Quismorio F P, Kaufman R L, Beardmore T, Mongan E S
Arthritis Rheum. 1983 Apr;26(4):494-9. doi: 10.1002/art.1780260407.
Serum antibodies reactive with the keratin layer of rat esophagus (AKA) were found in 46 of 80 (57.5%) rheumatoid arthritis (RA) patients. In contrast, AKA were present in only 7 of 82 (9.5%) patients with other types of rheumatic disorders and in 2 of 47 (4.2%) healthy subjects. AKA were not specific for RA, however, because in the former group, AKA were present in 4 of 20 (20%) systemic sclerosis patients and in 3 of 12 (25%) ankylosing spondylitis patients. AKA belong predominantly to the IgG class and are complement fixing. Although found in some RA joint fluids, AKA were not selectively concentrated in the joint fluid. Absorption of RA serum with type I human collagen or with human epidermal keratin did not remove AKA activity. The frequency of AKA in RA patients both negative and positive for DR4 was equal. There was no relationship between the frequency of AKA and the occurrence of other serum autoantibodies such as antibodies to intermediate filaments, smooth muscle, and nuclear antigens. Serum antibody reactive with human stratum corneum found in patients with psoriatic arthritis was shown to be different from AKA. Rabbit antiserum to human keratin did not inhibit the reaction of AKA against the keratin layer of rat esophagus. Autoimmunity to structural proteins including collagen, vimentin intermediate filaments, smooth muscle antigens, and keratin is a characteristic feature of RA.
在80例类风湿关节炎（RA）患者中，有46例（57.5%）检测到与大鼠食管角质层反应的血清抗体（AKA）。相比之下，在82例其他类型风湿性疾病患者中，只有7例（9.5%）存在AKA，在47例健康受试者中，有2例（4.2%）存在AKA。然而，AKA并非RA所特有，因为在前一组中，20例系统性硬化症患者中有4例（20%）存在AKA，12例强直性脊柱炎患者中有3例（25%）存在AKA。AKA主要属于IgG类，且具有补体结合能力。虽然在一些RA关节液中发现了AKA，但它并非选择性地在关节液中浓缩。用I型人胶原蛋白或人表皮角蛋白吸收RA血清并不能消除AKA活性。DR4阴性和阳性的RA患者中AKA的出现频率相同。AKA的出现频率与其他血清自身抗体（如抗中间丝、平滑肌和核抗原的抗体）的出现之间没有关系。银屑病关节炎患者中发现的与人类角质层反应的血清抗体被证明与AKA不同。兔抗人角蛋白抗血清不能抑制AKA与大鼠食管角质层的反应。对包括胶原蛋白、波形蛋白中间丝、平滑肌抗原和角蛋白在内的结构蛋白的自身免疫是RA的一个特征。
