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Factor reumatoideo, anticuerpos antipéptidos citrulinados y actividad de la enfermedad en pacientes con artritis reumatoidea
Resumen
Introducción: la artritis reumatoidea es una enfermedad inflamatoria crónica y multisistémica de causa autoinmune.Los anticuerpos antipéptidos citrulinados constituyen una herramienta importante para el diagnóstico de esta enfermedad.
Objetivo: determinar la relación de los anticuerpos factor reumatoideo y antipéptidos citrulinados de segunda y tercera generación, con indicadores clÃnicos y serológicos de actividad de la enfermedad en pacientes con artritis reumatoidea establecida.
Material y métodos: participaron 88 pacientes con artritis reumatoidea establecida y se determinaron la proteÃna C reactiva, la velocidad de sedimentación globular, el Ãndice de actividad de la enfermedad basado en el conteo de 28 articulaciones (DAS 28). Los autoanticuerpos factor reumatoideo y antipéptidos citrulinados de segunda y tercera generación se cuantificaron mediante el ensayo de inmunoabsorción ligado a enzimas.
Resultados: se observó asociación entre la positividad de proteÃna C reactiva y la presencia de todos los autoanticuerpos. El factor reumatoideo y los anticuerpos antipéptidos citrulinados mostraron correlación positiva con la velocidad de sedimentación globular y con el DAS 28. Solamente los anticuerpos antipéptidos citrulinados se asociaron con una actividad moderada o alta de la enfermedad.
Conclusiones: los anticuerpos antipéptidos citrulinados de segunda y tercera generación tienen gran valor para la identificación de pacientes con un curso más severo de la enfermedad en la artritis reumatoidea establecida.
Palabras clave: artritis reumatoidea, autoanticuerpos, factor reumatoideo, antipéptidos citrulinados, enfermedad autoinmune, indicadores clÃnicos, indicadores serológicos.
ABSTRACT
Introduction: rheumatoid arthritis is a chronic inflammatory disease, multisystem and with autoimmune cause. Antibodies anti- citrullinated peptides are an important tool for the diagnosis of this disease.
Objective: to determine the relationship of rheumatoid factor, anti-mutated citrullinated vimentin and anti-citrullinated peptides of second and third generation antibodies, with clinical and serological indicators of disease activity in patients with established rheumatoid arthritis.
Material and methods: 88 patients with established rheumatoid arthritis participated in the study and C reactive protein, erythrocyte sedimentation rate, disease activity score based on the count of 28 joints (DAS 28) and autoantibodies were measured. Rheumatoid factor and anti-citrullinated peptides of second and third generation autoantibodies were quantified by enzyme-linked immunosorbent assay.
Results: association between C reactive protein and the presence of all autoantibodies was observed. Rheumatoid factor and anti-citrullinated peptides antibodies of second and third generation showed positive correlation with ESR and DAS 28. Only anti-citrullinated peptide antibodies were associated with a moderate or high disease activity.
Conclusions: anti-citrullinated peptide antibodies of second and third generation are of great value for identifying patients with more severe disease course in established rheumatoid arthritis.
Keys words: rheumatoid arthritis, autoantibodies, rheumatoid factor, anti- citrullinated peptides, autoimmune disease, clinical indicators, serological indicators.
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