Suenaga Y, Yasuda M, Yamamoto M, Nonaka S, Wada T, Shiokawa S, Nobunaga M
Department of Clinical Immunology, Medical Institute of Bioregulation, Kyushu University, Oita, Japan.
Clin Rheumatol. 1998;17(4):311-7. doi: 10.1007/BF01451012.
The value of measuring soluble interleukin-2 receptor (sIL-2R) in the sera of patients with joint pain as a predicting parameter for the future development of rheumatoid arthritis (RA) was examined. sIL-2R was measured by the ELISA method. Sixty-four patients with joint pain (suspected RA: sus-RA) but no bone or joint destruction were enrolled over 2 years and 47 were selected for the study. Eleven patients whose diagnosis was sus-RA after a year of observation were successively followed-up for 5 years. Two-thirds of the patients whose sIL-2R levels were higher than those of normal healthy adults (< 82 pmol/l; mean +2SD) developed RA within a year. On the other hand, one-quarter of the patients with normal levels of sIL-2R also developed RA within a year. The presence of two or three of the following three items in patients with joint pain without any bone and joint destruction was thus indicated to be useful for the early diagnosis of RA: elevated CRP level (> or = 1.0 mg/dl), positive rheumatoid factor (RF) (> or = 30 IU/ml) and an elevated sIL-2R level (> or = 100 pmol/l). Sensitivity and specificity were 72.7% and 96.0%, respectively. The probability of development of RA is expressed as P = 1/[1 + exp(2.673 - 0.01784 x sIL-2R - 0.4398 x CRP - 0.004835 x RF)], with R2 = 0.3083 and p<0.0005. On the other hand, the sIL-2R levels did not correlate with any future bone or joint changes within a year of observation. The above criteria may therefore hopefully justify the early treatment of patients with joint pain using drugs that can modify the patients' immune function. However, the validity of these criteria still need to be examined more thoroughly in the future.
研究了检测关节疼痛患者血清中可溶性白细胞介素 - 2受体（sIL - 2R）作为类风湿关节炎（RA）未来发展预测指标的价值。采用酶联免疫吸附测定（ELISA）法检测sIL - 2R。在两年内纳入了64例有关节疼痛（疑似RA：sus - RA）但无骨或关节破坏的患者，其中47例被选入研究。对11例经过一年观察诊断为sus - RA的患者连续随访5年。sIL - 2R水平高于正常健康成年人（<82 pmol/l；均值 +2SD）的患者中有三分之二在一年内发展为RA。另一方面，sIL - 2R水平正常的患者中也有四分之一在一年内发展为RA。因此，对于无任何骨和关节破坏的关节疼痛患者，以下三项中的两项或三项存在被表明对RA的早期诊断有用：C反应蛋白（CRP）水平升高（≥1.0 mg/dl）、类风湿因子（RF）阳性（≥30 IU/ml）和sIL - 2R水平升高（≥100 pmol/l）。敏感性和特异性分别为72.7%和96.0%。RA发展的概率表示为P = 1/[1 + exp(2.673 - 0.01784×sIL - 2R - 0.4398×CRP - 0.004835×RF)]，R2 = 0.3083，p<0.0005。另一方面，在观察的一年内，sIL - 2R水平与未来任何骨或关节变化均无相关性。因此，上述标准有望为使用可调节患者免疫功能的药物对关节疼痛患者进行早期治疗提供依据。然而，这些标准的有效性仍需在未来进行更全面的研究。
