rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2011-1458rsp-1290Research ArticleСтатьиArticlesРЕВМАТОИДНЫЙ ФАКТОР И АНТИТЕЛА К ЦИКЛИЧЕСКОМУ ЦИТРУЛЛИНИРОВАННОМУ ПЕПТИДУ У БОЛЬНЫХ С ПСОРИАТИЧЕСКИМ АРТРИТОМRHEUMATOID FACTOR AND ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES IN PATIENTS WITH PSORIATIC ARTHRITISБадокинВ. В.BadokinV. V.ТрошкинаИ. А.TroshkinaI. A.АлександроваЕ. Н.AlexandrovaE. N.troshkina-irina@yandex.ru201115062011495№5 (2011)3237Copyright © Бадокин В.В., Трошкина И.А., Александрова Е.Н., 20112011Бадокин В.В., Трошкина И.А., Александрова Е.Н.Badokin V.V., Troshkina I.A., Alexandrova E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1290

Цель – определить клиническое значение ревматоидного фактора (РФ) и антител к циклическому цитруллинированному пеп- тиду (АЦЦП) у больных ранним псориатическим артритом (ПсА). Материал и методы. Изучено 56 больных (32 женщины и 24 мужчины) ранним ПсА со средней длительностью заболевания 12±6,7 мес. Возраст обследованных колебался от 18 до 76 лет (средний возраст 44±15,5 года). Длительность псориаза состав- ляла в среднем 12,5±2,2 года. IgM РФ определяли высокочувствительным нефелометрическим методом на анализаторе BN Pro-Spec (Siemens, Германия), а сывороточную концентрацию АЦЦП – иммунохемилюминесцентным методом на анализа- торе COBAS e411 (Roche, Швейцария). В 1-ю (основную) группу вошло 10 больных, у которых были выявлены АЦЦП и/или РФ, и во 2-ю (группу сравнения) – 46 больных без АЦЦП и РФ.Результаты. АЦЦП выявлены у 7 (12,5%) больных ранним ПсА, РФ – у 8 (14,3%), сочетание РФ и АЦЦП – у 5 (9%) из этих больных. Основная группа больных отличалась более тяжелым течением ПсА, которое сопровождалось полиартритом, воспа- лением дистальных межфаланговых суставов, осевым артритом, дактилитом, энтезитом, а в некоторых случаях – спондили- том и сакроилиитом. Число болезненных суставов (ЧБС) в 1-й и 2-й группах составляло 17,6±4 и 10±1,5 (р=0,04), число при- пухших суставов (ЧПС) – 12,6±1,5 и 7,0±1,1 (р=0,02), индекс DAS 28 – 5,9±1,7 и 4,5±1,5 (р=0,02), СОЭ – 34,5±5,9 и 22±2,3 (р=0,04), содержание С-реактивного белка, определявшегося высокочувствительным методом (вчСРБ), – 70±25,3 и 24,9±5,0 (р=0,06), индекс Шарпа – 68,7±14,3 и 21,3±3,8 (р<0,004) соответственно. Заключение. У больных ранним ПсА примерно с одинаковой частотой были выявлены АЦЦП и РФ, при этом они ассоциирова- лись с полиартритом, высокой воспалительной активностью, а также с эрозивным процессом. 

Objective: to define the clinical value of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP) in early psori- atic arthritis (PA). Subjects and methods. Fifty-six patients (32 females and 24 males) with early PA with a mean duration of 12±6.7 months were studied. The examinees' age ranged from 18 to 76 years (mean age 44±15.5 years). Mean psoriasis duration was 12.5±2.2 years. RF IgM was determined using a high-sensitive nephelometric method on a BN Pro-Spec analyzer (Siemens, Germany) and serum anti-CCP concentra- tions were measured by immunochemiluminescence on a COBAS e411 analyzer (Roche, Switzerland). Group 1 included 10 patients with anti-CCP and/or RF (a study group); Group 2 comprised 46 patients without anti-CCP and RF (a control group). Results. There was anti-CCP in 7 (12.5%) of the patients with early PA, RF in 8 (14.3%), both of them in 5 (9%). The study group had a severer course of PA accompanied by polyarthritis, inflamed distal interphalangeal joints, axial arthritis, dactylitis, enthesitis, and, in some cases spondylitis and sacroiliitis. In groups 1 and 2, the number of tender joints was 17.6±4 and 10±1.5, respectively (p = 0.04); that of swollen ones, 12.6±1.5 and 7.0±1.1 (p = 0.02); DAS28 index, 5.9±1.7 and 4.5±1.5 (p = 0.02); ESR, 34.5±5.9 and 22±2.3 (p = 0.04), high-sensitive C reactive protein, 70±25.3 and 24.9±5.0 (p = 0.06); and Sharp ratio, 68.7±14.3 and 21.3±3.8 (p < 0.004). Conclusion. In patients with early PA, anti-CCP and RF were encountered with an approximately equal frequency; at the same time, they were associated with polyarthritis, high disease activity, and an erosive process. 

псориатический артритантитела к циклическому цитруллинированному пептидуревматоидный факторpsoriatic arthritisanti-cyclic citrullinated peptide antibodiesrheumatoid factorReferences<div><p>Бадокин В.В. Избранные лекции по клинической ревматологии. Под ред. В.А. Насоновой и Н.В. Бунчука. М., 2001;82-90.</p><p>Barth W.F. Psoriatic arthritis sine psoriasis. In: Klippel J.N., Dieppe P., eds. Rheumatology. London: Mosby, 1994;341-3.</p><p>Агабабова Э.Р., Бадокин В.В., Эрдес Ш.Ф. и др. Разработка и апробация диагностических критериев псориатического артрита. Тер арх 1988;12:117-21.</p><p>Taylor W., Gladman D., Helliwell P. et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthr Rheum 2006;54:2665-73</p><p>Mc-onagle D., Conaghan P.G., Emery P. Psoriatic arthritis: a unified concept 20 years on. Arthr Rheum 1999;42:1080-6.</p><p>Swedler W., Wallman J., Froelich C. J. et al. Routine measurement of IgM, IgA rheumatoid factors: high sensitivity, specificity, and predictive value for rheumatoid arthritis. J Rheumatol 1997;24:1037-44</p><p>Shmerling R.H., Delbanco T.L. The rheumatoid factor: an analysis of clinical utility. Am J Med 1991;91:528-34.</p><p>Alenius G.M., Berglin E., Rantapaa Dahlqvist S. Antibodies against cyclic citrullinated peptide (CCP) in psoriatic patients with or without joint inflammation. Ann Rheum Dis 2006;65:398-400.</p><p>Gladman D.D., Shuckett R., Russell M.L. et al. Psoriatic arthritis (PsA) - an analysis of 220 patients. Q J Med 1987;62:127-41</p><p>Schellekens G.A., de Jong B.A., van den Hoogen F.H. et al. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis - specific autoantibodies. J Clin Invest 1998;101:273-81.</p><p>Meyer O., Labarre C., Dougados M. Anti-citrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five years radiographic damage. Ann Rheum Dis 2003;62:120-6.</p><p>Avouac J., Gossec L., Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2006;65:845-51</p><p>Vannini A., Cheung K., Fusconi M. et al. Anti-cyclic citrullinated peptide positivity in non-rheumatoid arthritis disease sampls: citrulline-dependent or not- Ann Rheum Dis 2007;66:511-6.</p><p>Matsui T., Shimada K., Ozawa N. Diagnostic utility of anti-cyclic citrullinated peptide antibodies for very early rheumatoid arthritis. J Rheumatol 2006;33:2390-7.</p><p>Abdel Fattah N.S., Hassan H.E., Galal Z.A., El Okda el S.E. Assessment of anti-cyclic citrullinated peptide in psoriatic arthritis. BMC Res Notes 2009;19:44.</p><p>Cruyssen V.B., Hoffman I.E.A., Zmierczak H. et al. Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. Ann Rheum Dis 2005;64:1145-9.</p><p>Korendowych E., Owen P., Ravindran J. et al. The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis. Rheumatology 2005;44:1056-60.</p><p>Inanc N., Dalkilic E., Kamali S. et al. Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 2007;26:17-23.</p><p>Aletaha D., Neogi T., Silman A.J. et al. The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Phase 2 methodological report. Arthr Rheum 2010;62:2582-91</p><p>Helliwell P.S., Porter G., Taylor W.J. Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis than rheumatoid arthritis. Ann Rheum Dis 2007;66:113-7.</p><p>Van Schaardenburg D., Lagaay A.M., Otten H.G. et al. The relation between classspecific serum rheumatoid factors and age in general population. Br J Rheumatol 1993;32:546-9</p><p>Ursum J., Bos W.H., van de Stadt R.J. et al. Different properties of ACPA and IgMRF derived from a large dataset: further evidence of two distinct autoantibody systems. Arthr Res Ther 2009;11:75.</p><p>Bogliolo L., Alpini C., Caporali R. et al. Antibodies to cyclic citrullinated peptides in psoriatic arthritis. J Rheumatol 2005;32:511-5</p><p>Vencovsky J., Machacek S., Sedova L. et al. Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis. Ann Rheum Dis 2003;62:427-30.</p></div><br /><div><p>Бадокин В.В. Избранные лекции по клинической ревматологии. Под ред. В.А. Насоновой и Н.В. Бунчука. М., 2001;82-90.</p><p>Barth W.F. Psoriatic arthritis sine psoriasis. In: Klippel J.N., Dieppe P., eds. Rheumatology. London: Mosby, 1994;341-3.</p><p>Агабабова Э.Р., Бадокин В.В., Эрдес Ш.Ф. и др. Разработка и апробация диагностических критериев псориатического артрита. Тер арх 1988;12:117-21.</p><p>Taylor W., Gladman D., Helliwell P. et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthr Rheum 2006;54:2665-73</p><p>Mc-onagle D., Conaghan P.G., Emery P. Psoriatic arthritis: a unified concept 20 years on. Arthr Rheum 1999;42:1080-6.</p><p>Swedler W., Wallman J., Froelich C. J. et al. Routine measurement of IgM, IgA rheumatoid factors: high sensitivity, specificity, and predictive value for rheumatoid arthritis. J Rheumatol 1997;24:1037-44</p><p>Shmerling R.H., Delbanco T.L. The rheumatoid factor: an analysis of clinical utility. Am J Med 1991;91:528-34.</p><p>Alenius G.M., Berglin E., Rantapaa Dahlqvist S. Antibodies against cyclic citrullinated peptide (CCP) in psoriatic patients with or without joint inflammation. Ann Rheum Dis 2006;65:398-400.</p><p>Gladman D.D., Shuckett R., Russell M.L. et al. Psoriatic arthritis (PsA) - an analysis of 220 patients. Q J Med 1987;62:127-41</p><p>Schellekens G.A., de Jong B.A., van den Hoogen F.H. et al. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis - specific autoantibodies. J Clin Invest 1998;101:273-81.</p><p>Meyer O., Labarre C., Dougados M. Anti-citrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five years radiographic damage. Ann Rheum Dis 2003;62:120-6.</p><p>Avouac J., Gossec L., Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2006;65:845-51</p><p>Vannini A., Cheung K., Fusconi M. et al. Anti-cyclic citrullinated peptide positivity in non-rheumatoid arthritis disease sampls: citrulline-dependent or not- Ann Rheum Dis 2007;66:511-6.</p><p>Matsui T., Shimada K., Ozawa N. Diagnostic utility of anti-cyclic citrullinated peptide antibodies for very early rheumatoid arthritis. J Rheumatol 2006;33:2390-7.</p><p>Abdel Fattah N.S., Hassan H.E., Galal Z.A., El Okda el S.E. Assessment of anti-cyclic citrullinated peptide in psoriatic arthritis. BMC Res Notes 2009;19:44.</p><p>Cruyssen V.B., Hoffman I.E.A., Zmierczak H. et al. Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. Ann Rheum Dis 2005;64:1145-9.</p><p>Korendowych E., Owen P., Ravindran J. et al. The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis. Rheumatology 2005;44:1056-60.</p><p>Inanc N., Dalkilic E., Kamali S. et al. Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 2007;26:17-23.</p><p>Aletaha D., Neogi T., Silman A.J. et al. The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Phase 2 methodological report. Arthr Rheum 2010;62:2582-91</p><p>Helliwell P.S., Porter G., Taylor W.J. Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis than rheumatoid arthritis. Ann Rheum Dis 2007;66:113-7.</p><p>Van Schaardenburg D., Lagaay A.M., Otten H.G. et al. The relation between classspecific serum rheumatoid factors and age in general population. Br J Rheumatol 1993;32:546-9</p><p>Ursum J., Bos W.H., van de Stadt R.J. et al. Different properties of ACPA and IgMRF derived from a large dataset: further evidence of two distinct autoantibody systems. Arthr Res Ther 2009;11:75.</p><p>Bogliolo L., Alpini C., Caporali R. et al. Antibodies to cyclic citrullinated peptides in psoriatic arthritis. J Rheumatol 2005;32:511-5</p><p>Vencovsky J., Machacek S., Sedova L. et al. Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis. Ann Rheum Dis 2003;62:427-30.</p></div><br />

The authors declare that there are no conflicts of interest present.