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类风湿关节炎继发干燥综合征患者血清毒蕈碱型乙酰胆碱受体3亚型(m3AChR)特异性自身抗体水平的研究

The study of serum muscarinic acetylcholine receptor subtype 3 (m3AChR)-Specific autoantibodies level in rheumatoid arthritis patients with secondary sjogren syndrome.

作者信息

Fakher Hagar Elsayed, El Gazzar Nagat Mohammed, Mabrouk Maaly Mohamed, Nada Doaa Waseem

机构信息

Department of Rheumatology, Rehabilitation & Physical Medicine, Faculty of Medicine, Tanta University, El-Gharbia Governorate, Tanta City, Egypt.

Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta City, El- Gharbia Governorate, Egypt.

出版信息

BMC Rheumatol. 2023 Dec 18;7(1):45. doi: 10.1186/s41927-023-00368-1.

Abstract

BACKGROUND

Dry eyes and mouth are symptoms of Sjogren syndrome, which can occur on its own and be referred to as primary Sjogren syndrome or in conjunction with other rheumatic diseases like rheumatoid arthritis and be referred to as secondary Sjogren syndrome. Anti-muscarinic type 3 receptors have been linked to neurological issues as well as secretory dysfunction in Sjogren patients. Consequently, the purpose of this study is to determine the serum level of muscarinic acetylcholine receptor subtype 3 (m3AChR)-specific autoantibodies in rheumatoid arthritis (RA) patients and evaluate its relationship to disease activity, functional disability, and to study its role in the development of secondary Sjogren syndrome manifestations in those patients.

METHODS

In this cross-sectional study, 30 RA patients with secondary Sjogren syndrome signs and 30 RA patients without secondary Sjogren syndrome manifestations were included, along with 30 healthy volunteers who were aged, and sex matched as controls. All participants underwent thorough clinical examination, evaluation of disease activity using the DAS28 score, assessment of functional status using the modified health assessment questionnaire (MHAQ), and evaluation of the serum level of (m3AChR) by (ELISA).

RESULTS

When compared to RA patients without secondary Sjogren syndrome and healthy controls (20.09 ± 4.24, 18.36 ± 3.59 ng/ml respectively), the serum level of m3AChR antibodies among 30 RA patients with secondary Sjogren syndrome considerably increased (mean 25.98 ± 4.81 ng/ml).Analysis of the m3AChR's (ROC)-curve revealed that the three groups under study differed significantly (P < 0.001), with the AUC (0.806), cutoff (> 22.63ng/ml), sensitivity (73.33%), and specificity (86.67%) all exceeding the threshold. Additionally, there was a significant positive connection between the serum level of m3AChR and the following variables (P < 0.05): DAS scores, MHAQ score, number of tender & swollen joints, and acute phase reactants.

CONCLUSION

Autoantibodies against m3AChR may be one of the serum components involved in the pathophysiology of secondary Sjogren syndrome in RA patients, and because of their high sensitivity and specificity, they can be utilized as a diagnostic marker in these individuals.

摘要

背景

干眼和口干是干燥综合征的症状,其可单独出现,称为原发性干燥综合征,或与类风湿关节炎等其他风湿性疾病并发,称为继发性干燥综合征。抗毒蕈碱3型受体与干燥综合征患者的神经问题以及分泌功能障碍有关。因此,本研究的目的是测定类风湿关节炎(RA)患者血清中毒蕈碱型乙酰胆碱受体亚型3(m3AChR)特异性自身抗体水平,并评估其与疾病活动度、功能残疾的关系,以及研究其在这些患者继发性干燥综合征表现发展中的作用。

方法

在这项横断面研究中,纳入了30例有继发性干燥综合征体征的RA患者、30例无继发性干燥综合征表现的RA患者,以及30名年龄和性别匹配的健康志愿者作为对照。所有参与者均接受了全面的临床检查,使用DAS28评分评估疾病活动度,使用改良健康评估问卷(MHAQ)评估功能状态,并通过酶联免疫吸附测定(ELISA)评估血清中(m3AChR)的水平。

结果

与无继发性干燥综合征的RA患者和健康对照(分别为20.09±4.24、18.36±3.59 ng/ml)相比,30例有继发性干燥综合征的RA患者血清中m3AChR抗体水平显著升高(平均25.98±4.81 ng/ml)。对m3AChR的曲线下面积(ROC)分析显示,所研究的三组差异显著(P<0.001),曲线下面积(AUC)为0.806,临界值(>22.63 ng/ml),敏感性(73.33%)和特异性(86.67%)均超过阈值。此外,m3AChR血清水平与以下变量之间存在显著正相关(P<0.05):DAS评分、MHAQ评分、压痛和肿胀关节数以及急性期反应物。

结论

抗m3AChR自身抗体可能是参与RA患者继发性干燥综合征病理生理过程的血清成分之一,因其具有较高的敏感性和特异性,可作为这些个体的诊断标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/428a/10726573/ce6eeef1a12e/41927_2023_368_Figa_HTML.jpg

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