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Juvenile idiopathic arthritis is a common connective tissue disease of children.The rate of disability is high.Therefore,early diagnosis is important.There are some study on the value of antibodies in juvenile idiopathic arthritts,such as rheumatoid factor,antiperinuclear factor,antikeratin antibody,antibodies to cyclic citrullinated peptides and so on.This review introduces the progress of them.
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Objective To evaluate efficacy and safety of ursodeoxycholic acid(UDCA)for preven-tion of obstruction of biliary plastic stent.Methods A total of 88 patients with plastic biliary stents at our hospital were divided into UDCA group and the control group.Stents were collected 3 months after the opera-tion for argile biliare in the stent.The contents of APF,calcium bilirubin and calcium carbonate were ana-lyzed by biochemistry,and bacterium culture was conducted.Results The obstruction rate of UDCA group (n=43)and control group(n=45)were 8. 9% and 58. 1% respectively with significant differences(P<0. 05).There were significant differences in the protein level of APF between the UDCA group(17. 29 ± 9. 52)μm/L and the control group(10. 39 ±2. 17)μm/L(P<0. 05).Calcium bilirubin[(13. 90 ±3. 80) vs.(30. 92 ±7. 07)]and calcium carbonate[(12. 60 ±5. 69)vs.(16. 52 ±4. 11)]were less than those of the control group (P<0. 05 ).Only one type of bacterium was found,and Escherichia coli were cultured in 40. 0% samples,a lower incidence compared with the control(72. 1%).Conclusion UDCA would lessen biofilm and smooth stent surface by promoting secretion of endogenous bile acid and increasing APF,and keep the biliary patency.
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BACKGROUND: The American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis (ACR/EULAR criteria) include the rheumatoid factor (RF) test and the anti-citrullinated peptide/protein antibody (ACPA) test as serologic makers for rheumatoid arthritis. Antiperinuclear factor (APF) test, an originator of ACPA, is highly specific for rheumatoid arthritis and can be detected in RF or anti-cyclic citrullinated peptide (anti-CCP) negative rheumatoid arthritis, but it is not included in the serologic criterion of ACR/EULAR criteria. In this study, we investigated the way for applying the APF test to ACR/EULAR criteria. METHODS: We analyzed clinical symptoms and laboratory findings of 53 patients who were suspected having rheumatoid arthritis. All patients were negative for the RF and anti-CCP and positive for APF. We classified these patients into 4 groups according to the fluorescence intensity of APF test, and gave 1-4 points for APF positivity. The proportion of patients who scored 6 or greater in ACR/EULAR criteria in relation to APF scores was evaluated. RESULTS: Median scores of ACR/EULAR criteria showed a tendency to increase as the level of fluorescence intensity of APF rises, but ACR/EULAR scores of 4 groups were not different significantly from each other (P>0.05). The proportion of patients who scored 6 or greater in ACR/EULAR criteria were 39.6% and 77.4%, when scores of APF positivity were 2 and 3 points, respectively. CONCLUSIONS: We think it is reasonable to include APF test in the ACPA of ACR/EULAR criteria and give 3 points for APF positivity, regardless of its fluorescence intensity.
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Humans , Antibodies, Antinuclear , Arthritis, Rheumatoid , Fluorescence , Rheumatic Diseases , Rheumatoid FactorABSTRACT
Se hizo una revisión sobre otros marcadores de diagnóstico para la artritis reumatoidea, una de las enfermedades autoinmunes sistémicas más comunes y de amplia distribución mundial, que afecta principalmente a las mujeres y es muy agresiva en la raza negra. Su diagnóstico precoz resulta de vital importancia para evitar las deformidades articulares características y para mejorar la calidad de vida de los pacientes. Actualmente se diagnostica siguiendo los criterios de clasificación definidos por la American Rheumatism Association, entre ellos, la detección del factor reumatoideo. Hoy día se sabe que este no es patognomónico de la enfermedad porque puede estar presente en otras entidades. Se realizó una revisión de otros marcadores sexológicos que están asociados a la artritis reumatoidea y que son mucho más específicos, de manera que podría considerarse su uso en el diagnóstico precoz de esta enfermedad.
A review of other diagnostic markers for rheumatoid arthritis, one of the commonest autoimmune systemic diseases, was made. It is widely spread all over the world. It mainly affects women and it is very aggressive among black people. Its early diagnosis is of vital importance to prevent the characteristic joint deformities and to improve the patients’ quality of life. At present, it is diagnosed according to the classification criteria defined by the American Rheumatism Association, among them, the detection of the rheumatoid factor. It is known that it is not pathognomonic of the disease, since it may be present in other entities. A review of other sexological markers that are associated with rheumatoid arthritis and that are much more specific was made, so that their use could be considered in the early diagnosis of this disease,.
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Objective To determine the diagnostic value of antifilaggrin antibodies(AFA) in rheumatoid arthritis(RA) and to compare the correlation among AFA,anti-perinuclear factor(APF) and anti-keratin antibodies(AKA). Methods Filaggrin was extracted from human epidermis and then partially purified. AFA in 103 cases of RA and 140 cases of controls were detected by western blot. APF and AKA were detected using indirect immunofluorescence. Results AFA test resulted in diagnosis of 35.9% of 103 RA samples, with a specificity of 93.7%. The result was significantly higher than the controls (P
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Objective To assess the diagnostic value of anti-cyclic citrullinated peptide antibody(an- ti-CCP),rheumatoid factor,anti-perinuclear factor(APF)and anti-keratin antibody(AKA)for juvenile rheumatoid arthritis(JRA)and compare it with rheumatoid arthritis(RA).Methods Anti-CCP was determined by ELISA in 54 serum samples of JRA patients,31 from patients with other rheumatic diseases and 116 RA patients.RF was determined in the same samples by latex agglutination test.APF and AKA were determined by indirect immunofluorescent assay.Results The sensitivity of anti-CCP,RF,APF and AKA was 61.1%, 57.4%,37.0% and 18.5% and their specificity was 96.8%,93.6%,96.8% and 100%,respectively for the diag- nosis of JRA.The sensitivity of anti-CCP resembleed that of RF,Anti-CCP was more sensitivity than APF and AKA in JRA.The sensitivity of anti-CCP,RF,APF and AKA was 82.3%,78.3%,48.7% and 25.4% and their specificity was 95.7%,73.7%,91.6%,94.0% respectively,for the diagnosis of RA.Anti-CCP,RF,APF and AKA were less sensitive in JRA than in RA.There was no statistical significance in specificity of these anti- bodies for the diagnosis of JRA and RA.Conclusion The detection of anti-CCP,RF,APF and AKA are use- ful for the diagnosis of JRA,but are less sensitive than in adults RA.
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Objective To explore the diagnostic value of anti cyclic citrullinated peptide (CCP) antibody (anti CCP) detected by ELISA in patients with rheumatoid arthritis (RA).Methods The synthesized CCP deduced from the known cDNA sequence was used as substrate in ELISA.The anti CCP was detected by ELISA in 294 RA,132 rheumatic diseases other than RA and 135 non rheumatic diseases.To compare the correlation among the anti CCP and APF (antiperinuclear factor),AKA (anti keratin antibody),RF (rheumatoid factor) and HLA DR4.Results One hundred and thirty seven (46 6%) RA sera,7 (5 3%) other rheumatic disease sera and 2 (1 8%) non rheumatic disease were found to be anti CCP positive by ELISA.The sensitivity of anti CCP was 46 6% with high specificity (96 9%) in RA.Anti CCP was associated with APF,AKA and HLA DR4 except RF.Conclusions Anti CCP presents a reasonable sensitivity (46 6%) with high specificity (96 6%) to RA and it is valuable to RA diagnosis.Anti CCP is associated with APF,AKA and HLA DR4 but not completely overlaps them.Anti CCP could be regarded as a new diagnostic marker in RA.
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OBJECTIVE: Antiperinuclear factor (APF)is regarded as a marker antibody with high sensitivity and specificity for rheumatoid arthritis (RA).However, the precise role of APF in the pathogenesis of RA has not yet been elucidated. Studying the isotype of APF may be a step in revealing the nature of this anti-body,but such studies have been rare,and none have been done in Korea.The present study is set out to identify the isotype of APF from sera of Korean patients with RA,and to determine whether certain isotypes are related to specific clinical aspects. METHODS: A total of 114 APF positive RA sera were tested against IgG,IgA and IgM separately by indirect immunofluorescence method,and the medical records were retrospectively reviewed. RESULTS: All 114 serum samples were positive for IgG-APF,100 positive for only IgG-APF (G group,87.7%),9 positive for IgG and IgA-APF (GA group, 7.9%),4 positive for IgG and IgM-APF (GM group,3.5%),and one sample was positive for IgG,IgA and IgM-APF (0.9%).The levels of rheumatoid factor (RF)and C-reactive protein (CRP)were different between the 3 groups (ANOVA test),and the RF and CRP of the GM group was higher than the other 2 groups (Bonferroni test). CONCLUSION: The APF identified in Korean patients with RA was always IgG-APF.IgM-APF may be used as a serological marker to assess disease activity in conjunction with CRP.The differences in the laboratory parameters between each isotype groups indicate the possibility of utilizing the isotype of APF to determine the disease activity or prognosis of RA.
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Humans , Arthritis, Rheumatoid , C-Reactive Protein , Fluorescent Antibody Technique, Indirect , Immunoglobulin G , Immunoglobulin M , Medical Records , Prognosis , Retrospective Studies , Rheumatoid Factor , Sensitivity and SpecificityABSTRACT
In systemic rheumatic disease, marker antibodies such as anti-Sm, anti Scl-70 and anti Jo-1 are helpful in the diagnosis of disease, but in rheumatoid arthritis, the diagnosis is difficult due to the low sensitivity and specificity of the rheumatoid factor(RF). So, a new maker antibody with high sensitivity and specificity was needed. Recently, the antiperi- nuclear factor(APF) has gained particular attention. The results of the APF and RF test in 165 patients with rheumatoid arthritis, 77 patients with osteoarthritis, and 109 normal healthy persons, which were taken between January, 1994 through December 1994 were as follows; 1. The sensitivity, specificity, and predictive value of positivity of the RF test in patients with rheumatoid arthritis were 58.2%, 93.5%, and 95.0%, and that of the APF test were 72.1%, 94.6% and 92.2%, respectively. 2. The sensitivity, specificity and predictive value of positivity when combining the APF with the RF were 83.0%, 85.7%, and 92.6%, respectively. 3. The disease status of the patients correlated with intensity of the APF test, that is, the more severe the disease status, the higher intensity. In conclusion, the APF was useful in the diagnosis of rheumatoid arthritis, and may be used as an indicator of disease status. When combining test the APF with RF, the incidence of sero-negative rheumatoid arthritis decreased.