Meyer Pieter W A, Ally Mahmood M T M, Anderson Ronald
Department of Immunology, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, 5 Bophelo Rd, PO Box X323, Pretoria, South Africa.
Tshwane Academic Division, National Health Laboratory Service, PO Box X323, Pretoria, 0001, South Africa.
Rheumatol Int. 2016 Jun;36(6):751-8. doi: 10.1007/s00296-016-3433-3. Epub 2016 Feb 9.
Early diagnosis of patients with rheumatoid arthritis (RA) optimises therapeutic benefit and the probability of achieving disease remission. Notwithstanding clinical acumen, early diagnosis is dependent on access to reliable serodiagnostic procedures, as well as on the discerning application and interpretation of these. In the case of RA, however, no disease-specific serodiagnostic procedure is available due to the multi-factorial and polygenic nature of this autoimmune disorder. This has resulted in the development of an array of serodiagnostic procedures based on the detection of autoantibodies reactive with various putative autoantigens. Other procedures based on measurement of elevations in the concentrations of systemic biomarkers of inflammation, most commonly acute phase reactants and cytokines/chemokines, are used as objective indices of disease activity. Following a brief overview of RA research in African populations, the current review is focused on those autoantibodies/biomarkers, specifically rheumatoid factor, anti-citrullinated peptide antibodies and C-reactive protein, which are currently recognised as being the most reliable and cost-effective with respect to disease prediction and diagnosis, as well as in monitoring activity and outcome.
类风湿关节炎(RA)患者的早期诊断可优化治疗效果并提高疾病缓解的可能性。尽管临床敏锐度很重要,但早期诊断依赖于可靠的血清学诊断方法,以及对这些方法的准确应用和解读。然而,由于这种自身免疫性疾病具有多因素和多基因的性质,在RA的情况下,尚无疾病特异性的血清学诊断方法。这导致了一系列基于检测与各种假定自身抗原反应的自身抗体的血清学诊断方法的发展。其他基于测量炎症系统性生物标志物浓度升高的方法,最常见的是急性期反应物和细胞因子/趋化因子,被用作疾病活动的客观指标。在简要概述非洲人群的RA研究之后,本综述重点关注那些自身抗体/生物标志物,特别是类风湿因子、抗瓜氨酸化肽抗体和C反应蛋白,它们目前被认为在疾病预测和诊断以及监测活动和结果方面是最可靠且最具成本效益的。
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