Department of Clinical Laboratory, Peking University Third Hospital, Beijing 100191, China.
Department of Clinical Laboratory, Peking University Third Hospital, Beijing 100191, China.
Clin Chim Acta. 2020 Mar;502:102-110. doi: 10.1016/j.cca.2019.12.011. Epub 2019 Dec 17.
As we already know, Rheumatoid arthritis (RA) cannot be excluded when the rheumatoid factor (RF) or anti-cyclic citrullinated peptide antibody (anti-CCP) is negative. Here, we determined the application value of 14-3-3η protein, anti-carbamylated proteins antibodies (anti-CarP), as well as their potential role to diagnose RA together with RF or anti-CCP.
Serum levels of anti-CCP, RF, 14-3-3η and anti-CarP antibodies were detected in 291 RA patients, 223 patients with autoimmune diseases except RA, and 156 healthy subjects recruited from Han population of Northern China. We examined the differences in the levels of these indicators among groups and compared the correlations between any two of the indicators. At the same time, a total of 12 testing strategies were established for comparison to maximize the diagnostic value.
The levels of RF, anti-CCP, anti-CarP and 14-3-3η were significantly higher in RA patients (12.5;[9.36-15.7], 30.7;[25.7-35.6], 1.90;[1.70-2.01], 15.8;[10.8-20.8], respectively) compared with either interference-control group (1.24;[1.07-1.41], 0.64;[0.42-0.86], 0.51;[0.46-0.57], 0.33;[0.23-0.44], respectively) (p < 0.0001) or healthy-control group (1.03;[0.99-1.08], 0.49;[0.38-0.59], 0.28;[0.21-0.35], 0.55;[0.27-0.85], respectively) (p < 0.0001). Among all 12 detection strategies, the YI and κ value of a novel strategy that either double-positive of any 2 markers or single-positive of anti-CCP can be diagnosed as RA had the highest diagnostic value.
The results of our study demonstrated that in Han population of Northern China, anti-CarP antibodies and 14-3-3η protein can be treated as valuable indicators of RA, especially when combined with RF and anti-CCP, the detection value is maximized.
众所周知,当类风湿因子(RF)或抗环瓜氨酸肽抗体(抗-CCP)阴性时,不能排除类风湿关节炎(RA)。在这里,我们确定了 14-3-3η 蛋白、抗氨甲酰化蛋白抗体(抗-CarP)的应用价值,以及它们与 RF 或抗-CCP 一起诊断 RA 的潜在作用。
检测了 291 例 RA 患者、223 例除 RA 以外的自身免疫性疾病患者和 156 例来自中国北方汉族的健康对照者血清中抗-CCP、RF、14-3-3η 和抗-CarP 抗体的水平。我们比较了各组之间这些指标的差异,并比较了任意两个指标之间的相关性。同时,建立了总共 12 种检测策略进行比较,以最大限度地提高诊断价值。
与干扰对照组(1.24;[1.07-1.41])或健康对照组(1.03;[0.99-1.08])相比,RA 患者的 RF、抗-CCP、抗-CarP 和 14-3-3η 水平均显著升高(12.5;[9.36-15.7]、30.7;[25.7-35.6]、1.90;[1.70-2.01]、15.8;[10.8-20.8])(p<0.0001)。在所有 12 种检测策略中,新型策略的 YI 和 κ 值最高,该策略要么两种标志物均为阳性,要么抗-CCP 为阳性,可诊断为 RA。
我们的研究结果表明,在中国北方汉族人群中,抗-CarP 抗体和 14-3-3η 蛋白可作为 RA 的有价值指标,尤其是与 RF 和抗-CCP 联合检测时,检测价值最大化。