The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press50810.17650/1818-8338-2022-16-3-K669REVIEWОБЗОРRheumatoid factor and antibodies against cyclic citrullinated peptide in patients without rheumatoid arthritisРевматоидный фактор и антитела к циклическому цитруллинированному пептиду у пациентов без ревматоидного артритаhttps://orcid.org/0000-0002-4728-400XBunchukN. V.БунчукН. В.
Russian Federation

Nikolay Vasil’evich Bunchuk

13 / 5 1st Tverskoy-Yamskoy Pereulok, Moscow 125047, Russia

Николай Васильевич Бунчук

Россия, 125047 Москва, 1‑й Тверской-Ямской пер., 13 / 5

nbunchuk@yandex.ruSesil+ООО «Сесиль+»1507202216325331501202315012023Copyright ©; 2022, Bunchuk N.V.Copyright ©; 2022, Бунчук Н.В.2022Bunchuk N.V.Бунчук Н.В.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/508

A review of data on the possible causes of an increase rheumatoid factor (RF), antibodies against cyclic citrullinated peptide (ACCP) and antibodies to modified citrullinated vimentin (AMCV) in patients without rheumatoid arthritis (RA) is presented. The possibility of hyperproduction of these autoantibodies before the development of the clinical picture of RA was indicated. It is indicated that ACCP and IgA RF have the greatest prognostic value in terms of the subsequent development of RA. These antibodies are recommended to be additionally determined in diagnostically difficult cases. Data on the sensitivity and specificity of detection of RF, ACCP and AMCV in the diagnosis of RA are summarized. The results of detection of the discussed antibodies in various rheumatic (other than RA) and non-rheumatic diseases are presented in detail. Particular attention is paid to diseases in which increased synthesis of RF, ACCP and AMCV may not be accompanied by clear clinical symptoms (Sjögren’s disease, autoimmune thyroiditis, some chronic infections, silicosis, monoclonal gammopathy, etc.). Recommendations are given for examining patients with “accidentally” identified increase in RF or ACCP.

В обзоре представлены данные о возможных причинах повышения уровней ревматоидного фактора (Рф), антител к циклическому цитруллинированному пептиду (АЦЦП) и антител к модифицированному цитруллинированному виментину (АМЦВ) у пациентов с отсутствием ревматоидного артрита (РА). Указано на возможность гиперпродукции этих аутоантител до развития клинической картины РА и наибольшее прогностическое значение АЦЦП и Рф IgA-класса. Именно эти антитела и рекомендуются дополнительно определять в диагностически трудных случаях. Обобщены данные о чувствительности и специфичности выявления Рф, АЦЦП и АМЦВ в диагностике РА. Подробно изложены результаты обнаружения обсуждаемых антител при различных ревматических (помимо РА) и неревматических заболеваниях. Особое внимание уделяется болезням, при которых усиленный синтез Рф, АЦЦП и АМЦВ может не сопровождаться яркими клиническими симптомами (болезнь Шегрена, аутоиммунный тиреоидит, некоторые хронические инфекции, силикоз, моноклональные гаммапатии и др.), и приводятся рекомендации по обследованию пациентов со «случайно» выявленным повышением уровня Рф или АЦЦП.

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