Abstract：【Objective】To explore the value of serum anti-carbamyl protein (anti-CarP) antibody in early diagnosis of rheumatoid arthritis (RA) and prediction of bone damage. 【Methods】A total of 100 patients with RA admitted to our hospital from June 2015 to June 2018 were selected as the observation group whose RA disease activity and bone damage were sub-divided into the active and stable status according to the DAS28 score and X-ray film image. Healthy volunteers in the same period were selected as the control group. Levels of anti-CarP antibody, C-reactive protein (CPR), anti-cyclic citrullinated peptide (CCP), rheumatoid factor (RF) and matrix metalloproteinase 3 (MMP3) plus DAS28 score were measured and compared. The correlations of serum anti-CarP antibody with different serum factors, DAS score and degrees of bone damage were analyzed. 【Results】The expression level and positive rate of serum anti-CarP antibody in the observation group were significantly higher than those in the control group (P<0.05). Levels of serum anti-CarP antibody,CRP, RF, CCP and MMP3 plus DAS28 score in patients with active RA were significantly higher than those in patients with stable RA (P<0.05). The results showed that there were significant differences in serum levels of anti-CarP antibody, CRP, RF, CCP and MMP3 in RA patients with different degrees of bone injury (P<0.05).Of which, values of stage Ⅱ RA patients were significantly higher than those of RA patients in stage Ⅰ and stage 0 (P<0.05); Values of stage I RA patients were significantly higher than those of RA patients in phase 0 (P<0.05). The serum anti-CarP antibody of RA patients showed significant positive correlation with CRP, RF, CCP, MMP3, DAS28 scores and bone injury stages (P<0.05). 【Conclusion】Anti-CarP antibodies are highly expressed in the serum of RA patients, and anti-CarP antibody levels increase with RA activity and bone damage.
吴钢, 谭云芝, 段雨函. 血清抗氨甲酰化蛋白自身抗体对类风湿关节炎诊断及骨质损伤评估的价值[J]. 医学临床研究, 2019, 36(12): 2292-2294.
WU Gang, TAN Yun-zhi, DUAN Yu-han. Evaluation of Serum Anti-CarP Antibody in Early Diagnosis of Rheumatoid Arthritis and Prediction of Bone Damage. JOURNAL OF CLINICAL RESEARCH, 2019, 36(12): 2292-2294.
[1] Smolen JS, Aletaha D, Barton A, et al. Rheumatoid arthritis[J]. Lancet, 2016, 388(10055):2023-2038. [2] 宋健, 于丽, 王文华,等. 类风湿性关节炎患者ACCP抗体联合风湿四项RF、ESR、CRP、ASO检测的临床价值[J]. 中国地方病防治杂志, 2016, 1(1):77-78. [3] Ni S.Follistatin-like protein 1 induction of matrix metalloproteinase 1, 3 and 13 gene expression in rheumatoid arthritis synoviocytes requires MAPK, JAK/STAT3 and NF-κB pathways.[J]. J Cell Physiol, 2018, 234(1):454-463. [4] Ajeganova S, van Steenbergen HW, Verheul MK, et al. The association between anti-carbamylated protein (anti-CarP) antibodies and radiographic progression in early rheumatoid arthritis: a study exploring replication and the added value to ACPA and rheumatoid factor[J]. Ann Rheum Dis, 2016, 76(1):112-118. [5] 史占军, 吕厚山, 许建中,等. 类风湿关节炎的诊断与治疗骨科专家共识[J]. 中国医学前沿杂志(电子版), 2013, 5(3):49-52. [6] 孙建, 王方明, 朱笑夏. 河南漯河地区中老年人群类风湿关节炎危险因素调查[J]. 中华老年医学杂志, 2017, 36(36):96-98. [7] Catrina AI, Joshua V, Klareskog L, et al. Mechanisms involved in triggering rheumatoid arthritis[J]. Immunol Rev, 2016, 269(1):162-174. [8] Hatterer E, Shang L, Simonet P, et al. A specific anti-citrullinated protein antibody profile identifies a group of rheumatoid arthritis patients with a toll-like receptor 4-mediated disease[J]. Arthritis Res Ther, 2016, 18(1):224-226. [9] Koppejan H, Trouw LA, Sokolove J, et al. Role of anti-carbamylated protein antibodies compared to anti-citrullinated protein antibodies in indigenous north americans with rheumatoid arthritis, their first-degree relatives, and healthy controls[J]. Arthritis Rheumatol, 2016, 68(9):2090-2098. [10] Nakabo S, Yoshifuji H, Hashimoto M, et al. Anti-carbamylated protein antibodies are detectable in various connective tissue diseases[J]. J Rheumatol, 2017, 44(9):1384-1386. [11] 陈燚琼, 赵迪, 任方, 等. 抗氨甲酰蛋白抗体与类风湿性关节炎的相关性分析[J]. 检验医学, 2018, 33(1): 26-29. [12] Shi J, Steenbergen HWV, Nies JABV, et al. The specificity of anti-carbamylated protein antibodies for rheumatoid arthritis in a setting of early arthritis[J]. Arthritis Res Ther, 2015, 17(1):339-341. [13] Verheul MK, B hringer S, Van MD, et al. The combination of three autoantibodies, ACPA, RF and anti-CarP antibodies is highly specific for rheumatoid arthritis: implications for very early identification of individuals at risk to develop rheumatoid arthritis[J]. Arthritis Rheumatol, 2018, 70(11):1721-1731. [14] Yee A , Webb T , Seaman A , et al. Erratum to: Anti-CarP antibodies as promising marker to measure joint damage and disease activity in patients with rheumatoid arthritis[J]. Immunol Res, 2015, 61(1-2):24-30.
2019, Vol. 36 
