I-arthritis ye-rheumatoid iyimithi engapheli, ehlelekile, ehamba ngegazi, uhlobo lokuvuvukala kwe-arthritis . Ayikho ivivinyo elilodwa eliqinisekisa ukutholakala kwamathambo e-rheumatoid arthritis. Lokho kusho ukuthi ukuhlolwa kwegazi kwesifo se-rheumatoid kuphakathi kwezinqubo ezisetshenziselwa ukuxilonga lesi sifo. Isici se-rheumatoid sabonakala kuma-1940. Eminyakeni yamuva, olunye uvivinyo olubizwa ngokuthi i- anti-CCP test (anti-cyclic citrullinated antibody peptide) litholakala ukuthi luwusizo ekuqaleni kwaleso sifo.
I-Autoantibodies Ehlanganiswe Ne-Seropositivity
Isisindo se-rheumatoid i-autoantibody, ngokuvamile i-IgM, ehlangene nesifunda se-Fc se-IgG. Ama-autoantibodies angamaprotheni akhiqizwa amasosha omzimba , kodwa ahlasela ngokungaziphathi izicubu zomzimba kunokuba ahlasele izinto zangaphandle. Ukuba khona komunye noma kokubili kwe-autoantibodies, i-rheumatoid factor, kanye ne-anti-CCP, kubizwa ngokuthi isisindo noma isifo samathambo esiyinkimbinkimbi. Ukungabikho kwe-autoantibodies ezimbili egazini legazi kuyaziwa ngokuthi i-seronegativity noma isifo samathambo esiyingozi se-rheumatoid. Cishe iziguli ezingu-80% ezine-arthritis ye-rheumatoid zine-seropositive ye-rheumatoid factor. Cishe iziguli ezingu-70% ezine-arthritis ye-rheumatoid zine-seropositive ye-anti-CCP.
Umehluko Ezifo Ukukhathazeka
Kuye kwaphakanyiswa, ngokususelwa ekufundeni kwezemitholampilo, ukuthi iziguli ezine-arthritis ye-rheumatoid ye-seropositive zinomkhuhlane omkhulu wesifo nokuguquka kwezifo, kanye nokuhlaselwa okubi nakakhulu kuneziguli ezine-arthritis ye-seronegative.
Kubonakala sengathi lezi ziguli ezinomsoco zidinga ukwelashwa okunamandla, kodwa lowo mbono ubonakala ulula kakhulu. Eqinisweni, ukuhlukaniswa kwezinsizakalo kungase kudukise.
Isiguli esichazwa njenge-seronegative singaba nama-autoantibodies ekuqaleni ayephansi kakhulu kwezinga ukuthi atholakale.
Ngokuyinhloko, ukuhlukaniswa okunembile kwalokhu kuzoba "ukungabonakali noma ukungaqondakali kwenyoka". Kungase kube nezinye izici zokudlala ezisezingeni elingakahlolwa ngazo njalo. Isibonelo, ngaphezu kwe-anti-CCP nesici se-rheumatoid, i-autoantibodies eyaziwa njenge-anti-CarP (iphrotheni elwa ne-carbamylated) ingase ibe khona ngaphambi kokuthi i-arthritis ye-rheumatoid itholakale. I-Anti-CarP ibonakala sengathi ikhona ku-45% weziguli ze-arthritis ze-rheumatoid, kanye neziguli ezingu-16% zezifo zesifo samathambo esingaba nomzimba we-anti-CCP. Ukutholakala kwe-AntiCarP kuthiwa ukubikezela inkambo yesifo esibi kakhulu yesifo samathambo. Ngakho-ke, iziguli ze-seronegative zingase zibe nomsebenzi wezofo noma inkambo yezifo ezinzima njengeziguli eziyisisindo futhi zingaphendula kahle ekwelashweni okunonya (isib. DMARD noma izidakamizwa ze-biologic ).
I-Seropositivity Isungula I-Rheumatoid Arthritis Diagnosis?
Kungenzeka ukuthi ube nomphumela omubi we-factor rheumatoid kanye ne-anti-CCP, kodwa isatholakala ukuthi une-arthritis ye-rheumatoid. Ngokusho kwe-2010 ACR / EULAR I-Score-Based Criteria ye-Rheumatoid Arthritis, inani elingenani okungu-6 kwabangu-10 lihambisana nokuxilongwa kwe-arthritis ye-rheumatoid. Ukubandakanya okuhlangene , ukuhlolwa kwe-serologic, ama-reaction reactants, futhi ubude bezimpawu zitholakala kulolu hlelo lokuhlukanisa.
Ngakolunye uhlangothi, isiguli singase sibe nesisindo se-rheumatoid factor futhi singatholakali sinesifo samathambo. Ezinye izimo ezingase zenzeke nge-rheumatoid factor zifaka:
- Sjogren's syndrome
- I-Systemic lupus erythematosus
- Scleroderma
- I-polymyositis
- Dermatomyositis
- Izifo Ezixubile Ezixhumene Nezifo
- Izifo ezithile
Ama-antibodies e-Anti-CCP azitholakalanga emvamisa enkulu kwezinye izifo. I-Anti-CCP ibhekwa ngokucacile kunesici se-rheumatoid sokuthola i-arthritis ye-rheumatoid.
Imithombo:
Amaprotheni anti-carbamylated (anti-CarP) angaphambi kokuqala kwamathambo e-rheumatoid. Shi J. et al. Ama-Annal of the Rheumatic Diseases. 2014 ngo-Ephreli; 73 (4): 780-3.
http://www.ncbi.nlm.nih.gov/pubmed/24336334
Ukuhlolwa kwe-Anti-CCP yokulwa negciwane njengethuluzi lokuxilonga nokubikezela ku-arthritis ye-rheumatoid. U-Niewold TB et al. QJM. 2007 ngo-Ephreli; 100 (4): 193-201.
http://www.ncbi.nlm.nih.gov/pubmed/17434910
I-arthritis ye-Rheumatoid: I-RA ye-Seronegative neSeopositive: Ehlukile Kodwa Ehlukile? Ajeganova noHuizinga. Ukubuyekeza Kwemvelo Rheumatology. 11, 8-9 (2015).
http://www.nature.com/nrrheum/journal/v11/n1/full/nrrheum.2014.194.html
I-Kelley's Bookbook of Rheumatology. Isahluko 69. I-Etiology ne-Pathogenesis ye-Rheumatoid Arthritis. UGary S. Firestein. Umagazini wesishiyagalolunye.