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血清蛋白14-3-3η(伊塔)作为类风湿性关节炎新型生物标志物的评估

Evaluation of Serum Protein 14-3-3η (Eta) as a Novel Biomarker for Rheumatoid Arthritis.

作者信息

El-Sherif Wafaa T, Nigm Dalia A, Abd-Elsamea Mona H, Kassem Alaa M

机构信息

Department of Clinical Pathology & Physical Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.

Department of Rheumatology & Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Egypt J Immunol. 2019 Jan;26(1):163-175.

Abstract

Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases. New markers are needed for early diagnosis of RA as seronegativity in both early and established RA remains a major limitation of both anticitrullinated protein antibodies (ACPA) and rheumatoid factor (RF). The 14-3-3η protein may represent a novel biomarker for the detection of RA. We evaluated the diagnostic performance of serum 14-3-3η protein in early and established cases of rheumatoid arthritis and we compared the diagnostic accuracy of it with those of the well-known RA markers (e.g. RF and ACPA). Sera from 50 patients with RA (20 early and 30 established) based on the 2010 ACR / EULAR Rheumatoid Arthritis Classification Criteria, 15 patients with non-RA arthritis as diseases control group (8 patients with OA and 7 patients with SLE) and 14 healthy controls were enrolled in the study. Serum RF was determined by latex, ACPA and 14-3-3η protein were determined by ELISA. Serum 14-3-3η protein levels in patients with RA were significantly higher (P=0.001*) as compared to healthy individuals. For serum 14-3-3η diagnostic accuracy in RA; Receiver operating characteristic curves (ROC) analysis comparing patient with RA with healthy control showed AUC (0.916) at optimum cutoff of > 2.5ng/mL, and a sensitivity of 100%, a specificity of 78.57%, a PPV of 94.3, and an NPV of 100. No significant difference in 14-3-3η protein serum levels was found between early and established RA groups. It was positive in 100% of early and established RA patients who were seronegative for RF and ACPA. It is concluded that, 14-3-3η protein could improve the sensitivity of RA diagnosis and cover the shortage of detection of RF and ACPA in RA patients.

摘要

类风湿关节炎(RA)是最常见的全身性自身免疫性疾病之一。由于早期和确诊的RA患者血清学阴性仍然是抗瓜氨酸化蛋白抗体(ACPA)和类风湿因子(RF)检测的主要局限性,因此需要新的标志物用于RA的早期诊断。14-3-3η蛋白可能是一种用于检测RA的新型生物标志物。我们评估了血清14-3-3η蛋白在早期和确诊类风湿关节炎病例中的诊断性能,并将其诊断准确性与已知的RA标志物(如RF和ACPA)进行了比较。根据2010年美国风湿病学会(ACR)/欧洲抗风湿病联盟(EULAR)类风湿关节炎分类标准,选取50例RA患者(20例早期患者和30例确诊患者)、15例非RA关节炎患者作为疾病对照组(8例骨关节炎患者和7例系统性红斑狼疮患者)以及14例健康对照者纳入本研究。血清RF采用乳胶法检测,ACPA和14-3-3η蛋白采用酶联免疫吸附测定(ELISA)法检测。与健康个体相比,RA患者血清14-3-3η蛋白水平显著升高(P = 0.001*)。对于血清14-3-3η蛋白在RA中的诊断准确性;将RA患者与健康对照者进行比较的受试者工作特征曲线(ROC)分析显示,在最佳临界值>2.5ng/mL时,曲线下面积(AUC)为0.916,灵敏度为100%,特异性为78.57%,阳性预测值(PPV)为94.3,阴性预测值(NPV)为100。早期和确诊RA组之间未发现14-3-3η蛋白血清水平有显著差异。在RF和ACPA血清学阴性的早期和确诊RA患者中,其阳性率为100%。结论是,14-3-3η蛋白可提高RA诊断的灵敏度,并弥补RA患者中RF和ACPA检测的不足。

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