Long-term follow-up of patients with anti-cyclic citrullinated peptide antibody-positive connective tissue disease: a retrospective observational study including information on the HLA-DRB1 allele and citrullination dependency

Arthritis Research & Therapy

Motomu Hashimoto¹  Yoshitaka Imura²  Tsuneyo Mimori³  Takeshi Iwasaki³  Hajime Yoshifuji³  Takao Fujii³  Ran Nakashima³  Kosaku Murakami³  Shuichiro Nakabo³  Koichiro Ohmura³  Myrthe A. M. van Delft⁴  Leendert A. Trouw⁴  Kimiko Yurugi⁵  Taira Maekawa⁵  Yasuo Miura⁵  Chikashi Terao⁶  Naoichiro Yukawa⁷ 

[1] Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University;Department of Clinical Immunology and Rheumatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital;Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University;Department of Rheumatology, Leiden University Medical Center;Department of Transfusion Medicine & Cell Therapy, Kyoto University Hospital;Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences;Yukawa Clinic;

关键词: Anti-cyclic citrullinated peptide antibody;    Connective tissue disease;    Rheumatoid arthritis;    Shared epitope;   

DOI  :  10.1186/s13075-020-02351-4

来源: DOAJ

【 摘 要 】

Abstract Background The anti-cyclic citrullinated peptide (CCP) antibody is a diagnostic biomarker of rheumatoid arthritis (RA). However, some non-RA connective tissue disease (CTD) patients also test positive for the anti-CCP antibody and, thus, may ultimately develop RA. We retrospectively investigated whether anti-CCP-positive non-RA CTD patients developed RA and attempted to identify factors that may differentiate RA-overlapping CTD from pure CTD. Methods In total, 842 CTD patients with a primary diagnosis that was not RA were selected from our CTD database as of December 2012. Anti-CCP antibody titers were obtained from a retrospective chart review or measured using stored sera. RA was diagnosed according to the 1987 revised American College of Rheumatology classification criteria. Thirty-three anti-CCP-positive non-RA CTD patients were retrospectively followed up for the development of RA. Bone erosions on the hands and feet were assessed by X-ray. Citrullination dependency was evaluated by an in-house ELISA, the HLA-DRB1 allele was typed, and the results obtained were then compared between RA-overlapping and non-RA anti-CCP-positive CTD patients. Results Two out of 33 anti-CCP-positive CTD patients (6.1%) developed RA during a mean follow-up period of 8.9 years. X-rays were examined in 27 out of the 33 patients, and only one (3.7%) showed bone erosions. The frequency of the HLA-DRB1 shared epitope (SE) and anti-CCP antibody titers were both significantly higher in anti-CCP-positive RA-overlapping CTD patients than in anti-CCP-positive non-RA CTD patients, while no significant differences were observed in citrullination dependency. Conclusions Anti-CCP-positive non-RA CTD patients rarely developed RA. HLA-DRB1 SE and anti-CCP antibody titers may facilitate the differentiation of RA-overlapping CTD from anti-CCP-positive non-RA CTD.

【 授权许可】

Unknown