纤维肌痛患者亚组中的抗聚合物抗体反应性与疾病严重程度相关。

Antipolymer antibody reactivity in a subset of patients with fibromyalgia correlates with severity.

作者信息

Wilson R B, Gluck O S, Tesser J R, Rice J C, Meyer A, Bridges A J

机构信息

Autoimmune Technologies, L.L.C., New Orleans, Louisiana 70112, USA.

出版信息

J Rheumatol. 1999 Feb;26(2):402-7.

PMID:9972976

Abstract

OBJECTIVE

To determine the prevalence of antipolymer antibodies (APA) in patients with fibromyalgia (FM) and autoimmune disease control groups and to determine if the presence of these antibodies correlates with severity in patients with FM.

METHODS

Sera from patients with FM (n = 47), osteoarthritis (OA) (n = 16), and rheumatoid arthritis (RA) (n = 13) were analyzed. Patients with implants of any kind and patients with concurrent autoimmune conditions were excluded from study. Banked sera from autoimmune disease controls including poly/dermatomyosis (n = 15), RA (n = 30), systemic lupus erythmatosus (SLE) (n = 30), and systemic sclerosis (SSc) (n = 30) were also analyzed. To determine if seroreactivity correlates with severity, banked sera from patients with FM assessed as severe (n = 28) or mild (n = 37) and from controls (n = 21) were assayed.

RESULTS

Following analysis, the prevalence of seroreactivity was found to be higher in patients with FM (22/47, 47%) compared to patients with OA (3/16, 19%; p<0.1) or RA (1/13, 8%; p<0.05) and the autoimmune disease control sera from poly/dermatomyosis (2/15, 13%; p<0.05), and patients with RA (3/30, 10%; p<0.01), SLE (1/30, 3%; p<0.01), and SSc (1/30, 3%; p<0.01). The prevalence of APA seroreactivity was also significantly higher in patients with severe FM (17/28, 61%) compared to patients with mild FM (11/37, 30%; p<0.05) and controls (4/21, 19%; p<0.01). In addition, both mean threshold and mean tolerance dolorimetry scores were significantly lower in the seropositive patients with mild FM (1.33+/-0.21, 1.95+/-0.25, respectively) compared to the seronegative patients (1.83+/-0.08, 2.53+/-0.11; p<0.05 for both comparisons, respectively).

CONCLUSION

These results reveal that an immunological response, production of anti-polymer antibodies, is associated with a subset of patients with FM. The results also suggest that the APA assay may be an objective marker in the diagnosis and assessment of FM and may provide additional avenues of investigation into the pathophysiological processes involved in FM.

摘要

目的

确定纤维肌痛（FM）患者和自身免疫性疾病对照组中抗聚合物抗体（APA）的患病率，并确定这些抗体的存在是否与FM患者的病情严重程度相关。

方法

分析FM患者（n = 47）、骨关节炎（OA）患者（n = 16）和类风湿关节炎（RA）患者（n = 13）的血清。排除有任何类型植入物的患者以及并发自身免疫性疾病的患者。还分析了自身免疫性疾病对照组的储存血清，包括多/皮肌炎（n = 15）、RA（n = 30）、系统性红斑狼疮（SLE）（n = 30）和系统性硬化症（SSc）（n = 30）。为了确定血清反应性是否与病情严重程度相关，对评估为重度（n = 28）或轻度（n = 37）的FM患者以及对照组（n = 21）的储存血清进行了检测。

结果

分析后发现，FM患者的血清反应性患病率（22/47，47%）高于OA患者（3/16，19%；p<0.1）或RA患者（1/13，8%；p<0.05），以及多/皮肌炎自身免疫性疾病对照血清（2/15，13%；p<0.05）、RA患者（3/30，10%；p<0.01）、SLE患者（1/30，3%；p<0.01）和SSc患者（1/30，3%；p<0.01）。重度FM患者的APA血清反应性患病率（17/28，61%）也显著高于轻度FM患者（11/37，30%；p<0.05）和对照组（4/21，19%；p<0.01）。此外，轻度FM血清阳性患者的平均阈值和平均耐痛量评分（分别为1.33±0.21、1.95±0.25）均显著低于血清阴性患者（1.83±0.08、2.53±0.11；两组比较p均<0.05）。