Presence and utility of IgA-class antibodies to cyclic citrullinated peptides in early rheumatoid arthritis: the Swedish TIRA project

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Svärd, AnnaLinköpings universitet,Reumatologi,Hälsouniversitetet (författare)

Presence and utility of IgA-class antibodies to cyclic citrullinated peptides in early rheumatoid arthritis : the Swedish TIRA project

Artikel/kapitelEngelska2008

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Springer Science and Business Media LLC,2008
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LIBRIS-ID:oai:DiVA.org:liu-44398
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-44398URI
https://doi.org/10.1186/ar2449DOI

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Språk:engelska
Sammanfattning på:engelska

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IntroductionThe present study was carried out to assess whether IgA-class antibodies against cyclic citrullinated peptides (IgA anti-CCP) in recent-onset rheumatoid arthritis add diagnostic and/or prognostic information to IgG anti-CCP analysis.MethodsSerum samples were obtained from 228 patients with recent-onset (<12 months) rheumatoid arthritis at the time of inclusion in the Swedish TIRA cohort (Swedish Early Intervention in Rheumatoid Arthritis). Sera from 72 of these patients were also available at the 3-year follow-up. Disease activity and functional ability measures (erythrocyte sedimentation rate, serum C-reactive protein, 28-joint count Disease Activity Score, physician's assessment of disease activity, and the Swedish version of the Health Assessment Questionnaire) were registered at inclusion and at regular follow-ups during 3 years. An IgA anti-CCP assay was developed based on the commercially available IgG-specific enzyme immunoassay from EuroDiagnostica (Arnhem, the Netherlands), replacing the detection antibody by an anti-human-IgA antibody. A positive IgA anti-CCP test was defined by the 99th percentile among healthy blood donors.ResultsAt baseline, a positive IgA anti-CCP test was observed in 29% of the patient sera, all of which also tested positive for IgG anti-CCP at a higher average level than sera containing IgG anti-CCP alone. The IgA anti-CCP-positive patients had significantly higher disease activity over time compared with the IgA anti-CCP-negative patients. After considering the IgG anti-CCP level, the disease activity also tended to be higher in the IgA anti-CCP-positive cases – although this difference did not reach statistical significance. The proportion of IgA anti-CCP-positive patients was significantly larger among smokers than among nonsmokers.ConclusionAnti-CCP antibodies of the IgA class were found in about one-third of patients with recent-onset rheumatoid arthritis, all of whom also had IgG anti-CCP. The occurrence of IgA-class antibodies was associated with smoking, and IgA anti-CCP-positive patients had a more severe disease course over 3 years compared with IgA anti-CCP-negative cases. Although IgA anti-CCP analysis does not seem to offer any diagnostic information in addition to IgG anti-CCP analysis, further efforts are justified to investigate the prognostic implications.

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Kastbom, Alf,1978-Linköpings universitet,Reumatologi,Hälsouniversitetet(Swepub:liu)alfka05 (författare)
Reckner Olsson, Åsa,1965-Linköpings universitet,Reumatologi,Hälsouniversitetet(Swepub:liu)asaol92 (författare)
Skogh, Thomas,1952-Linköpings universitet,Reumatologi,Hälsouniversitetet(Swepub:liu)thosk00 (författare)
Linköpings universitetReumatologi (creator_code:org_t)

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Ingår i:Arthritis Research & Therapy: Springer Science and Business Media LLC10:41478-63621478-6354

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Av författaren/redakt...: Svärd, Anna; Kastbom, Alf, 19 ...; Reckner Olsson, ...; Skogh, Thomas, 1 ...

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Av lärosätet: Linköpings universitet

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