泰国系统性硬化症患者临床和自身抗体谱的相关性

Relevance of clinical and autoantibody profiles in systemic sclerosis among Thais.

作者信息

Foocharoen Chingching, Watcharenwong Piyakarn, Netwijitpan Sittichai, Mahakkanukrauh Ajanee, Suwannaroj Siraphop, Nanagara Ratanvadee

机构信息

Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Int J Rheum Dis. 2017 Oct;20(10):1572-1581. doi: 10.1111/1756-185X.13060. Epub 2017 Mar 10.

DOI:10.1111/1756-185X.13060

PMID:28296274

Abstract

OBJECTIVE

Autoantibody profiles in systemic sclerosis (SSc) and their relative clinical association vary between studies. The rate for being anti-topoisomerase-I (ATA) positive and the association with diffuse cutaneous the SSc subset (dcSSc) is higher among Thais than among Caucasians. The objective was to evaluate the relevance of clinical presentation, namely being positive for one or more autoantibodies among Thai SSc patients.

METHOD

A retrospective, cohort study was performed among SSc patients over 18 years of age at Srinagarind Hospital, Khon Kaen University, Thailand, during January 2006 to December 2013. Autoantibodies comprising 13 SSc-specific antigens were evaluated using the EUROIMMUN AG (Lübeck, Germany) in order to define their clinical association(s).

RESULTS

Two hundred and eighty-five scleroderma patients (200 female; 85 male) were included. The majority (66.7%) were dcSSc subset. ATA was the most common antibody profile in our patients (231 cases; 81.1%), followed by anti-Ro 52 (87 cases; 30.5%). Eleven of our patients (3.9%) were negative for all antibody profiles and 44 cases (15.4%) were negative for ATA and anti-centromere antibody (anti-CENP). Almost 40% (112 cases) were positive for at least two autoantibodies. There was an association between the presence of ATA and hand deformity (odds ratio [OR] 3.94; 95% CI 1.12-13.84), anti-CENP and hand deformity (OR 0.20; 95% CI 0.02-0.90), anti-Ku and scleroderma-polymyositis overlap syndrome (OR 6.58; 95% CI 2.16-19.39) and the absence of both ATA and anti-CENP with female sex (OR 2.90; 95% CI 1.12-7.51), limited cutaneous SSc subset (OR 2.70; 95% CI 1.30-5.55) and scleroderma-polymyositis overlap syndrome (OR 2.53; 95% CI 1.04-6.16). Neither ATA nor anti-CENP were associated with the SSc subset.

CONCLUSIONS

ATA and anti-CENP were not helpful in differentiating the SSc subset in Thai SSc patients, albeit they were good for predicting hand function. Coexisting ATA and anti-CENP negativity were associated with less extensive skin tightness and SSc overlap syndrome.

摘要

目的

系统性硬化症（SSc）患者的自身抗体谱及其相关临床关联在不同研究中存在差异。泰国人中抗拓扑异构酶-I（ATA）阳性率及与弥漫性皮肤型SSc亚组（dcSSc）的关联高于白种人。本研究旨在评估泰国SSc患者中一种或多种自身抗体呈阳性的临床表现的相关性。

方法

对2006年1月至2013年12月期间泰国孔敬大学诗里拉吉医院18岁以上的SSc患者进行一项回顾性队列研究。使用德国吕贝克的EUROIMMUN AG公司的产品评估包含13种SSc特异性抗原的自身抗体，以确定它们的临床关联。

结果

纳入285例硬皮病患者（200例女性；85例男性）。大多数（66.7%）为dcSSc亚组。ATA是我们研究中最常见的抗体谱（231例；81.1%），其次是抗Ro 52（87例；30.5%）。11例患者（3.9%）所有抗体谱均为阴性，44例（15.4%）ATA和抗着丝点抗体（抗CENP）为阴性。近40%（112例）患者至少两种自身抗体呈阳性。ATA的存在与手部畸形相关（比值比[OR] 3.94；95%可信区间1.12 - 13.84），抗CENP与手部畸形相关（OR 0.20；95%可信区间0.02 - 0.90），抗Ku与硬皮病 - 多发性肌炎重叠综合征相关（OR 6.58；95%可信区间2.16 - 19.39），ATA和抗CENP均不存在与女性性别相关（OR 2.90；95%可信区间1.12 - 7.51）、局限性皮肤型SSc亚组相关（OR 2.70；95%可信区间1.30 - 5.55）以及硬皮病 - 多发性肌炎重叠综合征相关（OR 2.53；95%可信区间1.04 - 6.16）。ATA和抗CENP均与SSc亚组无关。