抗-CCP抗体在类风湿性关节炎中的临床意义  

Clinical significance of anti-CCP antibodies in rheumatoid arthritis

作　　者：黄梅[1] 贾丽[1] 李晓军[1] 

机构地区：[1]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《医学研究生学报》2008年第3期289-292,297,共5页Journal of Medical Postgraduates

基　　金：中国博士后科学基金资助项目(批准号:20060400940);江苏省博士后科学基金资助项目(批准号:0602008C)

摘　　要：近年来,在类风湿性关节炎(RA)患者中发现了多种新的自身抗体,特别是针对自身抗原瓜氨酸肽如聚丝蛋白和它的环状形式即环瓜氨酸肽(CCP)的自身抗体,因其在RA诊断中具有高度敏感性和特异性而尤受关注。大量研究表明,抗-CCP抗体可作为RA早期诊断及预后评估的有效血清学标记。联合检查抗-CCP抗体以及类风湿因子(RF)和抗-Sa抗体,对于疾病的诊断具有很高的特异性。抗瓜氨酸蛋白抗体产生于RA患者的关节局部,关节滑膜内的瓜氨酸肽可能是导致RA患者产生自身抗体的诱因。遗传因素如肽基精氨酸脱亚氨基酶基因PAD I的多态性,可能与自身耐受失衡并诱导针对瓜氨酸肽的自身免疫反应有关。A lot of novel autoantibodies have been described recently in patients with rheumatoid arthritis （ RA）, particularly those against citrullinated proteins such as filaggrin and its circular form cyclic citrullinated peptide （CCP）, which are especially noteworthy for their high specificity. Many studies indicate that anti-CCP antibodies may serve as powerful serologic markers for the early diagnosis of RA and prognostic prediction of joint destruction. Joint detection of anti-CCP antibodies, rheumatoid factors and anti-Sa antibodies may be highly specific for the diagnosis of RA. Anti-citrullinated protein antibodies are locally produced in the joints of RA patients and the citrullinated peptide in the RA synovial tissues may induce the production of autoantibodies. Genetic factors such as gene polymorphism of the citrullinating enzyme and PADI might be associated with the breakage of self-tolerance and induction of autoimmunity against proteins.

关 键 词：瓜氨酸肽 聚丝蛋白 类风湿性关节炎 自身抗体 

分 类 号：R593.22[医药卫生—内科学]