rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2018-235-238rsp-2530Research ArticleФОРУМ МОЛОДЫХ УЧЕНЫХYOUNG SCIENTISTS FORUMБолезнь Шёгрена, ассоциированная с антицентромерными антителамиPRIMARY SJOGREN'S SYNDROME ASSOCIATED WITH ANTICENTROMERE ANTIBODIESЧальцевБ. Д.ChaltsevB. D.

Богдан Дмитриевич Чальцев – аспирант 1-го года обучения ФГБНУ НИИР им. В.А.Насоновой, научный руководитель – профессор В.И.Васильев.

115522, Москва, Каширское шоссе, 34А

Bogdan Chaltsev.

34A, Kashirskoe Shosse, Moscow 115522

bodya92@inbox.ruФГБНУ Научноисследовательский институт ревматологии им. В.А. НасоновойРоссияV.A.Nasonova Research Institute of RheumatologyRussian Federation201808052018562235238Copyright © Чальцев Б.Д., 20182018Чальцев Б.Д.Chaltsev B.D.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/2530

В клинической практике серопозитивность по антицентромерным антителам (АЦА), как правило, расценивается врачами-ревматологами как признак системной склеродермии (ССД). Однако в литературе описано немало случаев болезни Шёгрена (БШ), ассоциированной с АЦА, которая представляет собой субтип данного заболевания, отличающийся от «классического» по ряду лабораторных и клинических проявлений. По данным литературы, даже при длительном наблюдении лишь у четверти позитивных по АЦА пациентов с достоверной БШ развивается достоверная ССД. Данный факт поднимает вопрос о необходимости включения АЦА в число аутоантител, патогенетически связанных с БШ.

Anti-centromere antibody (ANCA) seropositivity is generally regarded by rheumatologists as a sign of systemic sclerosis (SS) in clinical practice. However, the literature describes many cases of ANCA-associated primary Sjogren's syndrome (PSS) that is the subtype of this disease, which differs from the classic type in a number of laboratory and clinical manifestations. According to the literature, even a long-term follow-up indicates that only one quarter of patients with ANCA-positive PSS develop documented SS. This fact raises the question of whether it is necessary to include ANCA into the list of autoantibodies pathogenetically related to PSS.

болезнь Шёгренасистемная склеродермияантицентромерные антителаprimary Sjogren's syndromesystemic sclerosisanti-centromere antibodiesReferencesMavragani CP, Moutsopoulos HM. Sjögren syndrome. CMAJ. 2014 Oct 21;186(15):E579-E586. doi: 10.1503/cmaj.122037Mavragani CP, Moutsopoulos HM. Sjögren syndrome. CMAJ. 2014 Oct 21;186(15):E579-E586. doi: 10.1503/cmaj.122037Nocturne G, Mariette X. Sjogren syndrome-associated lymphomas: an update on pathogenesis and management. Brit J Haematol. 2015 Feb;168(3):317-27. doi: 10.1111/bjh.13192Nocturne G, Mariette X. Sjogren syndrome-associated lymphomas: an update on pathogenesis and management. Brit J Haematol. 2015 Feb;168(3):317-27. doi: 10.1111/bjh.13192Сафонова ТН, Васильев ВИ, Лихванцева ВГ. Синдром Шегрена. Руководство для врачей. Москва: Издательство МГУ; 2013. 1608 с.Cafonova TN, Vasil'ev VI, Likhvantseva VG. Sindrom Shegrena. Rukovodstvo dlya vrachei [Sjogren's syndrome. A guide for doctors]. Moscow: MSU Publishing House; 2013. 1608 p. (In Russ.).Ramos-Casals M, Nardi N, Brito-Zeron P, et al. Atypical autoantibodies in patients with primary Sjögren syndrome: Clinical characteristics and follow-up of 82 cases. Semin Arthritis Rheum. 2005;35:312-21. doi: 10.1016/j.semarthrit.2005.12.004Ramos-Casals M, Nardi N, Brito-Zeron P, et al. Atypical autoantibodies in patients with primary Sjögren syndrome: Clinical characteristics and follow-up of 82 cases. Semin Arthritis Rheum. 2005;35:312-21. doi: 10.1016/j.semarthrit.2005.12.004Shiboski SC, Shiboski CH, Criswell LA, et al; for the Sjögren's International Collaborative Clinical Alliance (SICCA) Research Groups. American College of Rheumatology Classification Criteria for Sjögren's Syndrome: a data driven, expert consensus approach in the Sjögren's International Collaborative Clinical Alliance Cohort. Arthritis Care Res. 2012;64(4):475-87. doi: 10.1002/acr.21591Shiboski SC, Shiboski CH, Criswell LA, et al; for the Sjögren's International Collaborative Clinical Alliance (SICCA) Research Groups. American College of Rheumatology Classification Criteria for Sjögren's Syndrome: a data driven, expert consensus approach in the Sjögren's International Collaborative Clinical Alliance Cohort. Arthritis Care Res. 2012;64(4):475-87. doi: 10.1002/acr.21591Shiboski CH, Shiboski SC, le Seror R, et al; and the International Sjogren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren's Syndrome. Arthritis Rheum. 2017 Jan;69(1):35-45. doi: 10.1002/art.39859Shiboski CH, Shiboski SC, le Seror R, et al; and the International Sjogren's Syndrome Criteria Working Group. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjogren's Syndrome. Arthritis Rheum. 2017 Jan;69(1):35-45. doi: 10.1002/art.39859Nakamura H, Kawakami A, Hayashi T, et al. Anticentromere antibody-seropositive Sjögren's syndrome differs from conventional subgroup in clinical and pathological study. BMC Musculoskelet Disord. 2010;11:140. doi: 10.1186/1471-2474-11-140Nakamura H, Kawakami A, Hayashi T, et al. Anticentromere antibody-seropositive Sjögren's syndrome differs from conventional subgroup in clinical and pathological study. BMC Musculoskelet Disord. 2010;11:140. doi: 10.1186/1471-2474-11-140Moroi Y, Peebles C, Fritzler MJ, et al. Autoantibody to centromere (kinetochore) in scleroderma sera. Proc Natl Acad Sci USA. 1980;77:1627-31. doi: 10.1073/pnas.77.3.1627Moroi Y, Peebles C, Fritzler MJ, et al. Autoantibody to centromere (kinetochore) in scleroderma sera. Proc Natl Acad Sci USA. 1980;77:1627-31. doi: 10.1073/pnas.77.3.1627Гусева НГ. Системная склеродермия. В кн.: Сигидин ЯА, Гусева НГ, Иванова ММ. Диффузные болезни соединительной ткани. Москва: Медицина; 2004. С. 343-487.Guseva NG. Systemic sclerosis. In: Sigidin YaA, Guseva NG, Ivanova MM. Diffuznye bolezni soedinitel'noi tkani [Diffuse connective tissue disease]. Moscow: Meditsina; 2004. P. 343-487 (In Russ.).Ананьева ЛП, Александрова ЕН. Аутоантитела при системной склеродермии: спектр, клинические ассоциации и прогностическое значение. Научно-практическая ревматология. 2016;54(1):86-99. doi: 10.14412/1995-4484-2016-86-99Ananyeva LP, Aleksandrova EN. Autoantibodies in scleroderma systematica: Spectrum, clinical associations, and prognostic value. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2016;54(1):86-99 (In Russ.). doi: 10.14412/1995-4484-2016-86-99Hudson M, Mahler M, Pope J, et al; Canadian Scleroderma Research Group, and Marvin Fritzler. Clinical Correlates of CENP-A and CENP-B Antibodies in a Large Cohort of Patients with Systemic Sclerosis. J Rheumatol. 2012;39:787-94. doi: 10.3899/rheum.111133Hudson M, Mahler M, Pope J, et al; Canadian Scleroderma Research Group, and Marvin Fritzler. Clinical Correlates of CENP-A and CENP-B Antibodies in a Large Cohort of Patients with Systemic Sclerosis. J Rheumatol. 2012;39:787-94. doi: 10.3899/rheum.111133Baer AN, Medrano L, McAdams-DeMarco M, Gniadek TJ. Anticentromere antibodies are associated with more severe exocrine glandular dysfunction in Sjögren's syndrome: Analysis of the Sjögren's International Collaborative Clinical Alliance cohort. Arthritis Care Res. 2016 Oct;68(10):1554-9. doi: 10.1002/acr.22859Baer AN, Medrano L, McAdams-DeMarco M, Gniadek TJ. Anticentromere antibodies are associated with more severe exocrine glandular dysfunction in Sjögren's syndrome: Analysis of the Sjögren's International Collaborative Clinical Alliance cohort. Arthritis Care Res. 2016 Oct;68(10):1554-9. doi: 10.1002/acr.22859Grace M, Varada, Dhanesh ES. Digital gangrene associated with anticentromere antibodies. Indian J Dermatol. 2014;59:195-6. doi: 10.4103/0019-5154.127686Grace M, Varada, Dhanesh ES. Digital gangrene associated with anticentromere antibodies. Indian J Dermatol. 2014;59:195-6. doi: 10.4103/0019-5154.127686Elqatni M, Mekouar F, Amezyane T, Ghafir D. A Rare Entity: RACAND Syndrome. Intern Med. 2014;53:2749. doi: 10.2169/internalmedicine.53.2757Elqatni M, Mekouar F, Amezyane T, Ghafir D. A Rare Entity: RACAND Syndrome. Intern Med. 2014;53:2749. doi: 10.2169/internalmedicine.53.2757Bolster L, Taylor-Gjevre RM, Nair B, Gjevre JA. Digital gangrene associated with anticentromere antibodies: a case report. J Med Case Rep. 2010;4:189. doi: 10.1186/1752-1947-4-189Bolster L, Taylor-Gjevre RM, Nair B, Gjevre JA. Digital gangrene associated with anticentromere antibodies: a case report. J Med Case Rep. 2010;4:189. doi: 10.1186/1752-1947-4-189Ahmed SS, Tan FK, Arnett FC, et al. Induction of apoptosis and fibrillin 1 expression in human dermal endothelial cells by sclera dermasera containing anti-endothelial cell antibodies. Arthritis Rheum. 2006;54(7):2250-62. doi: 10.1002/art.21952Ahmed SS, Tan FK, Arnett FC, et al. Induction of apoptosis and fibrillin 1 expression in human dermal endothelial cells by sclera dermasera containing anti-endothelial cell antibodies. Arthritis Rheum. 2006;54(7):2250-62. doi: 10.1002/art.21952Tanaka N, Muro Y, Suzuki Y, et al. Anticentromere antibody-positive primary Sjögren's syndrome: Epitope analysis of a subset of anticentromere antibody-positive patients. Mod Rheumatol. 2017;27(1):115-21. doi: 10.1080/14397595.2016.1176327Tanaka N, Muro Y, Suzuki Y, et al. Anticentromere antibody-positive primary Sjögren's syndrome: Epitope analysis of a subset of anticentromere antibody-positive patients. Mod Rheumatol. 2017;27(1):115-21. doi: 10.1080/14397595.2016.1176327Gelber AC, Pillemer SR, Baum BJ, et al. Distinct recognition of antibodies to centromere proteins in primary Sjogren's syndrome compared with limited scleroderma. Ann Rheum Dis. 2006;65:1028-32. doi: 10.1136/ard.2005.046003Gelber AC, Pillemer SR, Baum BJ, et al. Distinct recognition of antibodies to centromere proteins in primary Sjogren's syndrome compared with limited scleroderma. Ann Rheum Dis. 2006;65:1028-32. doi: 10.1136/ard.2005.046003Vlachoyiannopoulos PG, Drosos AA, Wiik A, Moutsopoulos HM. Patients with anticenromere antibodies, clinical features, diagnoses and evolution. Br J Rheumatol. 1993;32:297-301. doi: 10.1093/rheumatology/32.4.297Vlachoyiannopoulos PG, Drosos AA, Wiik A, Moutsopoulos HM. Patients with anticenromere antibodies, clinical features, diagnoses and evolution. Br J Rheumatol. 1993;32:297-301. doi: 10.1093/rheumatology/32.4.297Bournia VKK, Diamanti KD, Vlachoyiannopoulos PG, Moutsopoulos HM. Anticentromere antibody positive Sjögren's syndrome: a retrospective descriptive analysis. Arthritis Res Ther. 2010;12:R47. doi: 10.1186/ar2958Bournia VKK, Diamanti KD, Vlachoyiannopoulos PG, Moutsopoulos HM. Anticentromere antibody positive Sjögren's syndrome: a retrospective descriptive analysis. Arthritis Res Ther. 2010;12:R47. doi: 10.1186/ar2958Katano K, Kawano M, Koni I, et al. Clinical and laboratory features of anticentromere antibody positive primary Sjögren's syndrome. J Rheumatol. 2001;10:2238-44.Katano K, Kawano M, Koni I, et al. Clinical and laboratory features of anticentromere antibody positive primary Sjögren's syndrome. J Rheumatol. 2001;10:2238-44.Kyung-Eun Lee, Ji-Hyoun Kang, Jeong-Won Lee, et al. Anti-centromere antibody-positive Sjogren's syndrome: A distinct clinical subgroup? Rheum Dis. 2015 Sep;18(7):776-82. doi: 10.1111/1756185X.12684Kyung-Eun Lee, Ji-Hyoun Kang, Jeong-Won Lee, et al. Anti-centromere antibody-positive Sjogren's syndrome: A distinct clinical subgroup? Rheum Dis. 2015 Sep;18(7):776-82. doi: 10.1111/1756185X.12684Yan SM, Zeng XF, Zhao Y, Dong Y. A clinical analysis of primary Sjögren's syndrome with anticentromere antibodies. Zhonghua Nei ke Za Zhi. 2008;47:296-9.Yan SM, Zeng XF, Zhao Y, Dong Y. A clinical analysis of primary Sjögren's syndrome with anticentromere antibodies. Zhonghua Nei ke Za Zhi. 2008;47:296-9.Baldini C, Mosca M, Della Rossa A, et al. Overlap of ACA-positive systemic sclerosis and Sjögren's syndrome: a distinct clinical entity with mild organ involvement but at high risk of lymphoma. Clin Exp Rheumatol. 2013;31(2):272-80.Baldini C, Mosca M, Della Rossa A, et al. Overlap of ACA-positive systemic sclerosis and Sjögren's syndrome: a distinct clinical entity with mild organ involvement but at high risk of lymphoma. Clin Exp Rheumatol. 2013;31(2):272-80.Caramaschi P, Biasi D, Carletto A, et al. Sjögren's syndrome with anticentromere antibodies. Rev Rhum Engl Ed. 1997;64(12):785-8.Caramaschi P, Biasi D, Carletto A, et al. Sjögren's syndrome with anticentromere antibodies. Rev Rhum Engl Ed. 1997;64(12):785-8.Gulati D, Kushner I, File E, Magrey M. Primary Sjogren's syndrome with anticentromere antibodies – a clinically distinct subset. Clin Rheumatol. 2010;29:789-91. doi: 10.1007/s10067-009-1359-9Gulati D, Kushner I, File E, Magrey M. Primary Sjogren's syndrome with anticentromere antibodies – a clinically distinct subset. Clin Rheumatol. 2010;29:789-91. doi: 10.1007/s10067-009-1359-9Salliot C, Gottenberg JE, Bengoufa D, et al. Anticentromere antibodies identify patients with Sjögren's syndrome and autoimmune overlap syndrome. J Rheumatol. 2007;34:2253-8.Salliot C, Gottenberg JE, Bengoufa D, et al. Anticentromere antibodies identify patients with Sjögren's syndrome and autoimmune overlap syndrome. J Rheumatol. 2007;34:2253-8.Avouac J, Sordet C, Depinay C, et al. Systemic SclerosisAssociated Sjogren's Syndrome and Relationship to the Limited Cutaneous Subtype. Arthritis Rheum. 2006 Jul;54(7):2243-9. doi: 10.1002/art.21922Avouac J, Sordet C, Depinay C, et al. Systemic SclerosisAssociated Sjogren's Syndrome and Relationship to the Limited Cutaneous Subtype. Arthritis Rheum. 2006 Jul;54(7):2243-9. doi: 10.1002/art.21922Miyawaki S, Asanuma H, Nishiyama S, Yoshinaga Y. Clinical and serological heterogeneity in patients with anticentromere antibodies. J Rheumatol. 2005 Aug;32(8):1488-94.Miyawaki S, Asanuma H, Nishiyama S, Yoshinaga Y. Clinical and serological heterogeneity in patients with anticentromere antibodies. J Rheumatol. 2005 Aug;32(8):1488-94.Kitagawa T, Shibasaki K, Toya S.Clinical significance and diagnostic usefulness of anticentromere antibody in Sjogren's syndrome. Clin Rheumatol. 2012 Jan;31(1):105-12. doi: 10.1007/s10067-011-1789-zKitagawa T, Shibasaki K, Toya S.Clinical significance and diagnostic usefulness of anticentromere antibody in Sjogren's syndrome. Clin Rheumatol. 2012 Jan;31(1):105-12. doi: 10.1007/s10067-011-1789-zShen L, Suresh L. Autoantibodies, detection methods and panels for diagnosis of Sjögren's syndrome. Clin Immunol. 2017 Sep;182:24-9. doi: 10.1016/j.clim.2017.03.017Shen L, Suresh L. Autoantibodies, detection methods and panels for diagnosis of Sjögren's syndrome. Clin Immunol. 2017 Sep;182:24-9. doi: 10.1016/j.clim.2017.03.017Van den Hoogen F, et. al. Classification criteria for systemic sclerosis: An ACR-EULAR Collaborative Initiative. Arthritis Rheum. 2013 Nov;65(11):2737-47. doi: 10.1002/art.38098Van den Hoogen F, et. al. Classification criteria for systemic sclerosis: An ACR-EULAR Collaborative Initiative. Arthritis Rheum. 2013 Nov;65(11):2737-47. doi: 10.1002/art.38098Bowlus CB, Gershwin ME. The diagnosis of primary biliary cirrhosis. Autoimmun Rev. 2014 Apr-May;13(0):441-4. doi: 10.1016/j.autrev.2014.01.041Bowlus CB, Gershwin ME. The diagnosis of primary biliary cirrhosis. Autoimmun Rev. 2014 Apr-May;13(0):441-4. doi: 10.1016/j.autrev.2014.01.041Волков АВ. Легочная артериальная гипертензия при системных заболеваниях соединительной ткани. Научно-практическая ревматология. 2015;53(1):69-77. doi: 10.14412/1995-4484-2015-69-77Volkov AV. Pulmonary arterial hypertension in connective tissue diseases. NauchnoPrakticheskaya Revmatologiya = Rheumatology Science and Practice. 2015;53(1):69-77 (In Russ.). doi: 10.14412/1995-4484-2015-69-77Launay D, Hachulla E, Hatron P-Y, et al. Pulmonary arterial hypertension: A rare complication of primary Sjogren syndrome. Medicine. 2007;86:299-315. doi: 10.1097/MD.0b013e3181579781.Launay D, Hachulla E, Hatron P-Y, et al. Pulmonary arterial hypertension: A rare complication of primary Sjogren syndrome. Medicine. 2007;86:299-315. doi: 10.1097/MD.0b013e3181579781.

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