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Dibrov DA, Avdeeva AS, Diatroptov ME, Nasonov EL. Anti-Carbamylated Protein Antibodies in ACPA-Negative and ACPA-Positive Patients with Rheumatoid Arthritis. DOKL BIOCHEM BIOPHYS 2024; 517:235-242. [PMID: 39002007 DOI: 10.1134/s1607672924700960] [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: 04/12/2024] [Revised: 04/20/2024] [Accepted: 04/20/2024] [Indexed: 07/15/2024]
Abstract
The objective of this study was to assess the level of antibodies to carbamylated proteins and analyze the clinical and immunological associations in patients with ACPA-negative and ACPA-positive variants of rheumatoid arthritis. MATERIALS AND METHODS . The study involved 150 patients with a reliable diagnosis of rheumatoid arthritis and 25 patients as healthy controls. Depending on ACPA values, two groups of patients were recruited: ACPA-positive (n = 75) and ACPA-negative (n = 75). RA activity was assessed by the DAS28 index. Determination of antibodies to carbamylated proteins was performed by enzyme-linked immunosorbent assay (BlueGene Biotech, China). Quantitative determination of ACPA in serum was performed by enzyme immunoassay using a commercial reagent kit (AxisShield, UK; upper limit of normal 5.0 U/mL; Orgentec, Germany; upper limit of normal 20.0 U/mL). RESULTS AND DISCUSSION . Median anti-CarP in patients with RA was 126.2 [100.83; 157.41] ng/mL and was statistically significantly higher (p < 0.001) than in healthy controls (88.89 [70.53; 107.75] ng/mL). Among all patients with RA, 50 (33.3%) were anti-Carp-positive (22 (29.3%) in the ACPA(+) group and 28 (37.3%) in the ACPA(-) group), and one (2%) volunteer from healthy controls was anti-CarP(+) (p = 0.002). In ROC analysis performed to assess the diagnostic significance of anti-CarP for RA for all patients with RA, the area under the curve was 0.783 ± 0.047 with 95% CI: 0.691-0.874 (p < 0.001), with a cut-off point of 143 ng/mL, specificity 96%, sensitivity 36.7%. In the ACPA(+) RA group, the erosion count was statistically significantly higher (p = 0.044) in anti-CarP(+) patients than in anti-CarP(-) patients. A weak direct correlation between anti-CarP and DAS28 was found in the ACPA(-) RA group. CONCLUSIONS . We studied the predictive value of anti-CarP as an auxiliary biomarker in ACPA(+) and ACPA(-) subtypes of RA. ACPA(+) anti-CarP(+) patients have a more "erosive" subtype of the disease than ACPA(+) anti-CarP(-) patients. In ACPA(-) patients, anti-CarP helps to identify a more erosive subtype of the disease, and among ACPA(-) patients it helps to reduce the proportion of seronegative patients. Further studies are required to determine the optimal standards for the laboratory diagnosis of anti-CarP and to clarify the diagnostic potential of these ABs as part of the differential diagnosis of arthritis in other rheumatic diseases.
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Affiliation(s)
- D A Dibrov
- Nasonova Research Institute of Rheumatology, Moscow, Russia.
| | - A S Avdeeva
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - M E Diatroptov
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - E L Nasonov
- Nasonova Research Institute of Rheumatology, Moscow, Russia
- Sechenov First Moscow State Medical University of the Ministry of Health Care of the Russian Federation (Sechenov University), Moscow, Russia
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El Hawary MS, Hassan SA, ELatty SA, Khalil NM. Anti-Carbamylated Protein Antibodies, Tumour Necrosis Factor Alpha and Insulin Resistance in Egyptian Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus. REUMATOLOGIA CLINICA 2022; 18:469-474. [PMID: 36210141 DOI: 10.1016/j.reumae.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/19/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are autoimmune diseases. Premature atherosclerosis and cardiovascular diseases are two of the most important complications of these diseases. Anti-carbamylated protein antibody (Anti-carP Ab) is one of the antibodies which was studied in RA and SLE. In our study, we studied the relation between anti-carP Ab, disease activity and insulin resistance in RA and SLE patients. METHODS 90Patients with SLE and RA were enrolled and subjected to history taking, clinical examination and assessment of disease activity using SLE disease activity index 2000 (SLEDAI-2K) scoring for SLE patients and disease activity score 28 (DAS28-ESR) for RA patients. Samples were examined for complete blood count (CBC), creatinine, inflammatory markers, Tumour necrosis factor alpha (TNF alpha), fasting insulin, fasting blood sugar (FBS), lipid profile and anti-carPAb. HOMA-IR (homeostasis model assessment for insulin resistance) was calculated. RESULTS Patients with RA and SLE showed higher levels of anti-carPAb in comparison with healthy subjects (8.25ng/ml for RA, 7ng/ml for SLE and 0.6ng/ml for healthy subjects with p value <0.001). There was a positive correlation between anti-carPAb and disease activity of RA (p value <0.001) and a positive correlation between anti-carPAb and TNF alpha in RA. In SLE, there was no correlation of anti-carP Ab with disease activity while, HOMA-IR showed a positive correlation with nephritis (p value 0.04). CONCLUSION Anti-carP antibody is a marker of disease activity in RA patients and has high specificity for both RA and SLE detection.
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Affiliation(s)
| | - Sarah A Hassan
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Sahar Abd ELatty
- Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt.
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Li D, Chen P, Dong Q, Liu B, Zhang W, Wei DQ, Guo B. Investigating the stabilisation of IFN-α2a by replica exchange molecular dynamics simulation. J Mol Model 2022; 28:232. [PMID: 35882698 DOI: 10.1007/s00894-022-05212-w] [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: 08/28/2021] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
Abstract
Current biopharmaceutical drugs are mainly a class of peptides or proteins that play an essential role in the treatment of many diseases. Such peptides/proteins are usually thermally unstable and may lose their bioactivity when exposed to ambient conditions. Therefore, they are not suitable for long-term storage. Lyophilisation is the most common method to prolong shelf life of solid peptide/protein drugs; however, the freeze-drying process can lead to irreversible damage. In the present study, human interferon-alpha 2a (IFN-α2a) was selected as a model protein drug; four disaccharides (β-lactose, β-maltose, sucrose, and trehalose) were selected as bioactive protectants. We investigated the effects of different protectants on IFN-α2a under various ambient conditions (vacuum, dry state, and aqueous solution) using replica exchange molecular dynamics simulation. The protective effect of β-maltose on IFN-α2a was the highest in aqueous solution and dry state, β-lactose showed a poor protective effect in all three conditions, the performance of sucrose was good in all conditions, and trehalose showed a better protective effect under vacuum conditions and in aqueous solution. Disaccharides form H-bonds with water, thereby preventing water from the tertiary structure of proteins. Trehalose forms strong H-bonds with water which explains its extraordinary stability.
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Affiliation(s)
- Daixi Li
- Institute of Biothermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, 20093, China.
| | - Peiqin Chen
- Institute of Biothermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, 20093, China
| | - Qingli Dong
- Institute of Biothermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, 20093, China
| | - Baolin Liu
- Institute of Biothermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, 20093, China
| | - Wujie Zhang
- Physics and Chemistry Department, Milwaukee School of Engineering, Milwaukee, WI, 53202, USA
| | - Dong-Qing Wei
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center On Antibacterial Resistances, Joint Laboratory of International Cooperation in Metabolic and Developmental Sciences, Ministry of Education and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China
- Peng Cheng Laboratory, Shenzhen, 518055, China
| | - Baisong Guo
- Injection Laboratory, Shanghai Tofflon Science and Technology Co, Ltd, Shanghai, 201108, China
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El Hawary MS, Hassan SA, ELatty SA, Khalil NM. Anti-Carbamylated Protein Antibodies, Tumour Necrosis Factor Alpha and Insulin Resistance in Egyptian Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus. REUMATOLOGIA CLINICA 2021; 18:S1699-258X(21)00156-X. [PMID: 34266801 DOI: 10.1016/j.reuma.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are autoimmune diseases. Premature atherosclerosis and cardiovascular diseases are two of the most important complications of these diseases. Anti-carbamylated protein antibody (Anti-carP Ab) is one of the antibodies which was studied in RA and SLE. In our study, we studied the relation between anti-carP Ab, disease activity and insulin resistance in RA and SLE patients. METHODS 90Patients with SLE and RA were enrolled and subjected to history taking, clinical examination and assessment of disease activity using SLE disease activity index 2000 (SLEDAI-2K) scoring for SLE patients and disease activity score 28 (DAS28-ESR) for RA patients. Samples were examined for complete blood count (CBC), creatinine, inflammatory markers, Tumour necrosis factor alpha (TNF alpha), fasting insulin, fasting blood sugar (FBS), lipid profile and anti-carPAb. HOMA-IR (homeostasis model assessment for insulin resistance) was calculated. RESULTS Patients with RA and SLE showed higher levels of anti-carPAb in comparison with healthy subjects (8.25ng/ml for RA, 7ng/ml for SLE and 0.6ng/ml for healthy subjects with p value <0.001). There was a positive correlation between anti-carPAb and disease activity of RA (p value <0.001) and a positive correlation between anti-carPAb and TNF alpha in RA. In SLE, there was no correlation of anti-carP Ab with disease activity while, HOMA-IR showed a positive correlation with nephritis (p value 0.04). CONCLUSION Anti-carP antibody is a marker of disease activity in RA patients and has high specificity for both RA and SLE detection.
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Affiliation(s)
| | - Sarah A Hassan
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Sahar Abd ELatty
- Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt.
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Lamacchia C, Courvoisier DS, Jarlborg M, Bas S, Roux-Lombard P, Möller B, Ciurea A, Finckh A, Bentow C, Martinez-Prat L, Mahler M, Gabay C, Nissen MJ. Predictive value of anti-CarP and anti-PAD3 antibodies alone or in combination with RF and ACPA for the severity of rheumatoid arthritis. Rheumatology (Oxford) 2021; 60:4598-4608. [PMID: 33502443 DOI: 10.1093/rheumatology/keab050] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/14/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objective of this study was to analyse the predictive value of anti-carbamylated protein (anti-CarP) and anti-peptidyl-arginine deiminase type-3 (anti-PAD3) antibodies, alone or in combination with RF and ACPA, to identify patients at high risk of developing severe RA outcomes. METHODS Patients within the Swiss Clinical Quality Management registry with a biobank sample were tested for RF, ACPA, anti-CarP, and anti-PAD3 antibodies. We examined the association of each autoantibody with DAS28, HAQ and radiographic damage (Ratingen) at baseline and longitudinally. RESULTS Analyses included 851 established RA patients and 516 disease controls [axial spondyloarthritis (axSpA = 320) and PsA (196)]. Anti-CarP and anti-PAD3 antibodies were, respectively, present in 22.4% and 10.7% of the whole RA population, and in 13.2% and 3.8% of the RF and ACPA double seronegative patients. At baseline, RA patients with anti-PAD3 had higher DAS28 (4.2 vs 3.7; P= 0.005) and significantly more radiographic damage (14.9 vs 8.8; P= 0.02) than anti-PAD3-negative patients. In the ACPA-negative subgroup, baseline Ratingen scores were significantly higher in anti-PAD3-positive patients (P= 0.01). The combination of anti-PAD3, RF IgM, and ACPA was associated with significantly higher baseline radiographic scores than the double seropositive group (P= 0.04). The presence of any two of the previous autoantibodies was associated with significantly greater radiographic progression over 10 years than if all were absent (P= 0.02). There were no differences in RA outcome measures with regards to anti-CarP. CONCLUSIONS Anti-PAD3 antibodies are associated with higher disease activity and joint damage scores in RA patients.
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Affiliation(s)
| | | | | | | | | | - Burkhard Möller
- Department of Rheumatology, Immunology and Allergy, Bern University Hospital, Bern
| | - Adrian Ciurea
- Department of Rheumatology, Zurich University Hospital, Zurich, Switzerland
| | | | - Chelsea Bentow
- Research and Development, Inova Diagnostics, San Diego, CA, USA
| | | | - Michael Mahler
- Research and Development, Inova Diagnostics, San Diego, CA, USA
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O'Neil LJ, Barrera-Vargas A, Sandoval-Heglund D, Merayo-Chalico J, Aguirre-Aguilar E, Aponte AM, Ruiz-Perdomo Y, Gucek M, El-Gabalawy H, Fox DA, Katz JD, Kaplan MJ, Carmona-Rivera C. Neutrophil-mediated carbamylation promotes articular damage in rheumatoid arthritis. SCIENCE ADVANCES 2020; 6:6/44/eabd2688. [PMID: 33115748 PMCID: PMC7608797 DOI: 10.1126/sciadv.abd2688] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/11/2020] [Indexed: 05/22/2023]
Abstract
Formation of autoantibodies to carbamylated proteins (anti-CarP) is considered detrimental in the prognosis of erosive rheumatoid arthritis (RA). The source of carbamylated antigens and the mechanisms by which anti-CarP antibodies promote bone erosion in RA remain unknown. Here, we find that neutrophil extracellular traps (NETs) externalize carbamylated proteins and that RA subjects develop autoantibodies against carbamylated NET (cNET) antigens that, in turn, correlate with levels of anti-CarP. Transgenic mice expressing the human RA shared epitope (HLADRB1* 04:01) immunized with cNETs develop antibodies to citrullinated and carbamylated proteins. Furthermore, anti-carbamylated histone antibodies correlate with radiographic bone erosion in RA subjects. Moreover, anti-carbamylated histone-immunoglobulin G immune complexes promote osteoclast differentiation and potentiate osteoclast-mediated matrix resorption. These results demonstrate that carbamylated proteins present in NETs enhance pathogenic immune responses and bone destruction, which may explain the association between anti-CarP and erosive arthritis in RA.
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Affiliation(s)
- Liam J O'Neil
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Ana Barrera-Vargas
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y de la Nutricion, Salvador Zubiran, Mexico City, Mexico
| | - Donavon Sandoval-Heglund
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Javier Merayo-Chalico
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y de la Nutricion, Salvador Zubiran, Mexico City, Mexico
| | - Eduardo Aguirre-Aguilar
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y de la Nutricion, Salvador Zubiran, Mexico City, Mexico
| | - Angel M Aponte
- Proteomic Core, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yanira Ruiz-Perdomo
- Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Marjan Gucek
- Proteomic Core, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Hani El-Gabalawy
- Manitoba Centre for Proteomics and Systems Biology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - David A Fox
- Division of Rheumatology and Clinical Autoimmunity Center of Excellence, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - James D Katz
- Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mariana J Kaplan
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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