Significance of antibodies of IgG, IgA and IgM subtypes antibodies against cyclic citrullinated peptide in early rheumatoid arthritis
10.3760/cma.j.issn.1007-7480.2013.01.002
- VernacularTitle:IgG IgA和IgM亚型抗环瓜氨酸肽抗体在早期类风湿关节炎中的检测及意义
- Author:
Yingjian ZHANG
;
Jinxia ZHAO
;
Lin SUN
;
Changhong LI
;
Guiye LI
;
Xiangyuan LIU
;
Zhanguo LI
- Publication Type:Journal Article
- Keywords:
Arthritis,rheumatoid;
Immunoglobulin G;
Immunoglobulin A;
Immunoglobulin M;
Anti-cyclic citrullinated peptide
- From:
Chinese Journal of Rheumatology
2013;(1):5-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the prevalence and clinical values of anti-cyclic citrullinated peptide (anti-CCP) antibodies of IgG,IgA and IgM subtypes in individuals with early rheumatoid arthritis (RA).Methods IgG,IgA and IgM subtypes of anti-CCP antibodies were measured in the sera of 87 RA patients with disease duration shorter than 2 years,61 patients with other rheumatic diseases and 49 healthy subjects.We analyzed the diagnostic value of IgG,IgA and IgM subtypes of anti-CCP antibodies and their relationship with disease duration,DAS28,ESR,CRP,and rheumatoid factor (RF).Chi-square test,t test and Spearman's correlation analysis were used for statistical analysis.Results ① The diagnostic sensitivity of IgG,and IgA subtype for early RA was 75.9% and 67.8% respectively,which was higher than IgM subtype (14%,P<0.01 each).The specificity of IgG,IgA and IgM subtype was 96.4%,91.8% and 93.6% respectively.② IgG and IgA subtypes were correlated with CRP (r=0.278,P=0.01; r=0.217,P=0.047) and RF (r=0.430,P=0.000; r=0.271,P=0.012),while IgM subtype was positively correlated with disease duration (r=0.279,P=0.014).③ Patients who had IgG-and IgA subtype had a shorter disease course (3.3±2.3) than those patients who had IgA-and IgG+ (9.5±8.4) and who had IgG+ and IgA+ (8.2±7.0) (P<0.05).④ IgA subtype was positive in 19.0% of the IgG negative patients.When combining IgG,and antibodies of IgA subtypes together,the sensitivity and specificity was 63.2% and 100%,while the sensitivity and specificity was 80.5% and 85.2% when either one was positive.Conclusion Both the IgG,and IgA subtypes of anti-CCP antibodies have a good sensitivity for early RA.They are related to disease activity.Measuring IgA subtype of anti-CCP antibody in RA patients with negative IgG subtype may help to identify early RA.IgA subtype of anti-CCP antibody may play a role in very early RA.