Department of Rheumatology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Department of Biomolecular Chemistry, Radboud Institute for Molecular Life Sciences and Institute for Molecules and Materials, Radboud University, Nijmegen, the Netherlands
J Clin Rheumatol. 2018 Apr;24(3):122-126. doi: 10.1097/RHU.0000000000000619.
The aim of this study was to evaluate the presence of autoantibodies to cyclic citrullinated synthetic peptides (ACPAs) in the sputum of patients with long-standing rheumatoid arthritis (RA).
Nineteen consecutive RA patients and 16 age- and sex-matched control subjects participated in this cross-sectional study. All underwent complete lung function tests and provided induced sputum. Antibodies to citrullinated (CitP) and the corresponding norleucine-containing (NorP) peptides in the sputum of the RA patients and control subjects, as well as in the serum of the RA patients, were determined by enzyme-linked immunosorbent assay.
Patients with RA had the following characteristics: mean disease duration of 12 years, Disease Activity Score for 28 joints of 3.44, and Sharp-van der Heijde score of 57.5. Ten of the 19 RA patients showed high titers of ACPAs in their sera. Four of the seropositive (40%), none of the seronegative RA patients, and only 1 of the control subjects showed detectable levels of ACPAs in their sputum. The ratio between the reactivity with CitP and NorP peptides in the sputum was significantly higher in RA sputum than in control sputum (1.33 ± 1.2 vs. 0.64 ± 0.14, P = 0.02). A positive correlation was found between sputum ACPAs and age, serum ACPAs, sputum anti-NorP, serum anti-CitP/NorP reactivity ratio, and the proportion of neutrophils and lymphocytes in the sputum. No significant correlation was found between sputum ACPAs and disease severity, history of smoking, lung function tests, or treatment for RA.
Anticitrullinated protein/peptide antibodies can be detected in the sputum of RA patients and are correlated with the presence in the serum.
本研究旨在评估长期类风湿关节炎（RA）患者痰液中是否存在针对环瓜氨酸合成肽（ACPAs）的自身抗体。
本横断面研究纳入了 19 例连续 RA 患者和 16 例年龄和性别匹配的对照者。所有患者均接受了全面的肺功能检查，并提供了诱导痰。通过酶联免疫吸附试验检测 RA 患者和对照者痰液中瓜氨酸（CitP）和相应的正亮氨酸（NorP）肽抗体以及 RA 患者血清中的抗体。
RA 患者的特征如下：平均病程 12 年，28 关节疾病活动评分（DAS28）为 3.44，Sharp-van der Heijde 评分（SHS）为 57.5。19 例 RA 患者中有 10 例血清 ACPA 滴度较高。4 例（40%）血清阳性的 RA 患者、无一例血清阴性的 RA 患者以及仅 1 例对照者的痰液中可检测到 ACPA。RA 患者痰液中 CitP 与 NorP 肽的反应比值明显高于对照者痰液（1.33±1.2 比 0.64±0.14，P=0.02）。痰液 ACPA 与年龄、血清 ACPA、痰液抗 NorP、血清抗 CitP/NorP 反应比值以及痰液中性粒细胞和淋巴细胞比例呈正相关。痰液 ACPA 与疾病严重程度、吸烟史、肺功能检查或 RA 治疗无显著相关性。
抗瓜氨酸蛋白/肽抗体可在 RA 患者的痰液中检测到，并与血清中的抗体相关。
