The investigation of the level and influencing factors of serum uric acid among monks and nuns in Wutai Mountain area / 中华风湿病学杂志

Objective:To investigate the level and the influencing factors of blood uric acid in monks and nuns in Wutai Mountain area, and to explore the relationship between blood uric acid level and BMI and blood lipids levels.Methods:Physical examinations and laboratory tests were performed on monks and nuns in Wutai Mountain area. There were 207 males and 261 females. Physical examination includes height, weight, blood pressure, blood uric acid, blood lipid, blood glucose and other indicators. The blood uric acid level was measured using the uricase method. Chi-square test for trend, and t test were utilized for statistical analysis. Results:The average blood uric acid level of the monk and the nun was (372±6) μmol/L and (290±4) μmol/L, respectively. Obviously, the average blood uric acid level of the monk was significantly higher than it in the nun ( t=11.636, P<0.01). The total incidence rate of hyperuricemia, which was diagnosed when the blood uric acid level was higher than 420 μmol/L in males and the blood uric acid level was higher than 360 μmol/L in females. In particular, the incidence rate of hyperuricemia was much higher in the monk (24.3%, 50/207) than in the nuns (13.4%, 35/261) ( χ2=8.966, P<0.01) . Analysis by age, the prevalence of hyperuricemia in men was 20.3%(42/207) before the age of 50, which was higher than that after the age of 50 (3.9%, 8/207) ( χ2=26.3, P< 0.01); The prevalence of hyperuricemia in women before the age of 50 was 2.7%(7/261), which was lower than that after the age of 50 (10.7%, 28/261) ( χ2=13.51, P<0.01). The uric acid level of men and women between 50-60 years old, showed the opposite trend. The level of uric acid in men decreased and increased in women. In addition, the prevalence of triglyceride abnormalities and overweight was more significantly in monks and nuns with high uric acid than those with the normal uric acid level [71.8%(61/85) vs 45.2%(173/383), χ2=19.68, P<0.01; 54.1%(46/85) vs 19.8%(76/383), χ2=42.4, P<0.01]; while no significant difference of total cholesterol and blood glucose levels was observed between these two groups. Conclusion:There are differences in blood uric acid levels among Wutai Mountain area monks and nuns of different ages and genders. The level of blood uric acid in male is significantly higher than that in female. Lipid metabolism and over weight are closely related to elevated level of the uric acid, which might be the risk factors of uric acid abnormality in Wutai Mountain population.

The role of immunoglobulin G isotype rheumatoid factors on the diagnosis and prognosis of rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate the diagnostic and prognostic value of immunoglobulin (Ig)G isotype rheumatoid factors (IgG-RF) in rheumatoid arthritis (RA).Methods Five hundred patients with RA were enrolled randomly.IgG-RF antibody was detected by enzyme-linked immunosorbent assay (ELISA).The correlations between serum IgG-RF antibody and clinical features,disease activities,laboratory of RA patients were evaluated.The comparison of continuous variables was performed by using the Student t-test or Mann-Whitney U test in accordance with normality testing.Chi-square test was performed for categorical variables.A value of P less than 0.05 was considered statistically significant.Results ① IgG-RF was positive in 41.0％ (205/500) of RA patients.In patients with anti-citrullinated protein/peptide autoanti-bodies (ACPA) negative,RF negative or the seronegative patients (both ACPA and RF were negative),the positive rate of IgG-RF was 22.4％(24/107),13.2％(17/129) and 9.1％(5/55),respectively.② Compared with patients with negative IgG-RF,patients with positive IgG-RF had higher rates of joint deformity [(58.5％(120/205) vs 39.3％(116/295),x2=17.918] and bone erosion [(75.6％(118/156) vs 60.3％(140/232),x2=9.796] (P＜0.01,respectively).③ The patients with positive IgG-RF had higher rates of elevated ESR(86.3％ vs 67.8％,x2=22.426),IgG(29.9％ vs 20.0％,x2=6.310),compared to patients with negative IgG-RF (P＜0.05,respectively),and levels of ESR [(59±35) mm/1 h vs (47±32) mm/1 h,t=3.989] and CRP [(390±450) mg/L vs (290±340) mg/L,t=3.004] was higher in IgG-RF positive group than the negative (P＜0.01,respectivelys).④ Compared with the IgG-RF negative patients,the positive group had higher smoking rates (22.9％ vs 12.5％,x2=9.227),higher current smoking rates (16.6％ vs 7.1％,x2=11.119) and higher smoking index [(107±238) vs (49±161),t=3.199](P＜0.05,respectively).Conclusion IgG-RF had its clinical values in RA diagnosis.IgG-RF is significantly associated with joint deformity,bone erosions and smoking.

Anti-citrullinated alpha-enolase peptide 1 antibody in the diagnosis of rheumatoid arthritis / 中华风湿病学杂志

Objective To detect the anti-citrullinated alpha-enolase peptide 1 (CEP-1) antibody in rheumatoid arthritis (RA). Methods One hundred and twenty-nine patients with RA were enrolled randomly. Thirty-one patients with primary Sj?gren's syndrome (pSS), 32 patients with systemic lupus erythematosus (SLE), 32 patients with osteoarthritis (OA), and 106 healthy controls (HC) were include into this study. Anti-CEP-1 antibody was detected by enzyme-linked immunosorbent assay (ELISA). The correlations between serum anti-CEP-1 antibody and clinical features, disease activities,laboratory tests or Sharp scores of RA patients were evaluated. Mann-Whitney U test and χ2 test were used for statistical analysis. Results ①Anti-CEP-1 antibodies were positive in 64.3%(83/129) of RA patients, 22.6%(7/32) of pSS patients, 12.5%(4/32) of SLE patients, none of OA patients (0/32) or healthy controls. The positivity of anti-CEP-1 antibody was significantly higher than those in pSS ( χ2=17.7), SLE ( χ2=25.7), OA ( χ2=42.5), and healthy controls ( χ2=102.6) (P<0.01, respectively). The specificity of anti-CEP-1 antibody in RA was 94.5%. ②In patients without anti-citrullinated protein/peptide autoantibodies (ACPA), rheumatoid factor (RF) or the patients without ACPA and RF, the positive rate of anti-CEP-1 antibody was 30.3%(10/33), 41.9%(18/43) and 22.7%(5/22), respectively. ③Compared with patients without anti-CEP-1 antibodies, patients with anti-CEP-1 anti-bodies had higher rates of joint deformity, bone erosion and high disease activities (P<0.05, respectively). ④ Higher rate of interstitial lung disease (ILD) was found in RA patients with anti-CEP-1 antibody (19.3% vs 4.3%, χ2=5.494, P<0.05). ⑤The patients with anti-CEP-1 anti-body had higher rates of elevated erythrocyte sedimentation rate (ESR) ( χ2=6.543) and decreased serum albumin ( χ2=6.59), compared to patients without anti-CEP-1 antibody (P<0.05, respectively). Conclusion Anti-CEP-1 antibody has high sensitivity and specificity for RA diagnosis. Combination of anti-CEP-1 antibody with other RA antibodies might improve the early diagnosis of RA. Anti-CEP-1 antibody is significantly associated with joint damage, disease activity and pulmonary interstitial fibrosis.

Anti-citrullinated alpha-enolase peptide 1 antibody in the diagnosis of rheumatoid arthritis / 中华风湿病学杂志

Objective To detect the anti-citrullinated alpha-enolase peptide 1 (CEP-1) antibody in rheumatoid arthritis (RA). Methods One hundred and twenty-nine patients with RA were enrolled randomly. Thirty-one patients with primary Sj?gren's syndrome (pSS), 32 patients with systemic lupus erythematosus (SLE), 32 patients with osteoarthritis (OA), and 106 healthy controls (HC) were include into this study. Anti-CEP-1 antibody was detected by enzyme-linked immunosorbent assay (ELISA). The correlations between serum anti-CEP-1 antibody and clinical features, disease activities,laboratory tests or Sharp scores of RA patients were evaluated. Mann-Whitney U test and χ2 test were used for statistical analysis. Results ①Anti-CEP-1 antibodies were positive in 64.3%(83/129) of RA patients, 22.6%(7/32) of pSS patients, 12.5%(4/32) of SLE patients, none of OA patients (0/32) or healthy controls. The positivity of anti-CEP-1 antibody was significantly higher than those in pSS ( χ2=17.7), SLE ( χ2=25.7), OA ( χ2=42.5), and healthy controls ( χ2=102.6) (P<0.01, respectively). The specificity of anti-CEP-1 antibody in RA was 94.5%. ②In patients without anti-citrullinated protein/peptide autoantibodies (ACPA), rheumatoid factor (RF) or the patients without ACPA and RF, the positive rate of anti-CEP-1 antibody was 30.3%(10/33), 41.9%(18/43) and 22.7%(5/22), respectively. ③Compared with patients without anti-CEP-1 antibodies, patients with anti-CEP-1 anti-bodies had higher rates of joint deformity, bone erosion and high disease activities (P<0.05, respectively). ④ Higher rate of interstitial lung disease (ILD) was found in RA patients with anti-CEP-1 antibody (19.3% vs 4.3%, χ2=5.494, P<0.05). ⑤The patients with anti-CEP-1 anti-body had higher rates of elevated erythrocyte sedimentation rate (ESR) ( χ2=6.543) and decreased serum albumin ( χ2=6.59), compared to patients without anti-CEP-1 antibody (P<0.05, respectively). Conclusion Anti-CEP-1 antibody has high sensitivity and specificity for RA diagnosis. Combination of anti-CEP-1 antibody with other RA antibodies might improve the early diagnosis of RA. Anti-CEP-1 antibody is significantly associated with joint damage, disease activity and pulmonary interstitial fibrosis.

Clinical and laboratory features of 58 patients with positive cryoglobulin / 中华全科医师杂志

Objective To study the disease spectrum,clinical and lab characteristic of cryoglobulinaemia.Methods The clinical and laboratory data of 58 patients with positive cryoglobulin admitted in Peking University People's Hospital from April 2010 to May 2014 were retrospectively analyzed.Results Among 58 patients,34 were diagnosed as autoimmune disease,8 as infectious disease,4 as hematological disease and 12 as primary cryoglobulinemia.Renal involvement was the most frequent clinical presentation among all cryoglobulin positive patients.Patients with autoimmune disease presented all clinical manifestations related to cryoglobulinaemia.Renal involvement (7/8) was prominent in patients with HBV/HCV infection,while other clinical presentations were rare.Among 4 patients with hematological disease,purpura was presented in 3 cases,renal involvement in 2,arthralgia in 2,fatigue,thrombosis or hyperviscosity was presented in 1 case,respectively;however,none of these patients had elevated rheumatoid factor (RF) level.Renal lesions were the most common reason for patients with primary cryoglobulinaemia to consult doctors,and 5 of them had positive antinuclear antibodies (ANA).Conclusions There is a broad spectrum of disease in cryoglobulinaemia.Multi-system involvement was most common in patients with autoimmune disease.For patients with HBV/HCV infection,extra-hepatic presentations were rare except renal involvement.Hyperviscosity syndrome tended to occur in patients with hematological disease.Since patients with primary cryoglobulinaemia had a relatively high rate of positive antinuclear antibodies,we should keep vigilance at the occurrence of autoimmune disease.

Clinical and laboratory features of rheumatic autoimmune disease associated cryoglobulinaemia / 中华风湿病学杂志

Objective To investigate the clinical and laboratory features of autoimmune disease (AID) associated cryoglobulinaemia. Methods From April 2010 to May 2014, thirty threc patients with AID in Peking University Peopleˊs Hospital were tested positive for cryoglobulin. Their clinical and laboratory features were analyzed retrospectively. T test, Mann-Whitney U test, Chi-squaretest and Fisherˊs exact test were used for statistical analysis. Results Among the 33 patients, 26 were female, 7 were male, the average age was (47 ± 17) years old (range 12-75 years old). The spectrum of autoimmune diseases included, in order, systemic lupus erythematosus (SLE), Sj?grenˊs syndrome (SS), multiple myositis/dermatomyositis, rheumatoid arthritis (RA), systemic sclerosis (SSc), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, antiphospholipid syndrome and primary biliary cirrhosis. SLE and SS accounted for 84.8% (28/33) in tpatients with cryoglobulinaemia. In patients withSLE, cryoglobulinaemia occurred at 2.0 (1.0-12.0) years after disease onset, and cryoglobulinpositive patients had more frequent renal involvement (71% vs 40%, P=0.004), positive anti-RNP (56% vs21%, P=0.007) and ACL (53% vs 8%, P=0.000). However, among patients with SS, cryoglo-bulinaemia occurred at 11.0 (4.0-18.0) years after disease onset, and cryoglobulin positive patients had higher rheumatoid factors (RF) [1 170 (230.00, 2 800.00) U/ml vs 57.80 (20.00, 230.50) U/ml, U=-0.002, P=0.001], IgM [3.54 (1.83, 4.34) g/L vs 1.17 (0.81, 2.26) g/L , U=0.016, P=0.014] and lower complement C3 [0.58 (0.33, 0.68) g/L vs 0.81 (0.67, 0.98 g/L), U=0.004, P=0.003] and C4 [0.06 (0.03, 0.12) g/L vs 0.16 (0.12, 0.22), U=0.017, P=0.016]. Conclusion Autoimmune disease complicated with cryoglo-bulinaemia is not uncommon in clinical practice, in which SLE and SS account for the leading two causes. Patients with positive anti-RNP and/or ACL are positively associated with cryoglobulinaemia. renal involvement of SLE is increased by the presence of cryoglobulin.

Summary of the 2012 national autoantibody testing quality control and comparison with the past 9 years / 中华风湿病学杂志

Objective To investigate the current national situation of autoantibody test in order to improve the quality of autoantibodies test.Methods Hospitals or departments in the whole country participated voluntarily or on invitation.Fifteen samples in total were distributed double-blindly,and autoantibodies including anti-nuclear antibody (ANA),anti-double-stranded DNA (anti-dsDNA) antibody,anti-extractable nuclear antigens (anti-ENA),anti-citrulline antibody (anti-CCP),anti-mitochondria antibody (AMA) and anti-smooth muscle antibody (ASMA) were tested in 6 samples.The samples were used for AMA and ASMA tests.Results A total of 148 hospitals or departments participated and multiple testing methods were adopted.The accurate rate of ANA(97.3％),AMA (96.1％),ASMA (92.1％) and anti-CCP (97.4％) were higher than that of anti-dsDNA (81.9％) and anti-ENA (77.2％).Anti-RNP and anti-Scl70 in anti-ENAs had the lower accurate rate,90.9％ and 80.3％ respectively.Taking data of the past 10 years together,the accuracy of antiSSA,anti-SSB,anti-Sm had been stable since 2009,while that of anti-RNP and anti-Scl70 decreased slightly.For methodology,indirect immunofluorescence was mainly adopted in the testing of ANA,anti-dsDNA,AMA and ASMA,immunoblotting was mainly adopted in anti-ENA detection and enzyme linked immunosorbent serologic assay was used for anti-CCP test.Conclusion No major variation of primary testing method is found in recent 10 years.Although diverged greatly among different methods,the accuracy of antibody detection has improved year by year.

The relevance of anti-lymphocyte antibody with primary Sj(o)gren syndrome / 中华风湿病学杂志

Objective To investigate the relationship between anti-lymphocyte antibody (ALA) and clinical and immunological parameters in primary Sj(o)gren syndrome (pSS).The significance of ALA and lymphopenia in pSS was explored.Methods Serum samples were obtained from 143 patients with pSS.Clinical and laboratory data were collected.Sera from 45 healthy individuals were collected as the controls.Serum ALA IgG was detected by indirect immunofluorescence test (IIFT).x2 test and t test were used for statistical analysis.The reasons of lymphopenia in pSS patients were analyzed.The correlation between ALA,lymphopenia and clinical manifestations as well as laboratory parameters was analyzed.Results ① Of the 143 pSS patients,25.2％(36/143) were serological positive for ALA,which was significantly higher than the normal group (6.5％,5/77) (x2=27.496,P＜O.01).② The prevalence of leukopenia (55.6％,20/36),lymphopenia (77.8％,28/36),anti-nuclear antibody(80.5％,29/36) and C3 decrease(50.0％,18/36) was higher in pSS patients with ALA than those without (x2=8.296,25.348,3.929,3.866,P＜0.05).③ 46.2％(66/143) patients had lymphopenia.Comparing with patients with normal lymphocyte count,the incidence of ALA positive,leukopenia,PLT decrease and anti-SSB antibodies positivity was significantly higher in patients with lymphopenia (x2=27.496,51.344,5.320,8.950,7.782; P＜0.05).Conclusion The ALA is likely to be a meaningful sera marker for pSS patients with lymphopenia,and this suggests that it has an important role in the clinical progress of SS.

The diagnostic significance of anti-cyclic citrullinated peptide 3.1 IgG/IgA antibody in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective To explore the diagnostic value of anti-cyclic citrullinated peptide (CCP) 3.1 IgG/IgA antibody detected by enzyme-linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA).Methods The ELISA was used to measure the anti-CCP3.1 antibody in the serum of 169 RA patients,100 patients with other rheumatic diseases (including systemic lupus erythematosus,Sjogren's syndrome and osteoarthritis) and 72 healthy controls.The diagnostic value of CCP3.1 was assessed and compared with the second generation of anti-CCP IgG (CCP2) antibody,the correlations between anti-CCP3.1 antibody and the clinical and laboratory parameters were analyzed.Two-independent samples t test,chi-square test and Spearman's correlation were adopted for statistical analysis.Results ① The average cut-off concentration of anti-CCP3.1 antibody was (1122±1429) U/ml in RA,(13±14) U/ml in other rheumatic diseases and (6±5) U/ml in healthy controls.② The area under curve of ROC for anti-CCP3.1 antibody and anti-CCP2 antibody were 0.923 and 0.936 respectively.There was no difference between the sensitivity (82％ vs 79％)and specificity (97％ vs 99％) of anti-CCP3.1 antibody and anti-CCP2 antibody.The Kappa values between anti-CCP3.1 antibody and anti-CCP2 antibody was 0.763.③ We also found that anti-CCP3.1 antibody was positive in 20％(7/35) of anti-CCP2 antibody negative,43％(18/42) of RF negative,62％(47/76) of AKA negative,71％(49/69) of APF negative and 13％ of autoantibodies negative patients,indicated that antiCCP3.1 antibody had a potential value in the diagnosis of serum negative patients with RA.④ The presence of anti-CCP3.1 antibody was correlated with RF,HRF-IgG,APF,AKA,GPI and IgA (P＜0.05),except disease activity.Conclusion The sensitivity of anti-CCP3.1 antibody is slightly higher than anti-CCP2 antibody.The Anti-CCP3.1 antibody is a very valuable parameter for the diagnosis of RA,especially in serum negative patients.

Decoy receptor3 in rheumatoid arthritis patient and its clinical relevance / 中华风湿病学杂志

Objective To test serum decoy receptor 3 (DcR3) concentration in patients with rheumatoid arthritis (RA),and analyze its clinical significance.Methods The serum from 180 RA patients,29 osteoarthritis (OA) patients,60 systemic lupus erythematosus (SLE) patients,30 Sj(o)gren's syndrome (SS) patients and 100 healthy donators were selected.The serum DcR3 concentrations of the two groups were detected by enzyme-linked immunosorbent assay (ELISA).The correlation between serum DcR3 levels and clinical features of patients with RA were investigated.T test,x2 test and Spearman's correlation analysis were used for statistical analysis with software SPSS 16.0.Results Serum DcR3 levels in RA patients [(202±261)ng/ml] were significantly higher than those of the healthy controls [(32±31) ng/ml,t=5.33,P＜0.01],OA patients [(90±33)ng/ml,t=1.998,P＜0.01],SLE patients [(41±56)ng/ml,t=3.19,P＜0.01],and SS patients [(25±31) ng/ml,t=2.50,P＜0.01].The DcR3 cut value was 45.86 ng/ml for the diagnoses of RA,the sensitivity and specificity was 0.991 and 0.765 respectively.The levels of serum DcR3 in RA patients were related with rheumatoid factor (RF) IgM,RF-IgG,anti-cyclic citrullinated peptide antibodies (anti-CCP) and C3.Conclusion Serum DcR3 level is significantly elevated in RA and it is significantly associated with immunological index of RA including RF-IgM,RF-IgG,C3 and anti-CCP antibody,which may be a factor for unfavorable prognosis of RA patients.

Summary of the 2011 national autoantibody testing quality control / 中华风湿病学杂志

Objective To consecutively investigate the quality of auto-antibody testing of the whole country and to improve quality.Methods A nation-wide investigation was carried out and hospitals or departments participating were notified by letter or telephone communication.Autoantibodies tested for quality control survey included anti-nuclear antibody (anti-ANA),anti-double-stranded DNA (anti-dsDNA)antibody,anti-extractable nuclear antigens (anti-ENA) antibody,anti-mitochondria antibody (AMA),anti-smooth muscle antibody (ASMA) and anti-citrulline antibody (anti-CCP).There were 15 samples in total for testing,including 3 control samples for each test.Same sample was used for both AMA and ASMA test.Sample distribution and data analysis were carried out double-blindly.A total of 114 hospitals or departments participated in the survey.Multiple testing methods were adopted including indirect immumo-fluo-rescence (IIF),immuno-blot (IB),dot-blot (DB),double immuno-diffusion (DID),enzyme linked immuno-sorbent assay (ELISA),chemiluminescent assay,dot-immunogold filtration assay.Results The accurate rates for this survey were 98％,96.6％,89.5％,98.1％,92.1％,96.4％ respectively for ANA,anti-dsDNA,anti-ENA,AMA,ASMA and anti-CCP.Anti-ENAs were further divided into anti-RNP,anti-Sm,anti-SSA,anti-SSB and anti-Scl-70 subgroups,and the accurate rates were 88.4％,96.8％,100％,100％ and 95.8％,respectively.Titers of ANA varied greatly among different labs,so did quantitative analysis of anti-CCP,AMA and antidsDNA by ELISA.However,the accuracy of ANA types determined by IIF was greatly improved.Detection rate of AMA and AMSAwas still low.Conclusion Among detected antibodies,ANA,anti-dsDNA and antiCCP are the most prominently improved.Accurate rate of anti-ENA antibody is slightly increased.

Tumor necrosis factor like ligand-1A in rheumatoid arthritis patient and its clinical relevance analysis / 中华风湿病学杂志

ObjectiveTo analyze the correlated clinical significance by testing the serum tumor necrosis factor like ligand-1A(TL1A) levels of patients with rheumatoid arthritis(RA). MethodsThe serum from 100 RA patients and 50 healthy controls were selected. The serum TL1A concentrations of the two groups were detected by ELISA. The correlations between serum TL1A levels and clinical features or laboratory examinations of RA patients were investigated. Mann-Whitney U test, t-test, x2 test and Spearman correlation analysis were used for statistical analysis. ResultsThe levels of serum TL1A in RA patients [(959±1146) pg/ml]were significantly higher than those of the healthy controls[(529±154) pg/ml, t=3.683,P＜0.01]. The levels of serum TL1A in RA patients with positive rheumatoid factor(RF),occult rheumatoid factor immunoglobulin G (HRF-IgG) and anti-cyclic citrullinated peptide antibodies (anti-CCP)[(962±1043 ), ( 833±1104 ), (908±1115 ) pg/ml, respectively]were significantly increased when compared to those in RF, HRF-IgG and anti-CCP negative RA patients[(628±r343), (576±134),(628±401) pg/ml, respectively, t=3.224, 1.317, 1.003; P＜0.05]. The positive rates of RF, HRF-IgG and anti-CCP in the TL1A positive group(90％, 42％, 85％) were significantly higher than those of the TL1A negative group (56％, 11％,33％) (x2=-0.372, -2.402, -2.774; P＜0.05). ConclusionThe level of serum TL1A is significantly elevated in RA and it is significantly associated with auto-antibodies in RA including RF, HRF-lgG and antiCCP antibody, which may be a factor for unfavorable prognosis of RA patients.

The significance of anti-endothelial cell antibody AECA in Behcet's disease / 中华风湿病学杂志

Objective To evaluate the significance of anti-endothelial cell antibody (AECA) and the correlation between AECA and clinical features of Behcet's disease (BD). Methods AECA was detected in 73 BD, 60 SLE, 35 SSc, 30 RA, 62 systemic vasculitis patients and 40 health controls by indirect immunofluorescence analysis in which the endothelial cells from umbilical vein were used as the substrate. Results Higher frequency of AECA was found in BD (54.8%) with the specificity of 87.2%, compared to those in SLE (8%), SSc (9%), RA (10%), systemic vasculitis (27%) and healthy controls (2%, P<O.O1, respectively). However, the prevalence of ANA, other common auto-antibodies, hypocomplementemia, throm- bopenia and proteinuria were significantly lower in BD when compared with those with other autoimmune diseases (P<0.01). In addition, AECA- positive BD patients had significantly higher ESR than those with negative AECA (P<0.01). Conclusion AECA is one of the major parameters for the diagnosis of BD with high sensitivity and specificity.

Expression level of Interferon regulatory factor 5 in systemic lupus erythematosus / 中华风湿病学杂志

Objective To compare the expression level of interferon regulator factor 5 (IRF5) of the health controls and systemic lupus erythematosus (SLE) patients and analyze the relationship between IRF5 and SLE disease activity. Methods Peripheral blood monoeytes (PBMCs) from SLE patients and healthy donors were separated with Ficoll density gradient eentrifugation and total cellular RNA was isolated with Trizol from the PBMCs, the mRNA was reverse transcripted to cDNA. Real-time PCR was applied to determine the expression level of IRFS. The expression level of IRF5 between the two groups were compared. The correlations of expression level of IRF5 with SLE disease activity and other laboratory or clinical parameters of SLE patients were analyzed. Results The level of IRF5 was (2.1±2.2) in SLE patients and (1.5±1.2) in healthy controls, the difference was not statistically significant (P=0.161). And the levels of IRF5 in SLE patients were significantly correlated with their SLEDAI (r=0.616,P<0.01), but not correlated with other parameters such as bemoglobulin complements, immunoglobulin etc. Anti-dsDNA antibody positive patients had significantly higher expression of IRF5 compared to the anti-dsDNA-antibedy-negative patients. The IRF5 mRNA levels of SLE patients with fever or neuropsyehiatric symptoms were significantly higher than those of patients free of neuropsychiatrie involvement. Conclusion High expression level of 1RF5 may contribute to the pathogenesis of SLE in disease activity and antibody production.

Impact of rheumatoid arthritis-associated HLA-DRbeta1 subtypes on protein kinase A signaling / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the impact of rheumatoid arthritis (RA)-associated HLA-DRbeta1 * 0401, * 0402, * 0403, * 0404 and * 0101 subtypes on the protein kinase A (PKA) signaling pathway.</p><p><b>METHODS</b>Adenylate cyclase (AC), cAMP and PKA activity in transfectants expressing RA-associated HLA-DRbeta1 subtypes and their mutants were detected.</p><p><b>RESULTS</b>Compared to HLA-DRbeta1 * 0402 transfectants, the RA-associated HLA-DRbeta1 * 0401, * 0404 and * 0101 transfectants produced significantly lower levels of AC, cAMP and PKA.</p><p><b>CONCLUSION</b>RA-associated HLA-DRbeta1 molecules are involved in the pathogenesis of RA through down-regulation of the PKA signaling pathway.</p>

Quality control of autoantibody detection in China / 中华风湿病学杂志

Objective To evaluate the quality of autoantibodies detection in China. Method Standardized samples were sent to 73 laboratories that are able to detect autoantibodies. The autoantibodies detected included antinuclear antibody (ANA), anti-dsDNA antibody, anti-extractable nuclear antigen (ENA) antibody, anti-mitochondrial antibody (AMA) and anti-smooth muscle antibody (ASMA). The analysis of testing results was double-blinded. Result The consistent rates of ANA, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondrial antibody and anti-smooth muscle antibody were 86.2%, 75.4%, 62.7%, 100% and 61.1% respectively. Conclusion The overall accuracy has been elevated, but still needs to be improved.

Significance of anti-cell membrane associated DNA (mDNA) antibodies in systemic lupus erythematosus / 中华风湿病学杂志

Objective To establish the method of anti-cell membrane associated DNA (mDNA) antibody detection, to evalute its sensitivity and specificity in systemic lupus erythematosus (SLE), and to analyze the relationship between anti-mDNA antibody and the clinical features of SLE. Methods Indirect immunofluorescence assay was used to measure anti-mDNA antibodies in sera of 207 SLE patients, 167 patients with other rheumatic diseases and 82 healthy controls. Using indirect immunofluorescence to detect the expression of mDNA with positive standard serum samples on nine cultured cell lines and pre-treated cells by DNAse, RNAse or trypsin. Results Of the serum samples, 73.3% SLE and 5.4% other rheumatic diseases were positive for anti-mDNA, but negative in 82 blood donors (P0.05). This study also proved that mDNA was expressed on B and T lymphocytes, the strongest staining was expressed on Raji cell line. The mDNA molecule was confirmed by pattern extinction on the cells pre-treated with DNAse but not RNAse or trypsin. Conclusion Anti-mDNA antibody is one of the most valuable marker in the diagnosis of SLE. Anti-mDNA antibody is valuable in diagnosis of SLE with negative anti-dsDNA, Sm, DNP, AHA and AnuA antibodies; but it has no significant with relationship the disease activity of SLE.

Significance of combined detection of autoantibodies in systemic lupus erythematosus / 中华风湿病学杂志

Objective To compare the specificity and sensitivity of antibodies against cell membrane associated DNA (cmDNA)、 nucleosome (AnuA)、 double stranded DNA (dsDNA)、 deoxyribonucleoprotein (DNP) and antinuclear antibodies (ANA) in systemic lupus erythematosus (SLE). To analyze the relationship between these auto-antibodies in SLE. Methods One hundred and twenty five SLE patients and 118 other rheumatic diseases patients were studied. The latter included primary Sj?觟gren syndrome, ploymyositis, dermatomyositis, rheumatoid arthritis, osteoarthritis and systemic sclerosis. Indirect immunofluorescence was used to measure the anti-cmDNA antibodies and ANA. The enzyme-linked immunosorbent assay (ELISA) was used to measure the AnuA. Anti-DNP antibodies were detected by latex agglutination text and anti-dsDNA antibodies were detected by colloidal gold-technique. Results The seropositive rates of AnuA、 anti-cmDNA、 DNP、 dsDNA antibodies and ANA were 68%、 38.4%、 51.2%、 49.6% and 95.2% respectively in SLE patients. They were much higher than those of control groups (P

The relationship between amino-acid motif of HLA-DR?1*04(?chain) and the susceptibility to rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate the susceptibility to rheumatoid arthritis (RA) with HLA- DR?1*04 subtypes.Methods One hundred and thirty-six RA patients and 79 patients with other rheumatic diseases were recruited in this study.HLA typing was performed using high-resolution PCR-SSP DNA techniques.The clinical features and serologic markers between different motifs were analyzed.Results Compared with other rheumatic diseases,the frequency of HLA-DR?1*04 alleles in RA patients was significantly increased(33.8% vs 12.7%)(OR=3.52,95%CI=1.43~5.43,P

DNA-associated autoantibodies to cell membrane for rapid detection of systemic lupus erythematosus / 中华风湿病学杂志

Objective To evaluate the expression of autoantibodies to cell membrane associated with DNA (mDNA) in systemic lupus erythematosus (SLE).The specificity of these antibodies differs from antibodies to double stranded DNA.Method Using indirect immunofluorescence,serum samples were detected giving a characteristic pattern of peripheral membrane fluorescence on cultured HL60.Results This pattern was observed in 81 of 90 serum samplas of SLE patients,but absent in the serum samples of 35 rheumatoid arthritis,31 ankylosing spondylarthritis and 42 blood donors.In 20 Sjgren syndrome′s patients only one showed a positive test.Conclusion This novel rapid immunofluorescence method may serve as an identification test of SLE patients.Due to the sensitivity (90%) and specificity (98 8%),it is better than the other diagnostic tests such as the detection of antibodies to dsDNA and Sm.