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Secretory anti-citrullinated protein antibodies in serum associate with lung involvement in early rheumatoid arthritis
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- Roos Ljungberg, Karin (author)
- Karolinska Institutet,Linköpings universitet,Uppsala universitet,Centrum för klinisk forskning Dalarna,Linkoping Univ, Dept Rheumatol, Linkoping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland,Uppsala Univ, Sweden
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- Joshua, Vijay (author)
- Karolinska Institutet
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- Skogh, Thomas (author)
- Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland
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- (creator_code:org_t)
- 2019-09-05
- 2020
- English.
- In: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 59:4, s. 852-859
- Journal article (peer-reviewed)
Abstract
Subject headings
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- Objective. A 'mucosal connection' in RA presently attracts increasing attention. We recently described the occurrence of secretory antibodies to citrullinated protein (SC-ACPA) in sera from patients with recent-onset RA. The current study was performed to evaluate possible associations between serum levels of secretory ACPA and signs of lung involvement in patients with early, untreated RA. Methods. One hundred and forty-two RA patients were included as part of the 'LUng Investigation in newly diagnosed RA' study. One hundred and six patients were examined with high-resolution CT (HRCT) and 20 patients underwent bronchoscopy, where bronchial biopsies and bronchoalveolar lavage fluid (BALF) samples were obtained. SC-ACPA in serum and BALF were detected by an enzyme-linked immunoassay. Antibody levels were related to smoking history, pulmonary function, HRCT, BALF cell counts and findings in bronchial biopsies. Results. SC-ACPA occurred in 16% of the serum samples and in 35% of the BALF samples. SC-ACPA levels in serum correlated with SC-ACPA levels in BALF (sigma = 0.50, P = 0.027) and were higher among patients with HRCT parenchymal lung abnormalities (P = 0.022) or bronchiectasis (P = 0.042). Also, ever smoking was more frequent among serum SC-ACPA-positive patients (91% vs 67%, P = 0.023), and the SC-ACPA levels correlated with the number of pack-years (sigma=0.20, P = 0.020). Conclusion. In early, untreated RA, serum levels of SC-ACPA reflect lung involvement in terms of local ACPA levels, smoking and lung abnormalities on HRCT. These findings strengthen the link between mucosal ACPA responses and the lungs in RA.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- rheumatoid arthritis (RA)
- anti-cyclic citrullinated peptide antibodies (ACPA)
- mucosal immunity
- secretory antibodies
Publication and Content Type
- ref (subject category)
- art (subject category)
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- Nyren, Sven
- Svärd, Anna
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