Hakala M, Aman S, Luukkainen R, Risteli L, Kauppi M, Nieminen P, Risteli J
Department of Internal Medicine, University of Oulu, Finland.
Ann Rheum Dis. 1995 Nov;54(11):886-90. doi: 10.1136/ard.54.11.886.
To assess the potential of markers of collagen metabolism to reflect disease processes in rheumatoid arthritis (RA).
Serum (S) and synovial fluid (SF) from 59 patients with RA, and a knee joint effusion and serum from 90 control subjects were studied with radioimmunoassays for the aminoterminal propeptides of type I and type III procollagens (PINP and PIIINP, respectively). The breakdown of type I collagen was quantified with a radioimmunoassay for the cross linked carboxyterminal telopeptide of type I collagen (ICTP).
About 50% of the patients had increased S-ICTP and S-PIIINP values, whereas S-PINP was increased in only 20% of the patients. The mean SF:S ratios of these markers varied between 4 (for ICTP) and 340 (for PIIINP), indicating that markers of collagen metabolism are formed locally and then released into the circulation. SF-PINP and SF-PIIINP correlated with each other (rs = 0.86, p < 0.001) and with SF-ICTP (rs = 0.69, p < 0.001, and rs = 0.65, p < 0.001, respectively). SF-ICTP was clearly related to radiographic findings in the corresponding knee joint, patients with gross bone deformation having the greatest SF-ICTP concentrations. S-ICTP and S-PIIINP also correlated with conventional markers of disease activity, such as C reactive protein and joint swelling score.
Markers of collagen metabolism both in serum and synovial fluid can be measured to provide an assessment of disease process in patients with RA. ICTP and PIIINP are the most informative.
评估胶原蛋白代谢标志物反映类风湿关节炎（RA）疾病进程的潜力。
采用放射免疫分析法，对59例RA患者的血清（S）和滑液（SF），以及90例对照者的膝关节积液和血清进行研究，分别检测I型和III型前胶原氨基端前肽（分别为PINP和PIIINP）。采用放射免疫分析法，通过检测I型胶原交联羧基末端肽（ICTP）对I型胶原的降解进行定量分析。
约50%的患者S-ICTP和S-PIIINP值升高，而只有20%的患者S-PINP升高。这些标志物的平均SF:S比值在4（ICTP）至340（PIIINP）之间变化，表明胶原蛋白代谢标志物在局部形成后释放到循环中。SF-PINP和SF-PIIINP相互相关（rs = 0.86，p < 0.001），并与SF-ICTP相关（分别为rs = 0.69，p < 0.001和rs = 0.65，p < 0.001）。SF-ICTP与相应膝关节的影像学表现明显相关，严重骨变形的患者SF-ICTP浓度最高。S-ICTP和S-PIIINP也与疾病活动的传统标志物相关，如C反应蛋白和关节肿胀评分。
血清和滑液中的胶原蛋白代谢标志物均可用于评估RA患者的疾病进程。ICTP和PIIINP提供的信息最多。
