循环瓜氨酸化抗原和抗环单克隆瓜氨酸肽抗体在类风湿关节炎中的致病作用。

Pathogenic Role of Circulating Citrullinated Antigens and Anti-Cyclic Monoclonal Citrullinated Peptide Antibodies in Rheumatoid Arthritis.

机构信息

Clinical Immunology and Stem Cell Laboratory (CiSTEM) Laboratory, Catholic Induced Pluripotent Stem Cell (iPSC) Research Center, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Department of Biomedicine & Health Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

出版信息

Front Immunol. 2021 Jun 30;12:692242. doi: 10.3389/fimmu.2021.692242. eCollection 2021.

Abstract

We examined whether it is possible to directly detect citrullinated antigens in the serum of rheumatoid arthritis (RA) patients using a monoclonal antibody (mAb) designed to be specific for citrullinated peptides. In order to confirm the potential of the mAb as a direct arthritis-inducing substance through experimental model of RA, a monoclonal antibody (mAb) 12G1 was generated using by immunization of mice with a challenging cyclic citrullinated peptide. Immunohistochemical analysis of RA-affected synovial tissue showed that our mAb 12G1 could indeed detect citrullinated proteins in target tissues. Subsequently, serum levels of citrullinated type II collagen and filaggrin were measured in healthy volunteers, patients with RA, ankylosing spondylitis (AS), and systemic lupus erythematosus (SLE) using a 12G1-based sandwich ELISA. This showed that citrullinated filaggrin showed 78.9% sensitivity and 85.9% specificity for RA diagnosis with a cutoff optical density (OD) value of 1.013, comparable with the results from a second-generation anti-citrullinated protein antibody (ACPA) test. Circulating citrullinated collagen and filaggrin were detected even in sera of RA patients who were negative for both rheumatoid factor (RF) and ACPA. ELISA results also showed that RF and ACPA titers showed significantly positive correlation with both citrullinated collagen and filaggrin OD values in sera of RA patients. 12G1 challenging aggravated the severity of murine arthritis. In summary, mAb 12G1 can directly detect citrullinated proteins in RA target tissue and in sera of RA patients and 12G1 showed direct arthritogenic potential . This, 12G1 might be useful for diagnosis of RA including seronegative RA and may help to elucidate the pathophysiological role of citrullination in RA.

摘要

我们研究了使用针对瓜氨酸化肽设计的单克隆抗体 (mAb) 是否可以直接检测类风湿关节炎 (RA) 患者的血清中的瓜氨酸化抗原。为了通过 RA 的实验模型确认 mAb 作为直接致关节炎物质的潜力,我们使用具有挑战性的环状瓜氨酸化肽免疫小鼠生成了单克隆抗体 (mAb) 12G1。对受 RA 影响的滑膜组织的免疫组织化学分析表明,我们的 mAb 12G1 确实可以在靶组织中检测到瓜氨酸化蛋白。随后,我们使用基于 12G1 的夹心 ELISA 测量了健康志愿者、RA 患者、强直性脊柱炎 (AS) 患者和系统性红斑狼疮 (SLE) 患者血清中的瓜氨酸化 II 型胶原和角蛋白丝。结果显示,瓜氨酸化角蛋白丝的 OD 值为 1.013 时,对 RA 的诊断具有 78.9%的敏感性和 85.9%的特异性,与第二代抗瓜氨酸化蛋白抗体 (ACPA) 检测结果相当。甚至在 RF 和 ACPA 均为阴性的 RA 患者血清中也检测到循环瓜氨酸化胶原和角蛋白丝。ELISA 结果还显示,RA 患者血清中 RF 和 ACPA 滴度与瓜氨酸化胶原和角蛋白丝的 OD 值呈显著正相关。12G1 挑战加剧了小鼠关节炎的严重程度。综上所述,mAb 12G1 可以直接检测 RA 靶组织和 RA 患者血清中的瓜氨酸化蛋白,并且 12G1 具有直接致关节炎的潜力。这表明,12G1 可能有助于包括血清阴性 RA 在内的 RA 的诊断,并有助于阐明瓜氨酸化在 RA 中的病理生理作用。

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