗 Ro60 抗体或抗 SSB 抗体也无相关性。
我们的横断面数据表明，抗 Ro52 抗体可能是 MCTD 肺纤维化的潜在标志物。
