摘要
目的：我們假設(shè)慢性痛風(fēng)性關(guān)節(jié)炎患者會產(chǎn)生針對Ⅱ型膠原蛋白 (CII)的免疫反應(yīng)，可以通過發(fā)現(xiàn)血清抗Ⅱ型膠原蛋白抗體加以驗證，該反應(yīng)可能參與非緩解性關(guān)節(jié)炎的進展。
方法：慢性痛風(fēng)性關(guān)節(jié)炎被定義為結(jié)晶形成的痛風(fēng)，該類患者持續(xù)疼痛無間歇期，伴或不伴痛風(fēng)石形成，且沒有其他慢性關(guān)節(jié)炎的臨床表現(xiàn)。本研究將年齡匹配的、有明確發(fā)作間期的急性痛風(fēng)患者設(shè)為對照組，將4例活動期RA患者納為陽性對照組。使用人IgG型抗CⅡ抗體試劑盒通過ELISA方法對患者血清進行抗CⅡ抗體定量檢測。分析抗CⅡ抗體水平與臨床參數(shù)的相關(guān)性。
結(jié)果：15例患者明確診斷為慢性痛風(fēng)性關(guān)節(jié)炎。與對照組相比，慢性痛風(fēng)患者的抗CⅡ水平明顯升高，而對照組痛風(fēng)患者急性發(fā)作期與疾病間歇期抗CⅡ水平無顯著差異。5例慢性痛風(fēng)性關(guān)節(jié)炎患者的抗CⅡ水平高于200 AU/mL，而僅有1例對照組患者有此情況。2例活動期RA患者的抗CⅡ水平200 U/mL.伴有痛風(fēng)石形成的患者的抗CⅡ水平明顯高于無痛風(fēng)石形成者，而射線顯示骨侵蝕的患者抗CⅡ水平往往高于沒有骨侵蝕者。
結(jié)論：慢性痛風(fēng)性關(guān)節(jié)炎患者的抗CⅡ水平顯著高于對照組。這些抗體產(chǎn)生將引起軟骨損傷，可能在延續(xù)炎癥發(fā)揮作用。
原文
Objective: We hypothesized that chronic gouty arthritis patients would develop an immune response to type II collagen that would be revealed by the presence of anti-type II collagen (CII) antibodies in serum, which may in turn be involved in progression to non-remitting arthritis.
Methods: Chronic gouty arthritis was defined as crystal-confirmed gout in patients with no pain-free intercritical period, with or without the presence of tophi, who did not have clinical features of other forms of chronic arthritis. Age-matched gout patients suffering acute gouty attacks who had definite intercritical periods were selected as a control group. Four RA patients who had active disease were enrolled as a positive control group. Anti-CII antibodies were quantified in patient sera via ELISA using a human IgG anti-CII antibody assay kit. Correlations between anti-CII levels and clinical parameters were sought.
Results: Fifteen chronic gouty arthritis patients were identified. The anti-CII level was significantly higher among subjects with chronic gout compared to controls, but did not significantly differ in control gout patients during acute attacks and in the intercritical periods. Five patients with chronic gouty arthritis had anti-CII antibody levels higher than 200 AU/mL, whereas only one control gout patient exhibited this feature. Two of four patients with active RA had anti-CII antibody levels higher than 200 U/mL.Patients with tophi had significantly higher anti-CII levels than those without, whereas patients showing radiographic erosion tended to have higher anti-CII levels than those without.
CONCLUSION:Patients with chronic gouty arthritis had significantly higher levels of anti-CII antibodies than control gout patients. Such antibody production would be triggered by initiation of cartilage damage but may also play a role in perpetuation of inflammation.
引自：Kim, Hyun Ah MD, PhD; Seo, Young-Il MD, PhD; Lee, Jisoo MD, PhD,et al. Detection of Anti-Type II Collagen Antibodies in Patients With Chronic Gouty Arthritis: Findings From a Pilot Study. Journal of Clinical Rheumatology，2016，22（7），p 360–363.
