Institute of Rheumatology, Fondazione Policlinico Universitario A. Gemelli - Catholic University of the Sacred Heart, Rome, Italy.
Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Autoimmun Rev. 2017 Nov;16(11):1096-1102. doi: 10.1016/j.autrev.2017.09.002. Epub 2017 Sep 9.
Rheumatoid Arthritis (RA) is an autoimmune chronic disease that is characterized by the positivity of various antibodies, the most specific being autoantibodies against citrullinated antigens (ACPA). Despite ACPA are not arthritogenic by themselves, ACPA positive individuals have high risk of RA development and ACPA positivity is associated with severe erosive phenotype and higher mortality rate compared to seronegative RA. Moreover, ACPA status is associated with favorable response to biologics targeting pathways involving autoantibody producing cells as B lymphocytes. In the current review we have discussed the pros and cons on the available scientific evidences, regarding the diagnostic, prognostic and management implications of ACPAs in RA.
类风湿关节炎（RA）是一种自身免疫性慢性疾病，其特征是存在多种抗体，最具特异性的是针对瓜氨酸化抗原的自身抗体（ACPA）。尽管 ACPA 本身并非致关节炎性的，但 ACPA 阳性个体患 RA 的风险较高，与血清阴性 RA 相比，ACPA 阳性与严重的侵蚀性表型和更高的死亡率相关。此外，ACPA 状态与针对涉及产生自身抗体的细胞（如 B 淋巴细胞）的生物制剂的有利反应相关。在本综述中，我们讨论了关于 RA 中 ACPA 的诊断、预后和管理意义的现有科学证据的优缺点。
