呼
吸道和关节炎：根据《关节炎与风湿病》（Arthritis & Rheumatism）期刊发表的一项研究，会引起多个关节发炎和变形的致残疾病风湿性关节炎可能源自肺部。研究人员说，在关节出现炎症前就已经发现病人体内风湿性关节炎抗体水平的提高，这表明风湿性关节炎存在较早的临床前阶段。肺部疾病也与初期风湿性关节炎存在关联。这项研究对来自丹佛和洛杉矶的69名呼吸道异常的患者进行了检查，42人有风湿性关节炎抗体但无关节炎症状，15人无风湿性关节炎抗体也无关节炎症状，12人患有初期风湿性关节炎。所有患者都进行了肺功能检查和肺部CT显像。在肺显像时，50%抗体呈阳性者和53%抗体呈阴性者表示至少有一处关节有疼痛、僵硬和肿胀。在有风湿性关节炎的12人中，三人以往曾被诊断有气喘，三人被诊断有肺气肿。
抗体呈阳性者中有四分之三发现有呼吸道异常，抗体呈阴性者中是三分之一，几乎所有初期风湿性关节炎患者都有呼吸道异常。综合考虑抽烟、关节柔软或肺病史因素后，结果也未受影响。在抗体呈阳性的人群中，有两人在13个月内患上风湿性关节炎。研究人员说，这项研究中所见的呼吸道异常是由于炎症变化引起的。
注意：研究人员并未分析研究对象的肺组织。他们说，风湿性关节炎源自关节以外这一观点目前还只是一个推测。这项研究规模较小。
论文标题：《简报：未患关节炎者的呼吸道异常及风湿性关节炎相关的自身抗体：早期创伤还是自身免疫的启动器？》（Brief Report: Airways abnormalities and rheumatoid arthritis-related autoantibodies in subjects without arthritis: Early injury or initiating site of autoimmunity?）
Ann Lukits
（本文版权归道琼斯公司所有，未经许可不得翻译或转载。）
Rheumatoid arthritis, a disabling disease that can inflame and deform multiple joints, may originate in the lungs, according to research published in Arthritis & Rheumatism. Elevated levels of rheumatoid-arthritis antibodies have been found in patients before the appearance of joint symptoms, suggesting RA has an early preclinical phase, researchers said. Lung disease is also associated with early RA.
The study examined airway abnormalities in 69 patients from Denver and Los Angeles, 42 with RA antibodies and no joint symptoms, 15 with no RA antibodies or joint symptoms, and 12 with early RA. All the participants underwent lung-function testing and CT lung imaging. Pain, stiffness or swelling were reported in at least one joint by 50% of antibody-positive and 53% of antibody-negative subjects at the time of imaging. Of the 12 with RA, three had been previously diagnosed with asthma and three with emphysema.
Airway abnormalities were found in three quarters of the antibody-positive subjects, one third of the antibody-negative subjects, and nearly all the early RA subjects. Adjusting for smoking, joint tenderness, or previous lung disease didn't alter the findings. Of antibody-positive subjects, two developed RA within 13 months. Airway abnormalities seen in the study were due to inflammatory changes, researchers said.
Caveat: Researchers didn't analyze lung tissue from subjects. The concept that RA is generated outside the joints is speculative, they said. The study was small.
Title: Brief Report: Airways abnormalities and rheumatoid arthritis-related autoantibodies in subjects without arthritis: Early injury or initiating site of autoimmunity?
Ann Lukits
The study examined airway abnormalities in 69 patients from Denver and Los Angeles, 42 with RA antibodies and no joint symptoms, 15 with no RA antibodies or joint symptoms, and 12 with early RA. All the participants underwent lung-function testing and CT lung imaging. Pain, stiffness or swelling were reported in at least one joint by 50% of antibody-positive and 53% of antibody-negative subjects at the time of imaging. Of the 12 with RA, three had been previously diagnosed with asthma and three with emphysema.
Airway abnormalities were found in three quarters of the antibody-positive subjects, one third of the antibody-negative subjects, and nearly all the early RA subjects. Adjusting for smoking, joint tenderness, or previous lung disease didn't alter the findings. Of antibody-positive subjects, two developed RA within 13 months. Airway abnormalities seen in the study were due to inflammatory changes, researchers said.
Caveat: Researchers didn't analyze lung tissue from subjects. The concept that RA is generated outside the joints is speculative, they said. The study was small.
Title: Brief Report: Airways abnormalities and rheumatoid arthritis-related autoantibodies in subjects without arthritis: Early injury or initiating site of autoimmunity?
Ann Lukits
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