The Correlation Between Anti-citHSP90 Antibody And Rheumatoid Arthritis With Interstitial Lung Disease

Objective To investigate the clinical correlation between anti-citrullinated heat shock protein 90(cit HSP90)antibody and rheumatoid arthritis with Interstitial Lung Disease(RA-ILD).Methods A total of 208 patients with RA treated in Department of Rheumatology Ningxia Medical University from June 2016 to June 2017 and 40 healthy people were also collected at the same time,general data,laboratory tests are the information should be collected.According to the results of chest CT examination,these patients were divided into RA group,RA combined with ILD group and healthy control group.Among them,104 patients in RA group,104 patients in RA-ILD group and 40 patients in healthy group.The concentration of anti-citHSP90 antibody in three groups was determined by enzyme-linked immunosorbent assay(ELISA).Analyze and compare the results of laboratory tests in each group.Using the single factor analysis,subject working curve(ROC curve)and multivariate logistic regression,to obtain the cutoff value of RA-ILD we used.the accuracy of the diagnosis was evaluated by the area under the ROC curve(AUC),The standard:AUC=0.5 has no diagnostic value;0.5<AUC<0.7 has lower diagnostic accuracy;0.7<AUC<0.9 has moderate diagnostic accuracy;AUC>0.9 has higher accuracy.Results 1.There were 208 patients in the RA group,including the males is 47,and the female is 161,the aged is from 17 to 85 years,and the average aged of(53.77±13.16)years;There were 40 normal controls;According to the results of chest CT,the patients were divided into RA group,RA-ILD group and normal control group.Among them,104 patients in RA group,There were 13 males and 91 females,aged 17-72 years old,average(47.17+12.17)years old;There were 104 patients in theRA-ILD group,34 males and 70 females,aged 25-85 years,with an average of(60.37±10.59)years old.There were 40 normal controls,15 males and 25 females,aged 21-54 years old,average(30.75 ± 6.44)years old.2.There were significant differences in anti-citHS90 antibody levels between RA group,RA-ILD and normal control group(P<0.05).The serum anti-citHS90 antibody level in RA-ILD group was 255.89(125.21,301.97)U/ml,which was significantly higher than in RA group170.52(87.55,262.66)U/ml ? normal control group159.13(102.42,196.83)U/ml(P<0.01);The simple RA group was 170.52(87.55,262.66)U/ml,it was higher than the normal control group of 159.13(102.42,196.83)U/ml,but there was no significant difference between the two groups(P=0.101).3.There was a significant difference between the level of anti-citHS90 in different druations of patients with RA-ILD(P<0.05).There was no significant difference between the level of anti-citHS90 in different druations of patients with RA(P >0.05).4.There was no significant difference between the level of anti-citHS90 in different sex of patients with RA and RA-ILD(P >0.05).5.By drawing the ROC curve,the best cut-off value of anti-citHS90 antibody was 223.47U/ml in RA-ILD,the area under the curve(AUC)was 0.721,the specificity was 90.00%,and the sensitivity was 57.70%,the 95% CI was 0.638-0.804,According to the criteria,0.7<AUC<0.9 is a for a moderate,this show that anti-cit HSP90 antibody important for making a diagnosis for a patient with RA-ILD.6.There were difference between the sex,history of smoking,age,duration of disease,CRP,the level of anti-CCP antibody,the level of RF,the level of AKA of patients used the univariate analysis with RA-ILD and patient with RA(P<0.05),There were no statistical differences of DAS28,ESR,leukocytes,neutrophils,erythrocytes,platelets,C3,C4,IgA,IgG,IgM,ANA(P>0.05).It showed that anti-citHSP90 and age were independent risk factors for RA-ILD by multivariate analysis(P<0.05).Conclusion 1.The level of anti-citHSP90 antibody in serum of RA-ILD patients was significantly increased,it is important for making a diagnosis for a patient with RA-ILD.2.The elderly,anti-citHSP90 antibody level is a high risk factor for RA-ILD.