نقش آنتی بادی Anti-cyclic Citrullinated Peptide از مفصل تا مغز

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار، گروه فارماکولوژی، دانشکده‌ی علوم پزشکی، دانشگاه آزاد اسلامی، واحد نجف‌آباد، اصفهان، ایران

2 دانشیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، مرکز تحقیقات علوم اعصاب و گروه داخلی مغز و اعصاب، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استادیار، گروه روماتولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: آنتی بادی‌های CCP–Anti (Anti-cyclic citrullinated peptide) یکی از شاخص‌ترین و پیش‌بینی کننده‌ترین آزمایش تشخیصی در بیماری آرتریت روماتوئید (RA یا Rheumatoid arthritis) می‌باشد که وجود آن در بیماری‌های مختلفی مانند آرتریت پسوریازیس تا بیماری‌های نورودژنراتیو همچون آلزایمر گزارش شده است. هدف مطالعه‌‌‌ی حاضر، مقایسه‌ی بررسی میزان آنتی بادی Anti-CCP در دو گروه بیماران مبتلا به اختلال حافظه‌ی خفیف و پیشرفته به شکل آلزایمر و همچنین مقایسه‌ی میزان آنتی بادی در بیماران مبتلا به آرتریت روماتوئید (با درجه‌ی خفیف و متوسط) و بیماران مبتلا به آلزایمر بود.روش‌ها: 29 بیمار مبتلا به آلزایمر، 30 مورد بیماران با تشخیص اختلال حافظه‌ی خفیف (MCI یا Mild cognitive impairment)، 44 بیمار با تشخیص آرتریت روماتوئید و 30 نفر از افراد سالم به عنوان گروه شاهد (بعد از تطابق جنس و سن) مورد مطالعه قرار گرفتند. آنتی بادی‌های Anti-CCP به طور کمی به وسیله‌ی یک Solid phase enzyme immunoassay kit اندازه‌گیری شد.یافته‌ها: میزان Anti-CCP (میانگین ± انحراف معیار) به طور قابل ملاحظه‌ای در بین بیماران مبتلا به آلزایمر (6/1 ± 6/13) بالاتر از موارد سالم (1/1 ± 2/4) و بیماران مبتلا به MCI 3/1 ± 8/4 بود (0100/0 = P). در بیماران مبتلا به آلزایمر، سطح سرمی Anti-CCP در 1/32 درصد موارد غیر طبیعی بود. در مقایسه با آن، سطح سرمی Anti-CCP در موارد خفیف و متوسط آرتریت روماتوئید در 5/95 درصد موارد غیر طبیعی بود. میزان تیتر آنتی بادی به شکل معنی‌داری در بیماران مبتلا به آرتریت روماتوئید (8/4 ± 7/54) بالاتر از بیماران مبتلا به آلزایمر (6/1 ± 6/13) بود (0001/0 = P).نتیجه‌گیری: به طور مشخص تیتر Anti-CCP در بیماران مبتلا به آلزایمر کمتر از بیماران مبتلا به آرتریت روماتوئید خفیف می‌باشد و این امر، به طور کامل با توجه به حساسیت و اختصاصیت زیاد این آنزیم در بیماران مبتلا به آرتریت روماتوئید قابل پیش‌بینی است و این نشان می‌دهد که حتی در موارد خفیف تا متوسط در بیماران مبتلا به آرتریت روماتوئید، تیتر این آنتی بادی به عنوان نشانگر تشخیصی، قابلیت کاربرد دارد؛ اما در موارد خفیف اختلال حافظه، میزان تیتر این آنتی بادی تفاوت معنی‌داری با گروه شاهد ندارد. به هر حال، با پیشرفت روند بیماری به شکل آلزایمر، این آنتی بادی به شکل معنی‌داری افزایش یافت.

کلیدواژه‌ها


عنوان مقاله [English]

The Role of Anti-cyclic Citrullinated Peptide Antibody from Joint to Brain

نویسندگان [English]

  • Rokhsareh Meamar 1
  • Mohammadreza Maracy 2
  • Majid Ghasemi 3
  • Mansour Salesi 4
1 Assistant Professor, Department of Pharmacology, School of Medical Sciences, Islamic Azad University, Najafabad Branch, Isfahan, Iran
2 Associate Professor, Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Isfahan Neurosciences Research Center AND Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Anti-cyclic citrullinated peptide (CCP) antibodies are highly specific and predictive for rheumatoid arthritis (RA). Recently, existence of anti-CCP in several other inflammatory conditions from psoriatic arthritis to neurodegenerative disorder like Alzheimer's disease (AD) has been reported. We compared the level of anti-CCP titer between the patients with mild cognitive impairment (MCI) and Alzheimer's disease; then, we compared it between the patients with mild rheumatoid arthritis and Alzheimer's disease.Methods: In this cross-sectional study, 40 patients with rheumatoid arthritis, 29 patients with Alzheimer's disease, 30 patients with mild cognitive impairment and 30 healthy controls were enrolled. Anti-CCP titer was measured by solid phase enzyme immunoassay kit. Statistical analysis was performed using one-way analysis of variance and post-hoc Tukey tests.Findings: Level of anti-CCP titer (mean ± SD) was higher significantly in patients with Alzheimer's disease (13.6 ± 1.6) was higher than healthy subjects (4.2 ± 1.1) and patients with mild cognitive impairment (4.8 ± 1.3) (P = 0.0100 for both). Anti-CCP serum level in 32.1% of patients with Alzheimer's disease and 95.5% of patients with mild rheumatoid arthritis was higher than normal range. In addition, the antibody level was significantly higher in patients with rheumatoid arthritis (54.7 ± 4.8) compared to patients with Alzheimer's disease (P = 0.0001).Conclusion: We obviously observed differences in Anti-CCP titer between patients with Alzheimer's disease and those with mild rheumatoid arthritis. It was expected since anti-CCP has a high specificity for rheumatoid arthritis and become positive in early stages of disease with a high predictive value. However, we found that in early stages of cognitive impairment, we could not use this biomarker as a diagnostic test but during disease progression, a significant difference was observed between patients with mild cognitive impairment and those with Alzheimer's disease. It needs more studies to confirm the role of anti-CCP antibody production in patients with Alzheimer's disease.

کلیدواژه‌ها [English]

  • Anti-cyclic citrullinated peptide (CCP)
  • Arthritis rheumatoid
  • Memory impairment
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