Rheumatology Service and Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Department of Immunohematology and Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands.
Mod Rheumatol. 2022 Feb 28;32(2):330-337. doi: 10.1080/14397595.2021.1913277.
We aimed to determine the prevalence of anti-carbamylated protein (anti-CarP) antibodies in Mexican Hispanics with established rheumatoid arthritis (RA) and to assess their relationship with disease activity.
A cohort study was conducted in 278 patients with established RA during an 18-month follow-up. We measured IgG/IgM/IgA rheumatoid factor (RF), IgG anticitrullinated protein antibodies (ACPA) and IgG/IgM/IgA anti-CarP antibodies using enzyme-linked immunosorbent assay (ELISA). For disease activity, we performed the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR). Repeated measures one-way ANOVA was used to test the association between anti-CarP IgG antibody status and longitudinal DAS28-ESR scores. Patients were evaluated at baseline and at 6, 12, and 18 months during follow-up.
Anti-CarP IgG antibodies were positive in 47.8% of patients and, accounting for all isotypes, in 9.5% of patients with negative RF and ACPA. Triple antibody positivity was present in 42.6% of patients in our sample. Anti-CarP IgG antibody positivity did not show statistically significant differences in mean DAS28-ESR when compared to anti-CarP IgG antibody negative patients at baseline, 6, 12 or 18 months.
Anti-CarP IgG antibodies are not associated to a higher disease activity in Hispanic patients with established RA. Our findings suggest that the clinical value of measuring anti-CarP antibodies in RA diminishes over time.
我们旨在确定已确诊类风湿关节炎（RA）的墨西哥裔西班牙人群中抗氨甲酰化蛋白（anti-CarP）抗体的流行率，并评估其与疾病活动度的关系。
在 18 个月的随访期间，对 278 例已确诊的 RA 患者进行了队列研究。我们使用酶联免疫吸附试验（ELISA）测量 IgG/IgM/IgA 类风湿因子（RF）、IgG 抗瓜氨酸蛋白抗体（ACPA）和 IgG/IgM/IgA 抗 CarP 抗体。对于疾病活动度，我们使用红细胞沉降率（ESR）进行 28 关节疾病活动评分（DAS28-ESR）。重复测量的单向方差分析用于检验抗 CarP IgG 抗体状态与纵向 DAS28-ESR 评分之间的关联。患者在基线和随访期间的 6、12 和 18 个月进行评估。
抗 CarP IgG 抗体阳性患者占 47.8%，在 RF 和 ACPA 阴性的患者中，所有同种型的抗 CarP IgG 抗体阳性患者占 9.5%。在我们的样本中，42.6%的患者存在三联抗体阳性。与抗 CarP IgG 抗体阴性患者相比，基线、6、12 或 18 个月时，抗 CarP IgG 抗体阳性患者的平均 DAS28-ESR 无统计学差异。
在已确诊 RA 的墨西哥裔西班牙人群中，抗 CarP IgG 抗体与更高的疾病活动度无关。我们的研究结果表明，在 RA 中测量抗 CarP 抗体的临床价值随时间而降低。
