抗瓜氨酸化蛋白抗体特异性免疫复合物在类风湿关节炎中的作用  

Pathogenic role of anti-citrullinated protein antibody specific immune complexes and its pathogenesis in rheumatoid arthritis

作　　者：高德玉[1] 李晓军[1] 武建国[1] 

机构地区：[1]南京军区南京总医院全军临床检验医学研究所,南京医学硕士210002

出　　处：《医学研究生学报》2013年第2期202-205,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81071419)

摘　　要：类风湿关节炎(rheumatoid arthritis,RA)是一种以关节组织内炎症损害为主要病理变化的自身免疫性疾病。蛋白质抗原或多肽的瓜氨酸化是一种蛋白质翻译后修饰过程,并且与RA的发病过程及抗瓜氨酸蛋白抗体(anti-citrullinated pro-tein antibodies,ACPA)产生有关。在RA患者血液及关节滑膜液、血清和软骨细胞表层可发现大量免疫复合物(immune com-plex,IC)存在。IC可激活RA患者体内补体系统并促进细胞因子等炎性介质的释放,引起关节骨和软骨组织发生损伤,进而引起不可逆的关节畸变等功能损害。IC中抗原成分的鉴定对于深入了解RA的发病机制非常重要。含有抗瓜氨酸化蛋白的IC的沉积及作用可以诱发细胞因子的产生,进而引起持续性慢性炎症。RA患者滑膜液及血清中ACPA及其特异性IC显著高于正常人,提示ACPA特异性IC可能作为一种单独或者联合指标,在RA临床诊断应用中发挥一定作用。Rheumatoid arthritis （RA） is a common chronic immuine disease characterized by autoimmune inflammatory reac- tion in joints. Citrullination of peptide in synovial tissue is the post-translational conversion of arginine to citrulline, and involved in the generation of anti-citrullinated protein antibodies （ACPA） and pathogenesis of RA. High amounts of Immune complex are usually found in RA synovial fluids （SF） and on the surface of chondrocytes. IC in the sera and SF are involved in activation of complement cascade in RA synovial tissue and induction of cytokines secretion,which can cause the irreversible damage of joints. Because of the pathogenic nature of IC in RA, it is important to identify the antigens in these complexes. The interaction of eitrullinated protein deposits with lo- cally produced ACPA results in the formation of immune complexes were able to chronically maintain inflammation. Since anti-citrulli- nated protein antibodies and citrullinated immune complexes are noticeable higher than that in healthy control,it may contribute to the diagnosis and pathogenic evaluation of RA.

关 键 词：免疫复合物 类风湿关节炎 细胞因子 抗瓜氨酸化蛋白抗体 

分 类 号：R593.22[医药卫生—内科学]