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van den Beukel MD, van Wesemael TJ, Hoogslag ATW, Borggreven NV, Huizinga TW, van der Helm-van Mil AH, Toes RE, van der Woude D, Trouw LA. Antibodies against advanced glycation end-products and malondialdehyde-acetaldehyde adducts identify a new specific subgroup of hitherto patients with seronegative arthritis with a distinct clinical phenotype and an HLA class II association. RMD Open 2023; 9:e003480. [PMID: 38053459 DOI: 10.1136/rmdopen-2023-003480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE In rheumatoid arthritis (RA) around two-thirds of patients are autoantibody positive for rheumatoid factor, anti-citrullinated protein antibodies and/or anti-carbamylated protein antibodies. The remaining seronegative subgroup of patients is clinically heterogeneous and thus far, biomarkers predicting the disease course are lacking. Therefore, we analysed the value of other autoantibodies in RA directed against malondialdehyde-acetaldehyde adducts (MAA) and advanced glycation end-products (AGE). METHODS In sera of 648 patients with RA and 538 patients without RA from the Leiden Early Arthritis Clinic, anti-MAA and anti-AGE IgG antibody levels were measured using ELISA. Associations between genetic risk factors, acute phase reactants, radiological joint damage, remission and anti-PTM positivity were investigated using regression, correlation and survival analyses. RESULTS Anti-AGE and anti-MAA were most prevalent in RA (44.6% and 46.1% respectively) but were also present in non-RA arthritis patients (32.9% and 30.3% respectively). Anti-AGE and anti-MAA antibodies were associated with HLA-DRB1*03 within seronegative RA (OR=1.98, p=0.003, and OR=2.37, p<0.001, respectively) and, for anti-AGE also in non-RA arthritis patients (OR=2.34, p<0.001). Presence of anti-MAA antibodies was associated significantly with markers of inflammation, erythrocyte sedimentation rate and C reactive protein, in all groups independent of anti-AGE. Interestingly, the presence of anti-AGE and anti-MAA antibodies was associated with radiological progression in patients with seronegative RA, but not evidently with sustained drug-free remission. CONCLUSIONS Anti-AGE and anti-MAA were present in around 45% of RA patients and 30% of non-RA arthritis patients, and although not specific for RA, their presence associated with HLA, inflammation and, for RA, with clinical outcomes especially in patients with seronegative RA.
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Affiliation(s)
| | | | | | | | - Tom Wj Huizinga
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Annette Hm van der Helm-van Mil
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - René Em Toes
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Leendert A Trouw
- Immunology, Leiden University Medical Center, Leiden, The Netherlands
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2
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Amezcua-Guerra LM, Carbonell-Bobadilla N, Soto-Fajardo C, Vargas A, Batres-Marroquín AB, Vargas T, Medina-García AC, Hernández-Diazcouder A, Jiménez-Rojas V, Pineda C, Silveira LH. Influence of anti-carbamylated protein antibodies on disease activity and joint erosions in seronegative and seropositive rheumatoid arthritis. Rheumatol Int 2023; 43:2245-2250. [PMID: 37697044 DOI: 10.1007/s00296-023-05445-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
Anti-carbamylated protein (anti-CarP) antibodies are promising biomarkers in rheumatoid arthritis (RA), although their significance in seronegative disease (SNRA) remains uncertain. To assess the influence of anti-CarP antibodies on disease activity and erosive joint damage in SNRA patients. In RA patients, rheumatoid factor (RF), anti-citrullinated protein antibodies, and anti-CarP antibodies were measured. Disease activity was assessed using DAS28-CRP and SDAI indices, while musculoskeletal ultrasound identified bone erosions. A total of 77 patients were enrolled, comprising 49 with seropositive RA (SPRA) and 28 with SNRA. Notably, 28% of SPRA and 10% of SNRA patients were positive to anti-CarP antibodies. Anti-CarP-positive patients exhibited elevated C-reactive protein (median 10.6, interquartile range 4.6-20.0 vs. 3.4, 1.7-9.9 mg/L; p = 0.005), erythrocyte sedimentation rate (34, 19-46 vs. 16, 7-25 mm/h; p = 0.002), DAS28-CRP (3.2, 2.6-4.2 vs. 2.6, 1.9-3.5; p = 0.048), and SDAI (19.9, 6.3-32.1 vs. 10.9, 5.5-18.1; p = 0.034) indices. Multivariate analysis revealed RF positivity as the sole predictor for anti-CarP antibodies (odds ratio [OR] = 5.9). Musculoskeletal ultrasound revealed bone erosions in 36% of RA patients; 35% among anti-CarP-negative patients and 40% among anti-CarP-positive patients. Notably, RF presence (OR = 44.3) and DAS28-CRP index (OR = 2.4) emerged as predictors of musculoskeletal ultrasound-confirmed erosive joint disease. Anti-CarP antibodies are detected at similar frequencies among both SPRA and SNRA patients. While associated with increased disease activity, these antibodies did not correlate with increased erosive joint damage.
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Affiliation(s)
- Luis M Amezcua-Guerra
- Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
- Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico.
| | | | - Carina Soto-Fajardo
- Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Angelica Vargas
- Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Ana B Batres-Marroquín
- Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
- Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Tania Vargas
- Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Ana C Medina-García
- Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
- Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Adrian Hernández-Diazcouder
- Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Valentin Jiménez-Rojas
- Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Carlos Pineda
- Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Luis H Silveira
- Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
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de Moel EC, Trouw LA, Terao C, Govind N, Tikly M, El-Gabalawy H, Smolik I, Bang H, Huizinga TWJ, Toes REM, van der Woude D. Geo-epidemiology of autoantibodies in rheumatoid arthritis: comparison between four ethnically diverse populations. Arthritis Res Ther 2023; 25:37. [PMID: 36890568 PMCID: PMC9993621 DOI: 10.1186/s13075-023-03009-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/08/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) occurs across the globe in different ethnic populations. Most RA patients harbor anti-modified protein antibodies (AMPA); however, it is unclear whether differences exist in autoantibody responses at different geographic locations and between different ethnic groups, which could provide new clues regarding factors underlying autoantibody development. We therefore investigated AMPA prevalence and association with HLA DRB1 alleles and smoking in four ethnically diverse populations on four different continents. METHODS Anti-carbamylated (anti-CarP), anti-malondialdehyde acetaldehyde (anti-MAA), and anti-acetylated protein antibodies (anti-AcVim) IgG were determined in anti-citrullinated protein antibody-positive Dutch (NL, n = 103), Japanese (JP, n = 174), First Nations Peoples in Canada (FN, n = 100), and black South African (SA, n = 67) RA patients. Ethnicity-matched local healthy controls were used to calculate cut-offs. Risk factors associated with AMPA seropositivity in each cohort were identified using logistic regression. RESULTS Median AMPA levels were higher in First Nations Peoples in Canada and especially South African patients, as reflected by percentage seropositivity: NL, JP, FN, and SA: anti-CarP: 47%, 43%, 58%, and 76% (p < 0.001); anti-MAA: 29%, 22%, 29%, and 53% (p < 0.001); and anti-AcVim: 20%, 17%, 38%, and 28% (p < 0.001). Total IgG levels also differed markedly, and when autoantibody levels were normalized to total IgG, differences between cohorts became less pronounced. Although there were some associations with AMPA and HLA risk alleles and smoking, none was consistent across all four cohorts. CONCLUSIONS AMPA against various post-translational modifications could consistently be detected on different continents across ethnically diverse RA populations. Differences in AMPA levels corresponded to differences in total serum IgG levels. This suggests that, despite differences in risk factors, a common pathway may be involved in AMPA development across geographic locations and ethnicities.
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Affiliation(s)
- Emma C de Moel
- Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Leendert A Trouw
- Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Chikashi Terao
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nimmisha Govind
- Division of Rheumatology, University of the Witwatersrand, Johannesburg, South Africa
| | - Mohammed Tikly
- Division of Rheumatology, University of the Witwatersrand, Johannesburg, South Africa
| | - Hani El-Gabalawy
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Irene Smolik
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | | | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - René E M Toes
- Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Diane van der Woude
- Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands.
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Impact of Posttranslational Modification in Pathogenesis of Rheumatoid Arthritis: Focusing on Citrullination, Carbamylation, and Acetylation. Int J Mol Sci 2021; 22:ijms221910576. [PMID: 34638916 PMCID: PMC8508717 DOI: 10.3390/ijms221910576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/24/2022] Open
Abstract
Rheumatoid arthritis (RA) is caused by prolonged periodic interactions between genetic, environmental, and immunologic factors. Posttranslational modifications (PTMs) such as citrullination, carbamylation, and acetylation are correlated with the pathogenesis of RA. PTM and cell death mechanisms such as apoptosis, autophagy, NETosis, leukotoxic hypercitrullination (LTH), and necrosis are related to each other and induce autoantigenicity. Certain microbial infections, such as those caused by Porphyromonasgingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella copri, can induce autoantigens in RA. Anti-modified protein antibodies (AMPA) containing anti-citrullinated protein/peptide antibodies (ACPAs), anti-carbamylated protein (anti-CarP) antibodies, and anti-acetylated protein antibodies (AAPAs) play a role in pathogenesis as well as in prediction, diagnosis, and prognosis. Interestingly, smoking is correlated with both PTMs and AMPAs in the development of RA. However, there is lack of evidence that smoking induces the generation of AMPAs.
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Abstract
Based on the PubMed data, we have been performing a yearly evaluation of the publications related to autoimmune diseases and immunology to ascertain the relative weight of the former in the scientific literature. It is particularly intriguing to observe that despite the numerous new avenues of immune-related mechanisms, such as cancer immunotherapy, the proportion of immunology manuscripts related to autoimmunity continues to increase and has been approaching 20% in 2019. As in the previous 13 years, we performed an arbitrary selection of the peer-reviewed articles published by the major dedicated Journals and discussed the common themes which continue to outnumber peculiarites in autoimmune diseases. The investigated areas included systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriatic arthritis (PsA), autoantibodies (autoAbs), and common therapeutic avenues and novel pathogenic mechanisms for autoimmune conditions. Some examples include new pathogenetic evidence which is well represented by IL21 or P2X7 receptor (P2X7R) in SLE or the application of single-cell RNA sequencing (scRNA-seq), mass cytometry, bulk RNA sequencing (RNA-seq), and flow cytometry for the analysis of different cellular populations in RA. Cumulatively and of interest to the clinicians, a large number of findings continue to underline the importance of a strict relationship between basic and clinical science to define new pathogenetic and therapeutic developments. The therapeutic pipeline in autoimmunity continues to grow and maintain a constant flow of new molecules, as well illustrated in RA and PsA, and this is most certainly derived from the new basic evidence and the high-throughput tools applied to autoimmune diseases.
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Regueiro C, Casares-Marfil D, Lundberg K, Knevel R, Acosta-Herrera M, Rodriguez-Rodriguez L, Lopez-Mejias R, Perez-Pampin E, Triguero-Martinez A, Nuño L, Ferraz-Amaro I, Rodriguez-Carrio J, Lopez-Pedrera R, Robustillo-Villarino M, Castañeda S, Remuzgo-Martinez S, Alperi M, Alegre-Sancho JJ, Balsa A, Gonzalez-Alvaro I, Mera A, Fernandez-Gutierrez B, Gonzalez-Gay MA, Trouw LA, Grönwall C, Padyukov L, Martin J, Gonzalez A. HLA-B*08 Identified as the Most Prominently Associated Major Histocompatibility Complex Locus for Anti-Carbamylated Protein Antibody-Positive/Anti-Cyclic Citrullinated Peptide-Negative Rheumatoid Arthritis. Arthritis Rheumatol 2021; 73:963-969. [PMID: 33381897 DOI: 10.1002/art.41630] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/23/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Previously, only the HLA-DRB1 alleles have been assessed in rheumatoid arthritis (RA). The aim of the present study was to identify the key major histocompatibility complex (MHC) susceptibility factors showing a significant association with anti-carbamylated protein antibody-positive (anti-CarP+) RA. METHODS Analyses were restricted to RA patients who were anti-cyclic citrullinated peptide antibody negative (anti-CCP-), because the anti-CCP status dominated the results otherwise. Therefore, we studied samples from 1,821 anti-CCP- RA patients and 6,821 population controls from Spain, Sweden, and the Netherlands. The genotypes for ~8,000 MHC biallelic variants were assessed by dense genotyping and imputation. Their association with the anti-CarP status in RA patients was tested with logistic regression and combined with inverse-variance meta-analysis. Significance of the associations was assessed according to a study-specific threshold of P < 2.0 × 10-5 . RESULTS The HLA-B*08 allele and its correlated amino acid variant Asp-9 showed a significant association with anti-CarP+/anti-CCP- RA (P < 3.78 × 10-7 ; I2 = 0). This association was specific when assessed relative to 3 comparator groups: population controls, anti-CarP-/anti-CCP- RA patients, and anti-CCP- RA patients who were positive for other anti-citrullinated protein antibodies. Based on these findings, anti-CarP+/anti-CCP- RA patients could be separated from other antibody-defined subsets of RA patients in whom an association with the HLA-B*08 allele has been previously demonstrated. No other MHC variant remained associated with anti-CarP+/anti-CCP- RA after accounting for the presence of the HLA-B*08 allele. Specifically, the reported association of HLA-DRB1*03 was observed at a level comparable to that reported previously, but it was attributable to linkage disequilibrium. CONCLUSION These results identify HLA-B*08 carrying Asp-9 as the MHC locus showing the strongest association with anti-CarP+/anti-CCP- RA. This knowledge may help clarify the role of the HLA in susceptibility to specific subsets of RA, by shaping the spectrum of RA autoantibodies.
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Affiliation(s)
- Cristina Regueiro
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Karin Lundberg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Rachel Knevel
- Leiden University Medical Center, Leiden, The Netherlands, and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Raquel Lopez-Mejias
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Eva Perez-Pampin
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Triguero-Martinez
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Laura Nuño
- Instituto de Investigación del Hospital Universitario La Paz, Madrid, Spain
| | | | - Javier Rodriguez-Carrio
- University of Oviedo, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Reina Sofía de Investigación Nefrológica, REDinREN del ISCIII, Oviedo, Spain
| | - Rosario Lopez-Pedrera
- Maimonides Institute for Research in Biomedicine of Cordoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | | | - Santos Castañeda
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Sara Remuzgo-Martinez
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Mercedes Alperi
- Hospital Universitario Central de Asturias, and Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | | | - Alejandro Balsa
- Instituto de Investigación del Hospital Universitario La Paz, Madrid, Spain
| | - Isidoro Gonzalez-Alvaro
- Instituto de Investigación Sanitaria la Princesa and Hospital Universitario de la Princesa, Madrid, Spain
| | - Antonio Mera
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Miguel A Gonzalez-Gay
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Caroline Grönwall
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Leonid Padyukov
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Javier Martin
- Instituto de Parasitología y Biomedicina López-Neyra, IPBLN-CSIC, Granada, Spain
| | - Antonio Gonzalez
- Instituto de Investigacion Sanitaria and Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
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Wu CY, Yang HY, Luo SF, Lai JH. From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis. Int J Mol Sci 2021; 22:ijms22020686. [PMID: 33445768 PMCID: PMC7828258 DOI: 10.3390/ijms22020686] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 02/07/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy.
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Affiliation(s)
- Chao-Yi Wu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33303, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Huang-Yu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Shue-Fen Luo
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan;
| | - Jenn-Haung Lai
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan;
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei 114, Taiwan
- Correspondence: ; Tel.: +886-2-8791-8382; Fax: +886-2-8791-8382
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Sundaramurthy S, Jayavel P. A hybrid Grey Wolf Optimization and Particle Swarm Optimization with C4.5 approach for prediction of Rheumatoid Arthritis. Appl Soft Comput 2020. [DOI: 10.1016/j.asoc.2020.106500] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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9
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Zhang Y, Liang Y, Feng L, Cui L. Diagnostic performance of 14-3-3η and anti-carbamylated protein antibodies in Rheumatoid Arthritis in Han population of Northern China. Clin Chim Acta 2020; 502:102-110. [DOI: 10.1016/j.cca.2019.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
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10
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Regueiro C, Rodriguez-Rodriguez L, Lopez-Mejias R, Nuño L, Triguero-Martinez A, Perez-Pampin E, Corrales A, Villalba A, Lopez-Golan Y, Abasolo L, Remuzgo-Martínez S, Ortiz AM, Herranz E, Martínez-Feito A, Conde C, Mera-Varela A, Balsa A, Gonzalez-Alvaro I, González-Gay MÁ, Fernandez-Gutierrez B, Gonzalez A. A predominant involvement of the triple seropositive patients and others with rheumatoid factor in the association of smoking with rheumatoid arthritis. Sci Rep 2020; 10:3355. [PMID: 32098994 PMCID: PMC7042270 DOI: 10.1038/s41598-020-60305-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/07/2020] [Indexed: 01/16/2023] Open
Abstract
The major environmental risk factor for rheumatoid arthritis (RA) is smoking, which according to a widely accepted model induces protein citrullination in the lungs, triggering the production of anti-citrullinated protein antibodies (ACPA) and RA development. Nevertheless, some research findings do not fit this model. Therefore, we obtained six independent cohorts with 2253 RA patients for a detailed analysis of the association between smoking and RA autoantibodies. Our results showed a predominant association of smoking with the concurrent presence of the three antibodies: rheumatoid factor (RF), ACPA and anti-carbamylated protein antibodies (ACarPA) (3 Ab vs. 0 Ab: OR = 1.99, p = 2.5 × 10–8). Meta-analysis with previous data (4491 patients) confirmed the predominant association with the concurrent presence of the three antibodies (3 Ab vs. 0 Ab: OR = 2.00, p = 4.4 ×10–16) and revealed that smoking was exclusively associated with the presence of RF in patients with one or two antibodies (RF+1+2vs. RF−0+1+2: OR = 1.32, p = 0.0002). In contrast, no specific association with ACPA or ACarPA was found. Therefore, these results showed the need to understand how smoking favors the concordance of RA specific antibodies and RF triggering, perhaps involving smoking-induced epitope spreading and other hypothesized mechanisms.
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Affiliation(s)
- Cristina Regueiro
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Luis Rodriguez-Rodriguez
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Raquel Lopez-Mejias
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Laura Nuño
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Ana Triguero-Martinez
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Eva Perez-Pampin
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Alfonso Corrales
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Alejandro Villalba
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Yolanda Lopez-Golan
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Lydia Abasolo
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Sara Remuzgo-Martínez
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Ana M Ortiz
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Eva Herranz
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Ana Martínez-Feito
- Immuno-Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Carmen Conde
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain
| | - Antonio Mera-Varela
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain.,Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alejandro Balsa
- Rheumatology Department, Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Isidoro Gonzalez-Alvaro
- Rheumatology Department, Instituto de Investigación Sanitaria la Princesa, Hospital Universitario de la Princesa (IIS-lP), Madrid, Spain
| | - Miguel Ángel González-Gay
- Valdecilla Biomedical Research Institute, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Benjamín Fernandez-Gutierrez
- Rheumatology Department, Hospital Clínico San Carlos, Instituto Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Antonio Gonzalez
- Experimental and Observational Rheumatology and Rheumatology Unit, Instituto de Investigacion Sanitaria, Hospital Clínico Universitario de Santiago (IDIS), Santiago de Compostela, Spain.
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van Delft MAM, Huizinga TWJ. An overview of autoantibodies in rheumatoid arthritis. J Autoimmun 2020; 110:102392. [PMID: 31911013 DOI: 10.1016/j.jaut.2019.102392] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 12/21/2022]
Abstract
Rheumatoid arthritis (RA) is a systemic auto-immune disease principally effecting synovial joints. RA is characterized by immune cell infiltration in the joint. The presence of autoantibodies is a hallmark for the disease, among these are rheumatoid factor and antibodies against post-translational modified proteins like citrullination (ACPA) and carbamylation (anti-CarP antibodies). These autoantibodies may form immune complexes in the joint, leading to the attraction of immune cells. Based on the presence of these autoantibodies, RA patients can be subdivided in autoantibody positive and negative disease. Both subsets can be associated with genetic and environmental risk factors for RA, like the human leukocyte antigen (HLA) allele and smoking. Autoantibodies can already be detected years before disease onset in a subgroup of patients and at symptom onset a broad isotype spectrum is observed. This suggests that various events occur prior to the development of RA in which the first autoantibodies develop in predisposed individuals. Therefore, the presence of these autoantibodies can be useful in predicting future RA patients. Research on the characteristics and effector function of these autoantibodies is ongoing and will give more knowledge in the inflammatory responses underlying RA. This will give insight in the pathogenic role of autoantibodies in RA. Recent data are suggestive of a role for mucosal surfaces in the development of auto-immune responses associated with (the development of) RA. In conclusion, investigating the potential pathogenic effector functions of autoantibody isotypes and their molecular- and physicochemical-compositions might improve understanding of the disease origin and its underlying immunological processes. This may lead to the development of new therapeutic targets and strategies.
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Affiliation(s)
- Myrthe A M van Delft
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, Amsterdam, the Netherlands.
| | - Tom W J Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
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Elsayed SA, Esmail MA, Ali RM, Mohafez OM. Diagnostic and prognostic value of anti-CarP antibodies in a sample of Egyptian rheumatoid arthritis patients. Clin Rheumatol 2019; 38:2683-2689. [DOI: 10.1007/s10067-019-04616-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/25/2019] [Accepted: 05/16/2019] [Indexed: 12/31/2022]
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