Boire G, Ménard H A, Gendron M, Lussier A, Myhal D
Rheumatic Diseases Unit, Faculté de Médecine, Université de Sherbrooke, PQ, Canada.
J Rheumatol. 1993 Oct;20(10):1654-60.
To determine the clinical significance of anti-Ro antibodies in patients with rheumatoid arthritis (RA).
Cross sectional study of 278 consecutive patients with RA at a single academic rheumatology center. Clinical data were collected without knowledge of the anti-Ro status. Anti-Ro antibodies were detected in coded sera using immunoprecipitation of HeLa cell extracts.
Ten (3.6%) of the 278 patient sera were found anti-Ro positive. Age, sex, duration of disease, prevalence of rheumatoid factor (RF), and severity of joint involvement were similar in anti-Ro positive and negative patients. Anti-Ro positive patients had significantly more symptomatic Sjögren's syndrome (SS), leukopenia, hypocomplementemia, vasculitic purpura, and photosensitivity (odds ratio [OR] varying from 7.3 to 26.8). Although SS was frequent in anti-Ro positive patients with RA, secondary SS was not independently linked to any of the associated extraarticular manifestations. Histocompatibility studies revealed the absence of HLA-DR4 in the 8 anti-Ro positive patients available for typing and the presence of DR2 and/or DR3 in 6 of them.
Immunoprecipitating anti-Ro antibodies in serum delineate a clinical, non-HLA-DR4 associated cluster of patients with RA almost as numerous as systemic lupus erythematosus or primary SS. Production of these antibodies seems to precede clinical manifestations and may thus have prognostic implications.
确定类风湿关节炎（RA）患者中抗Ro抗体的临床意义。
在单一学术性风湿病中心对278例连续的RA患者进行横断面研究。在不知道抗Ro状态的情况下收集临床数据。使用HeLa细胞提取物免疫沉淀法检测编码血清中的抗Ro抗体。
278例患者血清中有10例（3.6%）抗Ro阳性。抗Ro阳性和阴性患者在年龄、性别、病程、类风湿因子（RF）患病率及关节受累严重程度方面相似。抗Ro阳性患者有症状的干燥综合征（SS）、白细胞减少、低补体血症、血管炎性紫癜和光敏反应明显更多（比值比[OR]从7.3至26.8不等）。虽然抗Ro阳性的RA患者中SS很常见，但继发性SS与任何相关的关节外表现均无独立关联。组织相容性研究显示，8例可进行分型的抗Ro阳性患者中无HLA - DR4，其中6例存在DR2和/或DR3。
血清中免疫沉淀的抗Ro抗体确定了一组临床的、与HLA - DR4无关的RA患者，其数量几乎与系统性红斑狼疮或原发性SS患者一样多。这些抗体的产生似乎先于临床表现，因此可能具有预后意义。
