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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Arthritis+Res+Ther
2016 ; 18
(1
): 127
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Antibodies directed against endogenous and exogenous citrullinated antigens
pre-date the onset of rheumatoid arthritis
#MMPMID27255888
Johansson L
; Pratesi F
; Brink M
; Ärlestig L
; D'Amato C
; Bartaloni D
; Migliorini P
; Rantapää-Dahlqvist S
Arthritis Res Ther
2016[Jun]; 18
(1
): 127
PMID27255888
show ga
BACKGROUND: Anti-citrullinated-peptide antibodies (ACPA) have been detected in
individuals with developing rheumatoid arthritis (RA) before the onset of
symptom, with an initially limited spectrum of reactivities that gradually
broadens. The aim was to analyze the evolution of ACPA response pre-dating
symptom onset, using four selected citrullinated exogenous and endogenous
antigens. METHODS: A cohort of 521 individuals sampled before symptoms of RA
appeared and 272 population controls were identified from the Biobank of Northern
Sweden; 241 samples from patients with early RA were also collected. ACPA were
detected by ELISA on viral citrullinated peptides (VCP) derived from
Epstein-Barr-virus nuclear antigen (EBNA)1 and EBNA2 (VCP1 and VCP2) and
histone-4-derived citrullinated peptides (HCP1 and HCP2). RESULTS: In
pre-symptomatic individuals vs. patients with early RA, anti-VCP1 antibodies were
detected in 10.4 % vs. 36.1 %, anti-VCP2 in 17.1 % vs. 52.3 %, anti-HCP1 in
10.2 % vs. 37.3 %, and anti-HCP2 in 16.3 % vs. 48.5 %, respectively. Anti-VCP and
anti-HCP concentrations were significantly increased in pre-symptomatic
individuals vs. controls (p?0.001) and were increased approaching symptom
onset. Anti-VCP and anti-HCP appeared simultaneously (median (IQR) 5.3 (6) years
before symptom onset) and in combination yielded a high-risk ratio for disease
development (OR?=?8.0-18.9). Anti-VCP2 and anti-HCP2 antibodies were associated
with HLA-DRB1*0401 in pre-symptomatic individuals. Three peptidylarginine
deiminase (PAD)I3/PADI4 single nucleotide polymorphisms (SNPs) were significantly
associated with anti-HCP1. CONCLUSIONS: Anti-VCP and anti-HCP antibodies pre-date
symptom onset and predict disease development, but no hierarchy of citrullinated
epitopes can be identified. These results suggest that no inciting citrullinated
antigen so far described is common to all patients with RA. The association
between PADI3/PADI4 polymorphism and anti-HCP1 antibodies suggests a novel link
between deimination and production of ACPA.