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Neue Immundiagnostik bei Arthritiden

Novel immunodiagnostics for inflammatory arthritis

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Zusammenfassung

Die Immundiagnostik von Arthritiden spielt eine wichtige Rolle in der Differenzialdiagnose einer Arthritis, muss aber obligat im klinischen Kontext interpretiert werden. Der Nachweis von Antikörpern (Ak) gegen citrullinierte Proteine hat die Immundiagnostik von Arthritiden wesentlich bereichert, während die Wertigkeit des Rheumafaktors aufgrund der geringeren Spezifität abgenommen hat. Ak gegen carbamylierte bzw. oxidierte Proteine werden die Immundiagnostik der Arthritis, insbesondere der rheumatoiden Arthritis zukünftig erweitern. Demgegenüber spielt die Bestimmung von Zytokinkonzentrationen in Plasma oder Synovia in der Diagnostik von Arthritiden eine eher untergeordnete Rolle. Die indirekte Immunfluoreszenz stellt nach wie vor den Goldstandard in der Detektion von antinukleären Antikörpern (ANA) dar, positive Befunde sollten hinsichtlich der Antigenspezifität weiter untersucht werden. ANA sind nicht obligat mit Autoimmunerkrankungen assoziiert. Beispiele für nichtpathogene ANA sind Anti-DFS70-Ak.

Abstract

Immunodiagnostics play an important role in the differential diagnostics of arthritis but the test results must be interpreted with respect to the clinical context. The detection of antibodies against citrullinated proteins has significantly improved the immunodiagnostics of arthritis, whereas the importance of testing for rheumatoid factor has decreased due to the low specificity. Antibodies against carbamylated or oxidized proteins will expand the immunodiagnostics of arthritis (especially rheumatoid arthritis) in the future. In contrast, the determination of cytokine concentrations in plasma or synovial fluid plays a subordinate role in the differential diagnostics of arthritis. Indirect immunofluorescence continues to be the gold standard in the detection of antinuclear antibodies (ANA) and in the case of positive results further testing for antigen specificity should be carried out. The presence of ANA is not necessarily associated with autoimmune diseases. An example of a non-pathogenic ANA is anti-DFS70 antibodies.

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Literatur

  1. Agmon-Levin N, Damoiseaux J, Kallenberg C et al (2014) International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis 73:17–23

    Article  CAS  PubMed  Google Scholar 

  2. Basu A, Sanchez TW, Casiano CA (2015) DFS70/LEDGFp75: an enigmatic autoantigen at the interface between autoimmunity, AIDS, and cancer. Front Immunol 6:116

    Article  PubMed  PubMed Central  Google Scholar 

  3. Besada E, Nikolaissen C, Nossent H (2012) Should rheumatoid factor in rheumatoid arthritis be sent to Davy Jones’s Locker? Scand J Rheumatol 41:85–88

    Article  CAS  PubMed  Google Scholar 

  4. Bizzaro N, Antico A, Platzgummer S et al (2014) Automated antinuclear immunofluorescence antibody screening: a comparative study of six computer-aided diagnostic systems. Autoimmun Rev 13:292–298

    Article  CAS  PubMed  Google Scholar 

  5. Burgoyne CH, Field SL, Brown AK et al (2008) Abnormal T cell differentiation persists in patients with rheumatoid arthritis in clinical remission and predicts relapse. Ann Rheum Dis 67:750–757

    Article  CAS  PubMed  Google Scholar 

  6. Burska A, Boissinot M, Ponchel F (2014) Cytokines as biomarkers in rheumatoid arthritis. Mediators Inflamm 2014:545493

    PubMed  PubMed Central  Google Scholar 

  7. Cantagrel A, Degboe Y (2016) New autoantibodies associated with rheumatoid arthritis recognize posttranslationally modified self-proteins. Jt Bone Spine 83:11–17

    Article  CAS  Google Scholar 

  8. Fabris M, Zago S, Tosolini R et al (2014) Anti-DFS70 antibodies: a useful biomarker in a pediatric case with suspected autoimmune disease. Pediatrics 134:e1706–e1708

    Article  PubMed  Google Scholar 

  9. Finckh A (2009) Early inflammatory arthritis versus rheumatoid arthritis. Curr Opin Rheumatol 21:118–123

    Article  PubMed  Google Scholar 

  10. Girbal-Neuhauser E, Durieux JJ, Arnaud M et al (1999) The epitopes targeted by the rheumatoid arthritis-associated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro)filaggrin by deimination of arginine residues. J Immunol 162:585–594

    CAS  PubMed  Google Scholar 

  11. Jesus AA, Jacob CM, Silva CA et al (2011) Common variable immunodeficiency associated with hepatosplenic T‑cell lymphoma mimicking juvenile systemic lupus erythematosus. Clin Dev Immunol 2011:428703

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kaltenhäuser S, Pierer M, Arnold S et al (2007) Antibodies against cyclic citrullinated peptide are associated with the DRB1 shared epitope and predict joint erosion in rheumatoid arthritis. Rheumatology 46:100–104

    Article  PubMed  Google Scholar 

  13. Klareskog L, Ronnelid J, Lundberg K et al (2008) Immunity to citrullinated proteins in rheumatoid arthritis. Annu Rev Immunol 26:651–675

    Article  CAS  PubMed  Google Scholar 

  14. Lee YH, Bae SC, Song GG (2015) Diagnostic accuracy of anti-MCV and anti-CCP antibodies in rheumatoid arthritis: A meta-analysis. Z Rheumatol 74:911–918

    Article  CAS  PubMed  Google Scholar 

  15. Mahler M, Meroni PL, Andrade LE et al (2016) Towards a better understanding of the clinical association of anti-DFS70 autoantibodies. Autoimmun Rev 15:198–201

    Article  CAS  PubMed  Google Scholar 

  16. Newkirk MM (2002) Rheumatoid factors: host resistance or autoimmunity? Clin Immunol 104:1–13

    Article  CAS  PubMed  Google Scholar 

  17. Nicaise-Roland P, Nogueira L, Demattei C et al (2013) Autoantibodies to citrullinated fibrinogen compared with anti-MCV and anti-CCP2 antibodies in diagnosing rheumatoid arthritis at an early stage: data from the French ESPOIR cohort. Ann Rheum Dis 72:357–362

    Article  PubMed  Google Scholar 

  18. Priori R, Colafrancesco S, Alessandri C et al (2014) Interleukin 18: a biomarker for differential diagnosis between adult-onset Still’s disease and sepsis. J Rheumatol 41:1118–1123

    Article  CAS  PubMed  Google Scholar 

  19. Pruijn GJ (2015) Citrullination and carbamylation in the pathophysiology of rheumatoid arthritis. Front Immunol 6:192

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rantapäa-Dahlqvist S, Jong BA De, Berglin E et al (2003) Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 48:2741–2749

    Article  PubMed  Google Scholar 

  21. Trouw LA, Mahler M (2012) Closing the serological gap: promising novel biomarkers for the early diagnosis of rheumatoid arthritis. Autoimmun Rev 12:318–322

    Article  CAS  PubMed  Google Scholar 

  22. Wild N, Karl J, Grunert VP et al (2008) Diagnosis of rheumatoid arthritis: multivariate analysis of biomarkers. Biomarkers 13:88–105

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Sektion Rheumatologie und Klinische Immunologie, III. Medizinische Klinik, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland

    M. Wahle

  2. Institut für Labormedizin und Mikrobiologie, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland

    E. Kling

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  1. M. Wahle
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Correspondence to M. Wahle.

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Interessenkonflikt

M. Wahle und E. Kling geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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M. Fleck, Bad Abbach

T. Dörner, Berlin

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Wahle, M., Kling, E. Neue Immundiagnostik bei Arthritiden. Z Rheumatol 75, 361–366 (2016). https://doi.org/10.1007/s00393-016-0090-6

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  • DOI: https://doi.org/10.1007/s00393-016-0090-6

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