論文 - 杉山　大典

Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis.

Nishimura Kunihiro, Sugiyama Daisuke, Kogata Yoshinori, Tsuji Goh, Nakazawa Takashi, Kawano Seiji, Saigo Katsuyasu, Morinobu Akio, Koshiba Masahiro, Kuntz Karen M., Kamae Isao, Kumagai Shunichi

Annals of Internal Medicine 146 （ 11 ） 797 - 808 2007年06月

ISSN  0003-4819

　概要を見る

<p>Background: Rheumatoid factor (RF) and autoantibodies against cyclic citrullinated peptide (CCP) are markers that might help physicians diagnose rheumatoid arthritis. Purpose: To determine whether anti-CCP antibody more accurately identifies patients with rheumatoid arthritis and better predicts radiographic progression than does RF. Data Sources: MEDLINE through September 2006 and reference lists of retrieved studies and review articles. Study Selection: Studies in any language that enrolled at least 10 participants and that examined the role of anti-CCP antibody and RF in the diagnosis or prognosis of known or suspected rheumatoid arthritis. Data Extraction: Two authors independently evaluated studies for inclusion, rated methodological quality, and abstracted relevant data. Data Synthesis: The DerSimonian-Laird random-effects method was used to summarize sensitivities, specificities, and positive and negative likelihood ratios from 37 studies of anti-CCP antibody and 50 studies of RF. The pooled sensitivity, specificity, and positive and negative likelihood ratios for anti-CCP antibody were 67% (95% CI, 62% to 72%), 95% (CI, 94% to 97%), 12.46 (CI, 9.72 to 15.98), and 0.36 (CI, 0.31 to 0.42), respectively. For IgM RF, the values were 69% (CI, 65% to 73%), 85% (CI, 82% to 88%), 4.86 (CI, 3.95 to 5.97), and 0.38 (CI, 0.33 to 0.44). Likelihood ratios among IgM RF, IgG RF, and IgA RF seemed to be similar. Results from studies of patients with early rheumatoid arthritis were similar to those from all studies. Three of 4 studies found that risk for radiographic progression was greater with anti-CCP antibody positivity than with IgM RF positivity. Limitations: Many studies had methodological limitations. Studies of RF were heterogeneous and had wide ranges of sensitivity and specificity. Conclusions: Anti-CCP antibodies are more specific than RF for diagnosing rheumatoid arthritis and may better predict erosive disease.</p>

Is SS-A/Ro52 a hydrogen peroxide-sensitive signaling molecule?

Nobuhara Yumiko, Kawano Seiji, Kageyama Goichi, Sugiyama Daisuke, Saegusa Jun, Kumagai Shunichi

Antioxidants and Redox Signaling 9 （ 3 ） 385 - 391 2007年03月

ISSN  1523-0864

　概要を見る

<p>SS-A/Ro52 (Ro52) protein is one of the targets of autoantibodies in Sjogren's syndrome and systemic lupus erythematosus. Ro52 structurally belongs to the RING-B-box/coiled-coil family, which appears to carry out diverse functions, but the physiological function of Ro52 remains largely unknown. Here, the authors demonstrate that hydrogen peroxide but not other oxidative stressors induced translocation of Ro52 protein from the cytoplasm to the nucleus and this phenomenon was attenuated by inhibition of MAP kinases, ERK in particular. These findings raise the possibility that SS-A/Ro52 may function as a hydrogen peroxide-selective, oxidative stress-sensitive signaling molecule that is activated via the MAP kinase pathway.</p>

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Usefulness of serum cystatin C for the diagnosis of impaired renal function

Oyabu Chinami, Hayashi Nobuhide, Sugiyama Daisuke, Umezu Mitio, Mukai Masahiko, Kawano Seiji, Kumagai Shunichi

Rinsho byori. The Japanese journal of clinical pathology 54 （ 12 ） 1204 - 1208 2006年12月

ISSN  0047-1860

　概要を見る

<p>Creatinine clearance (Ccr) is generally used as a halmark of glomerular filtration rate (GFR) in clinical medicine. Recently, it has been suggested that serum cystatin C measurement in serum reflects GFR. We compared serum cystatin C, serum creatinine, and serum beta2-microgrobrin in 70 patients with renal diseases in reference to creatinine clearance. The correlation between Ccr and 1/cystatin C was higher (r = 0.830) than that between Ccr and 1/serum creatinine (r = 0.789) or 1/serum beta2-microgroburin (r = 0.732). The levels of serum cystatin C in patients with Ccr ranging from 51 to 70 ml/min were significantly higher than those in patients with Ccr ranging more than 91 ml/min. Receiver-operated characteristic (ROC) analysis revealed that serum cystatin C showed the highest area under the curve among the three when Ccr = 90 ml/min was used as the cutoff point. We conclude that serum cystatin C is more useful than serum creatinine to detect early renal dysfunction.</p>