I-rheumatoid arthritis yindlela engapheliyo, indlela yokuziphatha, i-autoimmune, uhlobo lokuvuvukala lwe-arthritis . Akukho vavanyo olulodwa oluqinisekisa ukuxilongwa kwe-rheumatoid arthritis. Oko kwathiwa, uvavanyo lwegazi lwe- rheumatoid liphakathi kweendlela ezichongiweyo zesifo. Isixhobo se-Rheumatoid sachongwa kwii-1940. Kwiminyaka yakutshanje, olunye uvavanyo olubizwa ngokuba luvavanyo lwe- anti-CCP (anti-cyclic citrullinated peptide antibody) lufunyenwe luluncedo ekuqaleni kweso sifo.
I-Autoantibodies ezixhaswe noSeropositivity
I-rheumatoid factor is autoantibody, ngokuqhelekileyo i-IgM, ebopha kwi-Fc esifundeni se-IgG. I-Autoantibodies iiprotheni eziveliswa ngamajoni omzimba , kodwa zihlasela ngokungafanelekileyo izicubu zomzimba kunokuba zihlasele izinto zangaphandle. Ubukho bomntu omnye okanye zombini we-autoantibodies, i-rheumatoid factor, kunye ne-anti-CCP, ibhekiselwa ekubeni yi-seropositivity okanye isifo se-rheumatoid arthritis. Ukungabikho kweemoto ezinamanzi ezimbini kwigazi le-peripheral kuthiwa yi-seronegativity okanye i-rheumatoid arthritis. Phantse i-80% yezigulane ezine-arthritis ye-rheumatoid iseropositive kwi-rheumatoid factor. Phantse i-70% yezigulane ezine-arthritis ye-rheumatoid iseropositive for anti-CCP.
Umehluko kwiZifo ezinzima
Kuye kucetyiswa, ngokusekelwe kwizifundo zekliniki, ukuba izigulane ezine-arthritis zesifo se-rheumatoid zinesifo esikhulu sokukhula kwesifo kunye nokunyuka kwesifo, kunye nokuhlaselwa kwesifo esingakumbi kunezigulane ezine-rheumatoid arthritis.
Kuya kubonakala ngathi izigulane ezinomsoco zifuna unyango olungakumbi, kodwa loo mbono ibonakala ilula. Enyanisweni, ukuhlelwa kwe-seronegativity kungakhohlisa.
Isigulane esichazwe njenge-seronegative sinokukwazi ukuba ne-autoantibodies ekuqaleni ephantsi kakhulu kwinqanaba ukuba lifumaneke.
Okubalulekileyo, udidi oluchanekileyo lwalo luya kuba "olungabonakaliyo okanye olungafunyanwa yintsapho". Kukho nokuba kukho ezinye i-autoantibodies ekudlaleni ezingakhange zihlolwe rhoqo. Ngokomzekelo, ukongeza kwi-anti-CCP kunye ne-rheumatoid factor, i-autoantibodies eyaziwa njenge-anti-CarP (iprotheni ephikisayo) ingaba yiminyaka ngaphambi kokuba i-rhumatoid arthritis ifumaneke. I-Anti-CarP ibonakala ikhona kwi-45% yezigulane ze-rheumatoid arthritis, kunye ne-16% yezigulane ze-rheumatoid arthritis ezingenayo i-anti-CCP. Ubungqina be-AntiCarP kuthiwa liqikelele inkqubo yesifo esibi kakhulu yesifo se-rheumatoid arthritis. Ngenxa yoko, izigulane ze-seronegative zingaba nomsebenzi wesifo okanye isifundo sezifo ezinzima njengezigulane ezinomdla kwaye ziyakwazi ukuphendula kakuhle kwizonyango (umz., I- DMARD okanye iziyobisi ze-biologic ).
Ngaba i-Seropositivity isungula i-Rheumatoid Arthritis Diagnosis?
Kunokwenzeka ukuba ube nomphumo omubi we-rheumatoid factor kunye ne-anti-CCP, kodwa ufumaneka ukuba une-arthritis ye-rheumatoid. Ngokwe-2010 ACR / EULAR Impendulo-Based Based Criteria ye-Rheumatoid Arthritis, amanqaku angama-6 kwabangu-10 ahambelana nokuxilongwa kwe-rheumatoid arthritis. Ukubandakanya ngokuhlangeneyo , ukuvavanywa kwe-serologic, ama-reaction reactors, kunye nobude beempawu zonke zifunyenwe kule nkqubo yokuhlelwa.
Ngokuchasene, isigulane sinokuthi sibe nesimo esihle sengqondo se-rheumatoid kwaye singafumaneki ukuba sinesifo se-rheumatoid arthritis. Ezinye iimeko ezinokuthi zenzeke kwi-rheumatoid factor ziquka:
- Sjogren's syndrome
- Systemic lupus erythematosus
- Scleroderma
- Polymyositis
- Dermatomyositis
- Izifo ezixubileyo zeTissue Tissue
- Ezinye izifo
Amanqindi e-anti-CCP afunyananga kwixesha elininzi kwezinye izifo. I-Anti-CCP ithathwa ngokungakumbi kunokwakheka kwe-rheumatoid yokufumana isifo se-rheumatoid arthritis.
Imithombo:
Iiprotheni eziphambene ne-carbamylated (anti-CarP) zandulela ukuqala kwesifo se-rheumatoid arthritis. Shi J. et al. Iziganeko zeeRheumatic Diseases. 2014 Ngo-Apreli; 73 (4): 780-3.
http://www.ncbi.nlm.nih.gov/pubmed/24336334
Uvavanyo lwe-anti-CCP lokukhusela i-antibody njenge-diagnostic and prognostic kwisixhobo se-rheumatoid arthritis. Niewold TB kunye al. QJM. 2007 ngo-Ephreli; 100 (4): 193-201.
http://www.ncbi.nlm.nih.gov/pubmed/17434910
I-Rheumatoid Arthritis: I-Seronegative kunye ne-Seropositive RA: Ingafani Kodwa Ihlukile? Ajeganova no Huizinga. Uhlolo Lwemvelo Rheumatology. 11, 8-9 (2015).
http://www.nature.com/nrrheum/journal/v11/n1/full/nrrheum.2014.194.html
I-Kelley's Bookbook yeRheumatology. Isahluko 69. I-Etiology ne-Pathogenesis ye-Rheumatoid Arthritis. UGary S. Firestein. I-ninth edition.