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目的比较类风湿关节炎(rheumatoid arthritis,RA)患者血清中抗肽酰基精氨酸脱亚氨酶4(PADI4)抗体水平和其它风湿病组及正常对照组间的差异,以评估其在RA诊断中的价值。方法采用酶联免疫吸附法(enzyme-linked immunosorbentassay,ELISA)检测患者血清中抗PADI4抗体水平,并研究其与RA患者DAS28评分、抗CCP抗体、抗角蛋白抗体(anti-keratinantibody,AKA)、类风湿因子(rheumatoid factor,RF)等指标的相关性。结果RA患者血清中抗PADI4抗体阳性率为47%,明显高于其它风湿性疾病患者和健康对照组(P<0.05)。抗PADI4抗体对RA诊断的敏感性为43%,特异性为92%。相关性分析显示抗PADI4抗体水平与DAS28评分、抗CCP抗体无相关性(r=-0.025,P=0.82;r=-0.058,P=0.60)。RF阴性患者PADI4抗体阳性50%;AKA阴性的患者PADI4抗体阳性43%;抗CCP抗体阴性的患者抗PADI4抗体阳性60%。结论RA患者血清中抗PADI4抗体有较高的诊断价值,特别有助于RF、抗CCP抗体及AKA阴性RA的诊断。PADI4可能是RA的一个致病性抗原并在RA的发病和病理过程中起重要作用。
Objective To compare the serum level of anti-peptidyl arginine deiminase 4 (PADI4) antibody in patients with rheumatoid arthritis (RA) and other rheumatic diseases and normal controls to evaluate its diagnostic value in RA In the value. Methods The levels of anti-PADI4 antibody in sera of patients were detected by enzyme-linked immunosorbentassay (ELISA), and the relationship between them and DAS28 score, anti-CCP antibody, anti-keratinantibody (AKA) Rheumatoid factor (rheumatoid factor, RF) and other indicators of the correlation. Results The positive rate of anti-PADI4 antibody in serum of RA patients was 47%, which was significantly higher than those in other rheumatic diseases patients and healthy controls (P <0.05). Anti-PADI4 antibodies have a sensitivity of 43% for diagnosis of RA with a specificity of 92%. Correlation analysis showed that the level of anti-PADI4 antibody was not correlated with DAS28 score and anti-CCP antibody (r = -0.025, P = 0.82; r = -0.058, P = 0.60). Patients with RF negative had a PADI4 positive of 50%; patients with AKA negative had a positive PADI4 antibody of 43%; anti-CCP negative patients had a positive anti-PADI4 antibody of 60%. Conclusion The serum anti-PADI4 antibodies in RA patients have high diagnostic value, especially for the diagnosis of RF, anti-CCP antibodies and AKA-negative RA. PADI4 may be a pathogenic antigen of RA and plays an important role in the pathogenesis and pathological process of RA.