Boghdadi Ghada, El-Sokkary Rehab H, Elewa Enass A, Abbas Samah F
Department of Immunology Research Lab, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Egypt J Immunol. 2015 Jun;22(2):31-39.
Rheumatoid arthritis (RA) is a chronic autoimmune disease with joint inflammation and autoantibody production. Cytokines play an important role in the pathogenesis of RA. Among the cytokines that regulate B cell homeostasis is the "A Proliferation-Inducing Ligand" (APRIL). To determine the differences in APRIL in response to treatment in anti- cyclic citrllinated peptides (anti-CCP) positive versus anti-CCP negative patients with established RA. Concentrations of APRIL in sera of 10 anti-CCP positive RA patients, 18 anti-CCP negative RA patients, and 12 healthy controls were measured by enzyme-linked immunosorbent assay (ELISA) at treatment initiation and after 6 months of treatment with methotrexate and hydroxychloroquine. Correlations between serum anti-CCP, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), 28-joint Disease Activity Score (DAS28), and serum level of APRIL were analyzed. Serum APRIL levels were increased in rheumatoid arthritis patients in comparison with healthy volunteers. APRIL correlated positively with disease activity; swollen joint count, visual analog score and simplified disease activity index (all P < 0.05). In addition, APRIL was significantly higher in patients with positive anti-CCP. After treatment, APRIL levels significantly decreased in the anti-CCP positive RA patients than in anti-CCP negative RA patients. In conclusions, serum APRIL may be a good predictor marker for joint injury and therapeutic response in patients with RA.
类风湿关节炎（RA）是一种伴有关节炎症和自身抗体产生的慢性自身免疫性疾病。细胞因子在RA的发病机制中起重要作用。在调节B细胞稳态的细胞因子中，有“增殖诱导配体”（APRIL）。为了确定已确诊的RA患者中，抗环瓜氨酸肽（抗CCP）阳性与抗CCP阴性患者在治疗反应方面APRIL的差异。采用酶联免疫吸附测定（ELISA）法，在治疗开始时以及使用甲氨蝶呤和羟氯喹治疗6个月后，测量了10例抗CCP阳性RA患者、18例抗CCP阴性RA患者和12名健康对照者血清中APRIL的浓度。分析了血清抗CCP、C反应蛋白（CRP）、红细胞沉降率（ESR）、28关节疾病活动评分（DAS28）与血清APRIL水平之间的相关性。与健康志愿者相比，类风湿关节炎患者血清APRIL水平升高。APRIL与疾病活动呈正相关；关节肿胀计数、视觉模拟评分和简化疾病活动指数（均P<0.05）。此外，抗CCP阳性患者的APRIL显著更高。治疗后，抗CCP阳性RA患者的APRIL水平比抗CCP阴性RA患者显著降低。总之，血清APRIL可能是RA患者关节损伤和治疗反应的良好预测指标。
