Chen C T, Zhang X P, Yang L J, Ma J D, Xu Y H, Yang K M, Li H G, Zheng D H, Dai L
Department of Rheumatology and Immunology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Zhonghua Nei Ke Za Zhi. 2021 Feb 1;60(2):128-133. doi: 10.3760/cma.j.cn112138-20200318-00261.
To investigate the value of baseline anti-mutated citrullinated vimentin (MCV) antibody for predicting one-year radiographic progression in patients with rheumatoid arthritis (RA). Consecutive RA patients were recruited from November 2014 to July 2018 at Department of Rheumatology, Sun Yat-sen Memorial Hospital, Clinical data were collected including disease activity score in 28 joints with four variables including C-reactive protein (CRP).Serum anti-MCV antibody at baseline was detected by enzyme-linked immunosorbent assay. X ray assessment of both hands/wrists was performed and assessed according to the Sharp/van der Heijde modified score (mTSS) at baseline and the 12th month. Univariate and multivariate logistic regression analyses were used to identify the risk factors for one-year radiographic progression. Among 220 RA patients recruited, the positive rate of anti-MCV antibody at baseline was 77.7%. Compared with those with negative anti-MCV antibody, RA patients with positive anti-MCV antibody had higher disease activity score in 28 joints with four variables induding CRP [3.8 (2.4, 5.0) vs. 3.1 (2.1, 4.0), =0.007], more physical dysfunction (21.6% vs. 8.2%, =0.033) and higher radiographic indicators including mTSS [11 (2, 27) vs. 4 (1, 10), =0.003], joint space narrowing [JSN, 4 (0, 14) vs. 2 (0, 6), =0.024] and joint erosion[JE, 5 (1, 18)vs. 3 (0, 5), =0.003]. After one-year follow-up, sixty-six RA patients (30.0%) developed radiographic progression, the percentage of whom was significantly higher in positive anti-MCV group than that in negative anti-MCV group (33.9% vs.16.3%, =0.018). Multivariate logistic regression analysis suggested that positive anti-MCV antibody at baseline was an independent risk factor for one-year radiographic progression (=2.341, 95% 1.002-5.469). Positive anti-MCV antibody at baseline predicts one-year radiographic progression in RA patients. In the future, anti-MCV antibody can be used not only as a supplementary laboratory marker, but also in disease activity assessment and prognosis prediction for RA.
探讨基线抗瓜氨酸化波形蛋白（MCV）抗体对预测类风湿关节炎（RA）患者一年影像学进展的价值。2014年11月至2018年7月，在中山大学孙逸仙纪念医院风湿科招募连续的RA患者，收集临床资料，包括28个关节疾病活动评分及包括C反应蛋白（CRP）在内的4项变量。采用酶联免疫吸附测定法检测基线血清抗MCV抗体。对双手/腕关节进行X线评估，并根据基线及第12个月的Sharp/van der Heijde改良评分（mTSS）进行评价。采用单因素和多因素logistic回归分析确定一年影像学进展的危险因素。在招募的220例RA患者中，基线抗MCV抗体阳性率为77.7%。与抗MCV抗体阴性患者相比，抗MCV抗体阳性的RA患者在包括CRP在内的4项变量的28个关节疾病活动评分更高[3.8（2.4，5.0）对3.1（2.1，4.0），P=0.007]，身体功能障碍更多（21.6%对8.2%，P=0.033），影像学指标更高，包括mTSS[11（2，27）对4（1，10），P=0.003]、关节间隙狭窄[JSN，4（0，14）对2（0，6），P=0.024]和关节侵蚀[JE，5（1，18）对3（0，5），P=0.003]。随访一年后，66例RA患者（30.0%）出现影像学进展，抗MCV抗体阳性组患者的比例显著高于抗MCV抗体阴性组（33.9%对16.3%，P=0.018）。多因素logistic回归分析表明，基线抗MCV抗体阳性是一年影像学进展的独立危险因素（P=2.341，95%CI 1.002 - 5.469）。基线抗MCV抗体阳性可预测RA患者一年影像学进展。未来，抗MCV抗体不仅可作为补充实验室标志物，还可用于RA的疾病活动评估和预后预测。
