Independent associations of anti-cyclic citrullinated peptide antibodies and rheumatoid factor with radiographic severity of rheumatoid arthritisReportar como inadecuado




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Arthritis Research and Therapy

, 8:R128

First Online: 20 July 2006Received: 26 May 2006Revised: 07 July 2006Accepted: 20 July 2006

Abstract

Several recent publications have established a strong association between anti-cyclic citrullinated peptide antibody anti-CCP-positive rheumatoid arthritis RA and carriage of shared epitope SE alleles. Although anti-CCP have also been associated with more severe RA, the issue of whether this is independent of rheumatoid factor RF has not been addressed. To identify associations between RF, anti-CCP, SE status and radiological damage, we studied a large cross-sectional cohort with longstanding RA. Individuals n = 872 enrolled in the study all fulfilled the American College of Rheumatology criteria for RA, had a minimum disease duration of 3 years, and at least one definite radiographic erosion was present in hands or feet. Radiographs were scored blind at study entry by a single musculoskeletal radiologist using a modified Larsen-s score. Anti-CCP and RF levels were determined using enzyme-linked immunosorbent assay, and DRB1 typing was performed using polymerase chain reaction based methodology. Both anti-CCP and RF levels were strongly associated with radiographic severity P < 0.0001. In subgroups stratified for both anti-CCP and RF status, evidence of independent associations of both antibodies with radiographic outcome was found P < 0.0001. An association of SE alleles with radiographic severity was present only in RF-negative individuals. Anti-CCP positivity was associated with SE status with evidence of a gene-dose effect, most markedly in RF-negative individuals P < 0.01. Anti-CCP and RF status are independent severity factors for RA, with SE alleles playing at most a secondary role. Our data support the view that previously described associations between SE and radiological severity, especially in RF-negative patients, may be indirect and due to an association with anti-CCP.

Abbreviationsanti-CCP= anti-cyclic citrullinated peptide antibody

RA= rheumatoid arthritis

RF= rheumatoid factors

SE= shared epitope.

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Autor: Devesh Mewar - Annabel Coote - David J Moore - Ioanna Marinou - Jodie Keyworth - Marion C Dickson - Doug S Montgomery -

Fuente: https://link.springer.com/







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