Aktuelle Rheumatologie 2014; 39(01): 42-48
DOI: 10.1055/s-0033-1363973
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Labordiagnostik bei chronisch-entzündlichen rheumatischen Gelenkerkrankungen

Laboratory Diagnostics in Chronic Inflammatory Rheumatic Joint Diseases
E. Feist
1   Medizinische Klinik mit Schwerpunkt für Rheumatologie und klinische Immunologie, Charité – Universitätsmedizin Berlin, Campus Mitte, Berlin
,
T. Häupl
1   Medizinische Klinik mit Schwerpunkt für Rheumatologie und klinische Immunologie, Charité – Universitätsmedizin Berlin, Campus Mitte, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
20 January 2014 (online)

Zusammenfassung

Die Labordiagnostik bietet bei chronisch-entzündlichen rheumatischen Gelenkerkrankungen wichtige Befunde zur Diagnosestellung, Verlaufsbeurteilung und Prognoseabschätzung. Für den Klinker ist die Kenntnis der Vorzüge und Grenzen der einzelnen Laborparameter gleichermaßen wichtig, um diese richtig zu interpretieren. Dieser Artikel gibt einen Überblick zum Einsatz und zur Wertigkeit der Labordiagnostik bei autoimmunen und autoinflammatorischen Gelenkerkrankungen. Dabei wird insbesondere auf den Stellenwert von Entzündungswerten sowie Befunden der Autoantikörper- und Synoviadiagnostik eingegangen.

Abstract

Laboratory diagnostics provide essential results for diagnosis, follow-up assessment and prediction of outcome in chronic inflammatory rheumatic joint disorders. For the clinician, it is essential to know not only the advantages but also the limitations of the respective biomarkers to make a correct interpretation. This article gives an overview on the application and value of laboratory diagnostics in autoimmune and autoinflammatory joint disorders. The main focus is on inflammatory markers, autoantibodies and analysis of synovia.

 
  • Literatur

  • 1 Pincus T, Sokka T. Laboratory tests to assess patients with rheumatoid arthritis: advantages and limitations. Rheum Dis Clin North Am 2009; 35: 731-734 vi-vii
  • 2 Emery P, Gabay C, Kraan M et al. Evidence-based review of biologic markers as indicators of disease progression and remission in rheumatoid arthritis. Rheumatol Int 2007; 27: 793-806
  • 3 Inoue E, Yamanaka H, Hara M et al. Comparison of Disease Activity Score (DAS)28- erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values. Ann Rheum Dis 2007; 66: 407-409
  • 4 Aletaha D, Neogi T, Silman AJ et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569-2581
  • 5 Aletaha D, Neogi T, Silman AJ et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010; 69: 1580-1588
  • 6 Sokka T, Pincus T. Erythrocyte sedimentation rate, C-reactive protein, or rheumatoid factor are normal at presentation in 35%-45% of patients with rheumatoid arthritis seen between 1980 and 2004: analyses from Finland and the United States. J Rheumatol 2009; 36: 1387-1390
  • 7 Egerer K, Feist E, Burmester GR. The serological diagnosis of rheumatoid arthritis: antibodies to citrullinated antigens. Dtsch Arztebl Int 2009; 106: 159-163
  • 8 Feist E, Egerer K, Burmester GR. Autoantibody profile in rheumatoid arthritis. Z Rheumatol 2007; 66: 212-214 6-8
  • 9 Rantapaa-Dahlqvist S, de Jong BA, Berglin E et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 2003; 48: 2741-2749
  • 10 Turesson C, Eberhardt K, Jacobsson LT et al. Incidence and predictors of severe extra-articular disease manifestations in an early rheumatoid arthritis inception cohort. Ann Rheum Dis 2007; 66: 1543-1544
  • 11 Lopez-Longo FJ, Oliver-Minarro D, de la Torre I et al. Association between anti-cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis. Arthritis Rheum 2009; 61: 419-424
  • 12 Avouac J, Gossec L, Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2006; 65: 845-851
  • 13 Nielen MM, van Schaardenburg D, Reesink HW et al. Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum 2004; 50: 380-386
  • 14 Kokkonen H, Mullazehi M, Berglin E et al. Antibodies of IgG, IgA and IgM isotypes against cyclic citrullinated peptide precede the development of rheumatoid arthritis. Arthritis Res Ther 2011; 13: R13
  • 15 Coenen D, Verschueren P, Westhovens R et al. Technical and diagnostic performance of 6 assays for the measurement of citrullinated protein/peptide antibodies in the diagnosis of rheumatoid arthritis. Clin Chem 2007; 53: 498-504
  • 16 Despres N, Boire G, Lopez-Longo FJ et al. The Sa system: a novel antigen-antibody system specific for rheumatoid arthritis. J Rheumatol 1994; 21: 1027-1033
  • 17 Bang H, Egerer K, Gauliard A et al. Mutation and citrullination modifies vimentin to a novel autoantigen for rheumatoid arthritis. Arthritis Rheum 2007; 56: 2503-2511
  • 18 Harre U, Georgess D, Bang H et al. Induction of osteoclastogenesis and bone loss by human autoantibodies against citrullinated vimentin. J Clin Invest 122: 1791-1802
  • 19 Verpoort KN, Cheung K, Ioan-Facsinay A et al. Fine specificity of the anti-citrullinated protein antibody response is influenced by the shared epitope alleles. Arthritis Rheum 2007; 56: 3949-3952
  • 20 Mathsson L, Mullazehi M, Wick MC et al. Antibodies against citrullinated vimentin in rheumatoid arthritis: higher sensitivity and extended prognostic value concerning future radiographic progression as compared with antibodies against cyclic citrullinated peptides. Arthritis Rheum 2008; 58: 36-45
  • 21 Ursum J, Nielen MM, van Schaardenburg D et al. Antibodies to mutated citrullinated vimentin and disease activity score in early arthritis: a cohort study. Arthritis Res Ther 2008; 10: R12
  • 22 Renger F, Bang H, Feist E et al. Immediate determination of ACPA and rheumatoid factor–a novel point of care test for detection of anti-MCV antibodies and rheumatoid factor using a lateral-flow immunoassay. Arthritis Res Ther 12: R120
  • 23 Snijders GF, Broeder AA, Bevers K et al. Measurement characteristics of a new rapid anti-CCP2 test compared to the anti-CCP2 ELISA. Scand J Rheumatol 2008; 37: 151-154
  • 24 Burkhardt H, Sehnert B, Bockermann R et al. Humoral immune response to citrullinated collagen type II determinants in early rheumatoid arthritis. Eur J Immunol 2005; 35: 1643-1652
  • 25 Lundberg K, Kinloch A, Fisher BA et al. Antibodies to citrullinated alpha-enolase peptide 1 are specific for rheumatoid arthritis and cross-react with bacterial enolase. Arthritis Rheum 2008; 58: 3009-3019
  • 26 Sebbag M, Moinard N, Auger I et al. Epitopes of human fibrin recognized by the rheumatoid arthritis-specific autoantibodies to citrullinated proteins. Eur J Immunol 2006; 36: 2250-2263
  • 27 Pratesi F, Tommasi C, Anzilotti C et al. Deiminated Epstein-Barr virus nuclear antigen 1 is a target of anti-citrullinated protein antibodies in rheumatoid arthritis. Arthritis Rheum 2006; 54: 733-741
  • 28 Shi J, Knevel R, Suwannalai P et al. Autoantibodies recognizing carbamylated proteins are present in sera of patients with rheumatoid arthritis and predict joint damage. Proc Natl Acad Sci USA 2011; 108: 17372-17377
  • 29 Feist E, Dorner T. Personalized medicine for rheumatoid arthritis: serological and clinical patient profiles to optimize B and T cell targeted therapy. Z Rheumatol 72: 49-58
  • 30 Lakos G, Soos L, Fekete A et al. Anti-cyclic citrullinated peptide antibody isotypes in rheumatoid arthritis: association with disease duration, rheumatoid factor production and the presence of shared epitope. Clin Exp Rheumatol 2008; 26: 253-260
  • 31 Biljana Smiljanovic BSB, Pade S, Backhaus M et al. Synovial Tissue Transcriptome and Synovial Fluid Proteome have Stronger Discriminatory Power than Serum in Dissecting Inflammation in RA. Ann Rheum Dis 2013; 72 (Suppl. 01) A81, A10.25
  • 32 Taylor W, Gladman D, Helliwell P et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54: 2665-2673
  • 33 Inanc N, Dalkilic E, Kamali S et al. Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 2007; 26: 17-23
  • 34 Candia L, Marquez J, Gonzalez C et al. Low frequency of anticyclic citrullinated peptide antibodies in psoriatic arthritis but not in cutaneous psoriasis. J Clin Rheumatol 2006; 12: 226-229
  • 35 Rudwaleit M, Haibel H, Baraliakos X et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum 2009; 60: 717-727
  • 36 Poddubnyy DA, Rudwaleit M, Listing J et al. Comparison of a high sensitivity and standard C reactive protein measurement in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis. Ann Rheum Dis 69: 1338-1341
  • 37 van der Heijde D, Lie E, Kvien TK et al. ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis 2009; 68: 1811-1818
  • 38 Blachier M, Canoui-Poitrine F, Dougados M et al. Factors associated with radiographic lesions in early axial spondyloarthritis. Results from the DESIR cohort. Rheumatology (Oxford)
  • 39 Poddubnyy D, Haibel H, Listing J et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum 64: 1388-1398
  • 40 Poddubnyy D, Sieper J. Diagnosis and therapy of axial spondyloarthritis including ankylosing spondylitis (Bechterew’s disease). Orthopade 41: 533-538
  • 41 Poddubnyy D, Rudwaleit M, Haibel H et al. Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Ann Rheum Dis 71: 1616-1622
  • 42 Baerlecken NT, Nothdorft S, Stummvoll GH et al. Autoantibodies against CD74 in spondyloarthritis. Ann Rheum Dis
  • 43 Baraliakos X, Baerlecken N, Witte T et al. High prevalence of anti-CD74 antibodies specific for the HLA class II-associated invariant chain peptide (CLIP) in patients with axial spondyloarthritis. Ann Rheum Dis
  • 44 Almeida de Jesus A, Goldbach-Mansky R. Monogenic autoinflammatory diseases: Concept and clinical manifestations. Clin Immunol 147: 155-174
  • 45 Obici L, Merlini G. Amyloidosis in autoinflammatory syndromes. Autoimmun Rev 12: 14-17
  • 46 Kallinich T, Wittkowski H, Keitzer R et al. Neutrophil-derived S100A12 as novel biomarker of inflammation in familial Mediterranean fever. Ann Rheum Dis 69: 677-682
  • 47 Lainka E, Neudorf U, Lohse P et al. Incidence and clinical features of hyperimmunoglobulinemia D and periodic fever syndrome (HIDS) and spectrum of mevalonate kinase (MVK) mutations in German children. Rheumatol Int 32: 3253-3260
  • 48 Simon A, Asli B, Braun-Falco M et al. Schnitzler’s syndrome: diagnosis, treatment, and follow-up. Allergy 68: 562-568
  • 49 Baerlecken NT, Schmidt RE. Adult onset Still’s disease, fever, diagnosis and therapy. Z Rheumatol 71: 174-180
  • 50 Davi S, Consolaro A, Guseinova D et al. An international consensus survey of diagnostic criteria for macrophage activation syndrome in systemic juvenile idiopathic arthritis. J Rheumatol 38: 764-768