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抗MCV和抗CCP抗体在幼年特发性关节炎(JIA)患儿中的诊断和预后价值。

Anti-MCV and anti-CCP antibodies-diagnostic and prognostic value in children with juvenile idiopathic arthritis (JIA).

作者信息

Lipinska Joanna, Lipinska Stanislawa, Kasielski Marek, Smolewska Elzbieta

机构信息

Department of Pediatric Rheumatology, Medical University of Lodz, 36/50 Sporna St., 91-738, Lodz, Poland.

Outpatient Department of Pediatric Rheumatology, Maria Konopnicka' Memorial Hospital, Lodz, Poland.

出版信息

Clin Rheumatol. 2016 Nov;35(11):2699-2706. doi: 10.1007/s10067-016-3355-1. Epub 2016 Jul 25.

Abstract

The goal of the study was to evaluate the diagnostic and prognostic value of anti-mutated citrullinated vimentin (anti-MCV) antibodies in juvenile idiopathic arthritis (JIA) comparing to anti-cyclic citrullinated peptide (anti-CCP). Thirty children with confirmed JIA diagnosis and 20 children as a control group were included into the study. Serum and synovial fluid levels of anti-CCP, anti-MCV, and immunoglobulin M rheumatoid factor (IgM-RF) antibodies have been assessed. Anti-MCV was positive in 11/30 (36.6 %), whereas anti-CCP positivity was found in 12/30 (40 %) children with JIA. Among 11 children with JIA positive for anti-MCV, five (45.5 %) were also positive for anti-CCP and among 18 JIA children negative for anti-CCP, six (33.33 %) were also anti-MCV positive. Six out of 30 JIA children were found to be IgM-RF positive. In general, two out of all those 11 anti-MCV-positive patients demonstrated oligoarthritis and 9/11 had polyarticular type of onset. Anti-MCV serum concentration correlated positively with anti-CCP (p = 0.004). Almost 60 % of children in early stage of JIA were anti-MCV positive. Levels of anti-CCP antibodies correlated positively with the disease activity (p = 0.0014) and radiological outcome (p = 0.00017). In all synovial fluid samples, the concentration of autoantibodies was under the cut-off values. The results of our study indicate that anti-MCV as well as anti-CCP antibodies may be helpful in the diagnosis of JIA, especially in the early course of the disease. Anti-MCV antibodies could identify a group of children with JIA which is negative for anti-CCP antibodies and RF. However, it appears that in JIA, anti-CCP rather than anti-MCV antibodies have impact on radiographic changes.

摘要

本研究的目的是评估抗突变型瓜氨酸波形蛋白(anti-MCV)抗体与抗环瓜氨酸肽(anti-CCP)抗体相比,在幼年特发性关节炎(JIA)中的诊断和预后价值。30例确诊为JIA的儿童和20例儿童作为对照组纳入研究。评估了抗CCP、抗MCV和免疫球蛋白M类风湿因子(IgM-RF)抗体的血清和滑液水平。11/30(36.6%)的JIA患儿抗MCV呈阳性,而12/30(40%)的JIA患儿抗CCP呈阳性。在11例抗MCV阳性的JIA患儿中,5例(45.5%)抗CCP也呈阳性,在18例抗CCP阴性的JIA患儿中,6例(33.33%)抗MCV也呈阳性。30例JIA患儿中有6例IgM-RF呈阳性。总体而言,在这11例抗MCV阳性患者中,2例表现为少关节炎,9/11为多关节起病型。抗MCV血清浓度与抗CCP呈正相关(p = 0.004)。几乎60%的JIA早期儿童抗MCV呈阳性。抗CCP抗体水平与疾病活动度(p = 0.0014)和放射学结果(p = 0.000,17)呈正相关。在所有滑液样本中,自身抗体浓度均低于临界值。我们的研究结果表明,抗MCV以及抗CCP抗体可能有助于JIA的诊断,尤其是在疾病早期。抗MCV抗体可以识别出一组抗CCP抗体和RF阴性的JIA患儿。然而,在JIA中,似乎抗CCP而非抗MCV抗体对放射学改变有影响。

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