Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID); Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing.
Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Medicine (Baltimore). 2020 Dec 11;99(50):e23433. doi: 10.1097/MD.0000000000023433.
The European cohort study has indicated about CD74 IgG-autoantibodies as potential marker for axial spondyloarthritis (axSpA) diagnosis. However, multiple studies have questioned the diagnostic value of various disease-specific autoantibodies in different ethnic groups. Here, we have tried to assess the diagnostic value of anti-CD74 IgG and IgA autoantibodies in axSpA patients from Chinese Han population.The anti-CD74 IgG and IgA autoantibodies were analyzed using ELISA assay in a cohort of 97 axSpA patients, including 47 treatment-naïve axSpA patients never treated with steroids or immunosuppressants and 50 treated axSpA patients. The rheumatic disease control (RDC) group consisted of 40 rheumatoid arthritis, 25 systemic lupus erythematosus, 18 psoriatic arthritis patients, and 60 healthy controls (HC).Our data demonstrated the presence of anti-CD74 IgA auto-antibodies in 25.8% of the axSpA patients, 30.1% of the RDC group patients and none in HC. Similarly, anti-CD74 IgG autoantibodies were observed in 23.7% of the axSpA patients, 18.1% of the RDC patients and 18.3% of the HC. The sensitivity, specificity, and accuracy of IgA autoantibodies were 21.3%, 82.5%, & 67.4%, respectively, while for IgG, it was 27.7%, 81.8%, and 68.4%, in treatment-naïve axSpA patients. Furthermore, weak positive relationship between anti-CD74 IgA autoantibodies and bath ankylosing spondylitis disease activity index ( r = 0.253, P = .012) and functional index (bath ankylosing spondylitis functional index; r = 0.257, P = .011) was observed.Overall, our study demonstrated little clinical and predictive value of CD74 autoantibodies in the diagnosis of axSpA and its related manifestations, among Chinese Han population.
欧洲队列研究表明,CD74 IgG 自身抗体可作为轴性脊柱关节炎(axSpA)诊断的潜在标志物。然而,多项研究对不同种族人群中各种疾病特异性自身抗体的诊断价值提出了质疑。在这里,我们试图评估抗 CD74 IgG 和 IgA 自身抗体在汉族 axSpA 患者中的诊断价值。
使用 ELISA 法分析了 97 例 axSpA 患者(包括 47 例从未接受过激素或免疫抑制剂治疗的初治 axSpA 患者和 50 例治疗后的 axSpA 患者)的抗 CD74 IgG 和 IgA 自身抗体。风湿病对照组(RDC)包括 40 例类风湿关节炎、25 例系统性红斑狼疮、18 例银屑病关节炎患者和 60 例健康对照者(HC)。
我们的数据显示,25.8%的 axSpA 患者、30.1%的 RDC 组患者和 HC 中均存在抗 CD74 IgA 自身抗体。同样,23.7%的 axSpA 患者、18.1%的 RDC 患者和 18.3%的 HC 患者存在抗 CD74 IgG 自身抗体。在初治 axSpA 患者中,IgA 自身抗体的灵敏度、特异性和准确性分别为 21.3%、82.5%和 67.4%,而 IgG 自身抗体的灵敏度、特异性和准确性分别为 27.7%、81.8%和 68.4%。此外,抗 CD74 IgA 自身抗体与bath 强直性脊柱炎疾病活动指数(r=0.253,P=0.012)和功能指数(bath 强直性脊柱炎功能指数;r=0.257,P=0.011)之间存在弱正相关关系。
综上所述,本研究表明汉族人群中抗 CD74 自身抗体在 axSpA 及其相关表现的诊断中临床和预测价值有限。