Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan.
Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan.
Arthritis Res Ther. 2020 Nov 12;22(1):268. doi: 10.1186/s13075-020-02366-x.
The positivity of anti-citrullinated protein/peptide antibodies (ACPAs) is a clinically useful diagnostic and prognostic marker in rheumatoid arthritis (RA). However, the significance of ACPA titer and its fluctuation remain unclear. This study aimed to assess the role of ACPA titer and its fluctuation on disease activity and the prognosis of RA.
Data obtained from the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort was analyzed. Patients whose ACPA was measured at least twice between 2011 and 2019 and whose ACPA was positive at least once were included in this study. The association between the clinical variable and ACPA titer or its change was investigated.
ACPA titer was measured in a total of 3286 patients, 1806 of whom were ACPA-positive at least once. Among them, the ACPA titer level was measured more than once in 1355 patients. Very weak correlation was observed between the ACPA titer level and disease activity. Additionally, there was no trend in the fluctuation of ACPA titer level in each patient; ACPA titer level fluctuated in some patients, but not in others. Patients with high variable levels of ACPA titer were more likely to relapse from remission. In the analysis of two consecutive ACPA measurements, the titer changes predicted the relapse from remission within a year of the second measurement.
The ACPA titer level fluctuated in some patients. Very weak correlation was observed between the ACPA titer level and disease activity. Fluctuation in ACPA titer level predicted relapse from remission in patients with RA.
抗瓜氨酸化蛋白/肽抗体（ACPAs）的阳性是类风湿关节炎（RA）中具有临床应用价值的诊断和预后标志物。然而，ACPAs 滴度及其波动的意义尚不清楚。本研究旨在评估 ACPA 滴度及其波动对 RA 疾病活动和预后的作用。
对京都大学类风湿关节炎管理联盟（KURAMA）队列的数据进行分析。纳入至少在 2011 年至 2019 年期间两次检测 ACPA 且至少一次 ACPA 阳性的患者。研究调查了临床变量与 ACPA 滴度或其变化的相关性。
共检测了 3286 例患者的 ACPA，其中 1806 例至少一次 ACPA 阳性。在这 1355 例至少两次检测 ACPA 的患者中，有非常微弱的相关性。此外，每个患者的 ACPA 滴度水平波动没有趋势；一些患者的 ACPA 滴度水平波动，而另一些患者的滴度水平则没有波动。ACPA 滴度水平变化较大的患者更有可能从缓解中复发。在对两次连续 ACPA 检测的分析中，滴度变化预测了第二次检测后一年内的缓解复发。
一些患者的 ACPA 滴度水平波动。ACPAs 滴度水平与疾病活动之间的相关性非常微弱。ACPA 滴度水平的波动可预测 RA 患者的缓解复发。
