Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea.
Korean J Intern Med. 2019 Mar;34(2):426-433. doi: 10.3904/kjim.2016.276. Epub 2017 Nov 24.
BACKGROUND/AIMS: Fibromyalgia (FM) is a common rheumatologic disease characterized by chronic widespread pain, along with various clinical manifestations including atypical autoimmune characteristics. Despite its high prevalence, there remain no approved laboratory tests to identify specific manifestations of FM, or to rule out FM from other rheumatic diseases. Anti-dense fine speckled 70 (anti-DFS70) antibodies were initially identified as a form of anti-nuclear antibodies in a patient with interstitial cystitis. Anti-DFS70 antibodies are found in ≤ 10% of healthy individuals, but have suggestive negative association with autoimmune diseases; however, the clinical significance of these autoantibodies in FM patients remains poorly understood.
We examined 39 patients with FM, along with 17 patients with systemic lupus erythematosus (SLE), and 19 healthy individuals (HI). Patients were compared based on physical measurements, disease duration, tender point counts, FM Impact Questionnaire (FIQ) scores, visual analog scale (VAS) for pain, somatic symptoms, and anti-DFS70 antibodies.
Levels of anti-DFS70 antibodies were significantly higher in the FM and HI groups than in those with SLE. Both anti-DFS70 antibodies and VAS scores were positively correlated with FM. Within the FM group, patients with arthralgia had higher anti-DFS70 antibody values compared to those without arthralgia (p = 0.024); antibody levels were also higher in patients with sleep disturbances relative to those without sleep issues (p = 0.024). In contrast, there were no correlations between anti-DFS70 antibodies and age, body mass index, disease duration, tender point counts, FIQ, short-form health survey results, or other clinical manifestations.
Anti-DFS70 antibodies may represent a useful biomarker for differentiating between FM and other autoimmune diseases. The levels of anti-DFS70 antibodies were also significantly higher among patients with arthralgia and sleep disturbances. Further investigations are necessary to evaluate the relationships between anti-DFS70 antibodies and other cytokines as a predictive marker for pain.
背景/目的:纤维肌痛(FM)是一种常见的风湿性疾病,其特征为慢性广泛性疼痛,以及各种临床表现,包括非典型自身免疫特征。尽管其患病率较高,但目前尚无经过批准的实验室检测方法可识别 FM 的具体表现,或排除 FM 与其他风湿性疾病的关联。抗致密细斑点 70(anti-DFS70)抗体最初在一名间质性膀胱炎患者中被鉴定为一种核抗体形式。anti-DFS70 抗体在≤10%的健康个体中发现,但与自身免疫性疾病呈负相关提示性关联;然而,这些自身抗体在 FM 患者中的临床意义仍知之甚少。
我们检测了 39 名 FM 患者、17 名系统性红斑狼疮(SLE)患者和 19 名健康个体(HI)。根据体格检查、疾病持续时间、压痛点计数、纤维肌痛影响问卷(FIQ)评分、疼痛视觉模拟量表(VAS)、躯体症状和抗-DFS70 抗体对患者进行比较。
FM 和 HI 组的抗-DFS70 抗体水平明显高于 SLE 组。抗-DFS70 抗体和 VAS 评分均与 FM 呈正相关。在 FM 组中,有关节痛的患者的抗-DFS70 抗体值高于无关节痛的患者(p=0.024);与无睡眠问题的患者相比,有睡眠障碍的患者的抗体水平也更高(p=0.024)。相反,抗-DFS70 抗体与年龄、体重指数、疾病持续时间、压痛点计数、FIQ、简短健康调查结果或其他临床表现之间无相关性。
抗-DFS70 抗体可能是区分 FM 和其他自身免疫性疾病的有用生物标志物。关节痛和睡眠障碍患者的抗-DFS70 抗体水平也明显更高。需要进一步研究以评估抗-DFS70 抗体与其他细胞因子之间的关系,作为疼痛的预测标志物。