TY - JOUR
T1 - The extent of the anti-citrullinated protein antibody repertoire is associated with arthritis development in patients with seropositive arthralgia
AU - van de Stadt, Lotte A.
AU - van der Horst, Ann R.
AU - de Koning, Margret H. M. T.
AU - Bos, Wouter H.
AU - Wolbink, Gerrit Jan
AU - van de Stadt, Rob J.
AU - Pruijn, Ger J. M.
AU - Dijkmans, Ben A. C.
AU - van Schaardenburg, Dirkjan
AU - Hamann, Dörte
PY - 2011
Y1 - 2011
N2 - OBJECTIVES: /st> To determine the fine specificity of anti-citrullinated protein antibodies (ACPA) in the early phase of arthritis development, the ACPA repertoire in arthralgia patients and the association with arthritis development were studied. METHODS: /st> A total of 244 patients with arthralgia positive for anti-cyclic citrullinated peptide antibodies (aCCPs) and/or IgM rheumatoid factor (IgM-RF), without arthritis were included. Development of arthritis was defined as presence of one or more swollen joints at clinical examination during follow-up. Sera were tested at baseline for reactivity to five citrullinated peptides derived from fibrinogen (three), vimentin (one) and α-enolase (one) and five corresponding arginine peptides in an ELISA. RESULTS: /st> In all, 69 patients (28%) developed arthritis in a median of 3 joints after a median follow-up of 11 (IQR 5-20) months. Reactivity to each peptide was significantly associated with arthritis development (p <0.001). The ACPA repertoire did not differ between patients who did or did not develop arthritis. Among aCCP-positive patients, patients recognising two or more additional citrullinated peptides developed arthritis more often (p=0.04). The number of recognised peptides was positively associated with the aCCP level (p <0.001). Crossreactivity between different peptides was minimal. CONCLUSIONS: /st> Arthritis development is not associated with recognition of a specific citrullinated peptide once joint complaints are present. The ACPA repertoire in some patients with arthralgia is expanded. High aCCP levels are associated with a qualitatively broad ACPA repertoire. Patients with an extended ACPA repertoire have a higher risk of developing arthritis
AB - OBJECTIVES: /st> To determine the fine specificity of anti-citrullinated protein antibodies (ACPA) in the early phase of arthritis development, the ACPA repertoire in arthralgia patients and the association with arthritis development were studied. METHODS: /st> A total of 244 patients with arthralgia positive for anti-cyclic citrullinated peptide antibodies (aCCPs) and/or IgM rheumatoid factor (IgM-RF), without arthritis were included. Development of arthritis was defined as presence of one or more swollen joints at clinical examination during follow-up. Sera were tested at baseline for reactivity to five citrullinated peptides derived from fibrinogen (three), vimentin (one) and α-enolase (one) and five corresponding arginine peptides in an ELISA. RESULTS: /st> In all, 69 patients (28%) developed arthritis in a median of 3 joints after a median follow-up of 11 (IQR 5-20) months. Reactivity to each peptide was significantly associated with arthritis development (p <0.001). The ACPA repertoire did not differ between patients who did or did not develop arthritis. Among aCCP-positive patients, patients recognising two or more additional citrullinated peptides developed arthritis more often (p=0.04). The number of recognised peptides was positively associated with the aCCP level (p <0.001). Crossreactivity between different peptides was minimal. CONCLUSIONS: /st> Arthritis development is not associated with recognition of a specific citrullinated peptide once joint complaints are present. The ACPA repertoire in some patients with arthralgia is expanded. High aCCP levels are associated with a qualitatively broad ACPA repertoire. Patients with an extended ACPA repertoire have a higher risk of developing arthritis
U2 - https://doi.org/10.1136/ard.2010.132662
DO - https://doi.org/10.1136/ard.2010.132662
M3 - Article
C2 - 21062853
SN - 0003-4967
VL - 70
SP - 128
EP - 133
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 1
ER -