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Infantino M, Palterer B, Benucci M, Grossi V, Pancani S, Manfredi M, Bizzaro N. Testing for isotypes does not help differentiating rheumatoid arthritis from other rheumatoid factor positive diseases. Immunol Res 2023; 71:883-886. [PMID: 37322352 DOI: 10.1007/s12026-023-09402-3] [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: 04/11/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
Rheumatoid factors (RFs) are useful for diagnosis and classification of rheumatoid arthritis (RA). Nephelometric and turbidimetric techniques, which detect total RF but do not reveal the antibody isotype, are common diagnostic methods in clinical routine. Given the recent development of isotype-specific immunoassays, the detection of IgG, IgM, and IgA RFs represents an interesting challenge. The aim of the study was to evaluate whether specific RF tests performed as a second step after traditional nephelometry could help differentiating RA from other RF-positive diseases. We tested 117 consecutive serum samples that were RF-positive at nephelometry (BNII nephelometric analyzer, Siemens) for IgA, IgG, and IgM RF isotypes by a fluoroimmunoenzymatic assay (FEIA) on the Phadia 250 instrument (ThermoFisher). Fifty-five subjects had RA and 62 presented non-RA diagnoses. Eighteen sera (15.4%) were positive only by nephelometry, two were positive only for IgA RF, and the remaining 97 sera were all positive for IgM RF isotype (with or without IgG and IgA RF). Positive findings did not correlate with RA or non-RA diagnosis. Spearman rho correlation coefficient between nephelometric total RF and IgM isotype was moderate (0.657), and weak between total RF and IgA (0.396) and IgG (0.360) isotypes. Despite its low specificity, measurement of total RF by nephelometry still seems to be the method that performs best. As IgM, IgA, and IgG RF isotypes showed only a moderate correlation with total RF measurement, their diagnostic use as a second level test remains controversial.
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Affiliation(s)
- Maria Infantino
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Via Torregalli, 3, 50143, Firenze, Italy.
| | - Boaz Palterer
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Firenze, Italy
| | | | - Valentina Grossi
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Via Torregalli, 3, 50143, Firenze, Italy
| | | | - Mariangela Manfredi
- Laboratorio di Immunologia e Allergologia, Ospedale S. Giovanni di Dio, Via Torregalli, 3, 50143, Firenze, Italy
| | - Nicola Bizzaro
- Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata, Udine, Italy
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Arleevskaya MI, Larionova RV, Shagimardanova EI, Gogoleva NE, Kravtsova OA, Novikov AA, Kazarian GG, Carlé C, Renaudineau Y. Predictive risk factors before the onset of familial rheumatoid arthritis: the Tatarstan cohort study. Front Med (Lausanne) 2023; 10:1227786. [PMID: 37877020 PMCID: PMC10593450 DOI: 10.3389/fmed.2023.1227786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/14/2023] [Indexed: 10/26/2023] Open
Abstract
Background A familial history of rheumatoid arthritis (RA) predisposes an individual to develop RA. This study aimed at investigating factors associated with this conversion from the Tatarstan cohort. Methods A total of 144 individuals, referred to as pre-RA and at risk for familial RA, were selected 2 years (range: 2-21 years) before conversion to RA and compared to non-converted 328 first-degree relatives (FDR) from RA as assessed after ≥2 years follow-up, and 355 healthy controls were also selected (HC). Preclinical parameters and socio-demographic/individual/HLA genetic factors were analyzed when data were available at the time of enrollment. Results As compared to FDR and HC groups, pre-RA individuals were characterized before conversion to RA by the presence of arthralgia, severe morning symptoms, a lower educational level, and rural location. An association with the HLA-DRB1 SE risk factor was also retrieved with symmetrical arthralgia and passive smoking. On the contrary, alcohol consumption and childlessness in women were protective and associated with the HLA-DRB1*07:01 locus. Conclusion Before RA onset, a combination of individual and genetic factors characterized those who are at risk of progressing to RA among those with familial RA relatives.
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Affiliation(s)
- Marina I. Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Regina V. Larionova
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Elena I. Shagimardanova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Natalia E. Gogoleva
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Olga A. Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Andrej A. Novikov
- Innovation Department, Sobolev Institute of Mathematics, Siberian Brunch of Russian Academy of Science, Novosibirsk, Russia
- Immunology Department Laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, Toulouse, France
- INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | | | - Caroline Carlé
- Immunology Department Laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, Toulouse, France
- INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | - Yves Renaudineau
- Immunology Department Laboratory, Institut Fédératif de Biologie, Toulouse University Hospital Center, Toulouse, France
- INFINITy, Toulouse Institute for Infectious and Inflammatory Diseases, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
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3
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Grąźlewska W, Holec-Gąsior L. Antibody Cross-Reactivity in Serodiagnosis of Lyme Disease. Antibodies (Basel) 2023; 12:63. [PMID: 37873860 PMCID: PMC10594444 DOI: 10.3390/antib12040063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
Lyme disease is a tick-borne disease caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex. The disease is characterized by a varied course; therefore, the basis for diagnosis is laboratory methods. Currently, a two-tiered serological test is recommended, using an ELISA as a screening test and a Western blot as a confirmatory test. This approach was introduced due to the relatively high number of false-positive results obtained when using an ELISA alone. However, even this approach has not entirely solved the problem of false-positive results caused by cross-reactive antibodies. Many highly immunogenic B. burgdorferi s.l. proteins are recognized nonspecifically by antibodies directed against other pathogens. This also applies to antigens, such as OspC, BmpA, VlsE, and FlaB, i.e., those commonly used in serodiagnostic assays. Cross-reactions can be caused by both bacterial (relapsing fever Borrelia, Treponema pallidum) and viral (Epstein-Baar virus, Cytomegalovirus) infections. Additionally, a rheumatoid factor has also been shown to nonspecifically recognize B. burgdorferi s.l. proteins, resulting in false-positive results. Therefore, it is necessary to carefully interpret the results of serodiagnostic tests so as to avoid overdiagnosis of Lyme disease, which causes unnecessary implementations of strong antibiotic therapies and delays in the correct diagnosis.
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Affiliation(s)
| | - Lucyna Holec-Gąsior
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdansk University of Technology, 80-233 Gdansk, Poland;
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Carlé C, Degboe Y, Ruyssen-Witrand A, Arleevskaya MI, Clavel C, Renaudineau Y. Characteristics of the (Auto)Reactive T Cells in Rheumatoid Arthritis According to the Immune Epitope Database. Int J Mol Sci 2023; 24:ijms24054296. [PMID: 36901730 PMCID: PMC10001542 DOI: 10.3390/ijms24054296] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
T cells are known to be involved in the pathogenesis of rheumatoid arthritis (RA). Accordingly, and to better understand T cells' contribution to RA, a comprehensive review based on an analysis of the Immune Epitope Database (IEDB) was conducted. An immune CD8+ T cell senescence response is reported in RA and inflammatory diseases, which is driven by active viral antigens from latent viruses and cryptic self-apoptotic peptides. RA-associated pro-inflammatory CD4+ T cells are selected by MHC class II and immunodominant peptides, which are derived from molecular chaperones, host extra-cellular and cellular peptides that could be post-translationally modified (PTM), and bacterial cross-reactive peptides. A large panel of techniques have been used to characterize (auto)reactive T cells and RA-associated peptides with regards to their interaction with the MHC and TCR, capacity to enter the docking site of the shared epitope (DRB1-SE), capacity to induce T cell proliferation, capacity to select T cell subsets (Th1/Th17, Treg), and clinical contribution. Among docking DRB1-SE peptides, those with PTM expand autoreactive and high-affinity CD4+ memory T cells in RA patients with an active disease. Considering original therapeutic options in RA, mutated, or altered peptide ligands (APL) have been developed and are tested in clinical trials.
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Affiliation(s)
- Caroline Carlé
- Referral Medical Biology Laboratory, Immunology Department, Institut Fédératif de Biologie, Toulouse University Hospital Center, 31300 Toulouse, France
- Laboratory of Cell Biology and Cytology, Institut Fédératif de Biologie, Toulouse University Hospital Center, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), INSERM U1291, CNRS U5051, University Toulouse III, 31062 Toulouse, France
| | - Yannick Degboe
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), INSERM U1291, CNRS U5051, University Toulouse III, 31062 Toulouse, France
- Rheumatology Department, Toulouse University Hospital Center, 31300 Toulouse, France
| | | | - Marina I. Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Cyril Clavel
- Laboratory of Cell Biology and Cytology, Institut Fédératif de Biologie, Toulouse University Hospital Center, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), INSERM U1291, CNRS U5051, University Toulouse III, 31062 Toulouse, France
| | - Yves Renaudineau
- Referral Medical Biology Laboratory, Immunology Department, Institut Fédératif de Biologie, Toulouse University Hospital Center, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), INSERM U1291, CNRS U5051, University Toulouse III, 31062 Toulouse, France
- Correspondence: ; Tel.: +33-561-776-245
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5
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Li W, Bi S, Liang Y, Zhu H. Construction of Rheumatoid Arthritis Risk Prediction and Medical Image Applications from Rheumatoid Factor Levels. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8617467. [PMID: 36238489 PMCID: PMC9553335 DOI: 10.1155/2022/8617467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022]
Abstract
Objective To study the value of rheumatoid factor (RF) levels in the risk assessment of rheumatoid arthritis (RA) and combined hypertension and diabetes mellitus (DM) and construct RA risk prediction and medical image applications from rheumatoid factor levels. Methods A total of 249 RA patients who were treated in the First People's Hospital of Yunnan Province, and another 149 non-RA people were selected as the controls. The clinical data and the detection results of serum circulating RF_IgA, RF_IgG, and RF_IgM were collected. The receiver operating curve (ROC) and logistic regression were used to analyze the value of RF levels in the risk assessment of RA and combined hypertension and DM. Results After adjusting for age, BMI, smoking, drinking, hypertension, and diabetes, logistic regression analysis showed that RF_IgA positive, RF_IgG positive, and RF_IgM positive were all independent risk factors for RA (P < 0.05). The area under the curve (AUC) of circulating RF_IgA, RF_IgG, and RF_IgM levels in predicting RA was 0.79 (95% CI: 0.74-0.83, P < 0.001), 0.73 (95% CI: 0.68-0.78, P < 0.001), and 0.87 (95% CI: 0.84-0.91, P < 0.001), respectively. The AUC for predicting RA was 0.88 (95% CI: 0.85-0.92, P < 0.001) when combined detection of circulating RF_IgA, RF_IgG, and RF_IgM levels in peripheral blood. After adjusting for age and sex, logistic regression analysis showed that RF_IgA positive, RF_IgG positive, and RF_IgM positive were not independent risk factors for DM in RA patients (P > 0.05). Conclusion The levels of serum circulating RF_IgA, RF_IgG, and RF_IgM are valuable indicators for predicting the risk of RA, but not for the risk of RA complicated with hypertension and DM.
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Affiliation(s)
- Wenrun Li
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Sheng Bi
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yu Liang
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Hongyan Zhu
- Department of Medical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
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6
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Feyzkhanova GU, Voloshin SA, Novikov AA, Aleksandrova EN, Smoldovskaya OV, Rubina AY. Analysis of rheumatoid factor and acute phase proteins using microarrays in patients with rheumatoid arthritis. Klin Lab Diagn 2022; 67:43-47. [PMID: 35077069 DOI: 10.51620/0869-2084-2022-67-1-43-47] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
One of the biomarkers of biggest clinical importance in rheumatoid arthritis (RA) is rheumatoid factor (IgM RF). The rheumatoid factor has insufficient sensitivity and specificity, therefore, to increase the diagnostic information of the test, acute phase proteins were used as concomitant biomarkers. Using biological microchips, we measured IgM RF, C-reactive protein (CRP) and Serum amyloid protein A (SAA) in patients with RA (n = 60), ankylosing spondylitis (AS) (n=55), systemic lupus erythematosus (SLE) (n=20) and healthy donors (HD) (n=9). It was shown that the medians of IgM RF concentrations are significantly higher (p<0.01) in patients with RA compared to patients suffering from other diseases and healthy donors. CRP and SAA were also significantly increased (p<0.05) in patients with RA and AS compared with SLE and HD. It has been shown that the complex determination of three biomarkers in differentiating RA patients with the comparison group had a higher diagnostic sensitivity than the isolated determination of IgM RF, while the addition of SAA makes the greatest contribution to improving the diagnostic characteristics of the biomarker panel: the use of a logistic regression model based on IgM RF and SAA allowed to increase the diagnostic sensitivity of the analysis from 58.3% to 65%. Thus, the developed microarray-based method can be used to detect and elucidate the diagnostic characteristics of RA biomarkers; however, further use requires validation of the obtained results on an expanded sampling.
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Affiliation(s)
- G U Feyzkhanova
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - S A Voloshin
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - A A Novikov
- SBIHC Moscow Clinical Scientific Center n.a. A.S. Loginov
| | | | - O V Smoldovskaya
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - A Yu Rubina
- FSBIS Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
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7
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Van Hoovels L, Studenic P, Sieghart D, Steiner G, Bossuyt X, Rönnelid J. Impact of autoimmune serology test results on RA classification and diagnosis. J Transl Autoimmun 2022; 5:100142. [PMID: 35036891 PMCID: PMC8749172 DOI: 10.1016/j.jtauto.2022.100142] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/04/2022] Open
Abstract
Rheumatoid arthritis (RA) is the most common systemic autoimmune disease and also the most severe arthritic disorder. The measurement of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) in serum supports the diagnosis of RA, which gained increasing significance over the last 65 years. However, a high variability between RF and ACPA methods has been described, impacting the diagnostic performance of the current ACR/EULAR RA classification criteria. The great number of commercially available assays, often lacking traceability to an international standard, is a major factor attributing to this in-between assay variability. The adoption of an international standard for ACPA, as is since long available for rheumatoid factor, is therefore highly desirable. Further harmonization in clinical interpretation of RF/ACPA assays could be obtained by harmonization of the cut-offs, for both the low and high antibody levels, based on predefined specificity in disease controls. Reporting test result specific likelihood ratios (LR) adds value in the interpretation of autoantibody tests. However, a good understanding of the control population used to define antibody test result interval-associated LRs is crucial in defining the diagnostic performance characteristics of antibody serology. Finally, specificity in RA classification can be improved by refining serological weight scoring taking into account the nature of the antibody, the antibody level and double RF + ACPA positivity.
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Affiliation(s)
- Lieve Van Hoovels
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine, OLV Hospital, Aalst, Belgium
| | - Paul Studenic
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Division of Rheumatology, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Daniela Sieghart
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Günter Steiner
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Xavier Bossuyt
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine, University Hospital Leuven, Leuven, Belgium
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Larionova R, Byvaltsev K, Kravtsova О, Takha E, Petrov S, Kazarian G, Valeeva A, Shuralev E, Mukminov M, Renaudineau Y, Arleevskaya M. SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases. J Transl Autoimmun 2022; 5:100154. [PMID: 35434592 PMCID: PMC9005220 DOI: 10.1016/j.jtauto.2022.100154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022] Open
Abstract
The clinical and immunological spectrum of acute and post-active COVID-19 syndrome overlaps with criteria used to characterize autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Indeed, following SARS-Cov2 infection, the innate immune response is altered with an initial delayed production of interferon type I (IFN-I), while the NF-kappa B and inflammasome pathways are activated. In lung and digestive tissues, an alternative and extrafollicular immune response against SARS-Cov2 takes place with, consequently, an altered humoral and memory T cell response leading to breakdown of tolerance with the emergence of autoantibodies. However, the risk of developing severe COVID-19 among SLE and RA patients did not exceed the general population except in those having pre-existing neutralizing autoantibodies against IFN-I. Treatment discontinuation rather than COVID-19 infection or vaccination increases the risk of developing flares. Last but not least, a limited number of case reports of individuals having developed SLE or RA following COVID-19 infection/vaccination have been reported. Altogether, the SARS-Cov2 pandemic represents an unique opportunity to investigate the dangerous interplay between the immune response against infectious agents and autoimmunity, and to better understand the triggering role of infection as a risk factor in autoimmune and chronic inflammatory disease development.
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Key Words
- ACE2, angiotensin converting enzyme 2
- ACPA, anti-cyclic citrullinated peptide autoAb
- ANA, antinuclear autoAb
- AutoAb, autoantibodies
- BAFF/BlySS, B-cell-activating factor/B lymphocyte stimulator
- CCL, chemokine ligand
- COVID-19, coronavirus disease 2019
- DMARDs, disease-modifying anti-rheumatic drugs
- E, envelope
- HEp-2, human epithelioma cell line 2
- IFN-I, interferon type I
- IFNAR, IFN-alpha receptors
- IL, interleukin
- IRF, interferon regulatory factor
- ISGs, IFN-stimulated genes
- ITP, immune-thrombocytopenic purpura
- Ig, immunoglobulin
- Infection
- Inflammation
- Jak, Janus kinase
- LDH, lactate dehydrogenase
- M, membrane
- MDA-5, melanoma differentiation-associated protein
- MERS-Cov, Middle East respiratory syndrome coronavirus
- MIS-C, multisystem inflammatory syndrome in children
- N, nucleocapsid
- NET, nuclear extracellular traps
- NF-κB, nuclear factor-kappa B
- NK, natural killer
- NLRP3, NOD-like receptor family
- Rheumatoid arthritis
- Risk factors
- SARS-Cov2
- Systemic lupus erythematosus
- T cell receptor, TLR
- Toll-like receptor, TMPRSS2
- aPL, antiphospholipid
- mAb, monoclonal Ab
- open reading frame, PACS
- pathogen-associated molecular patterns, pDC
- pattern recognition receptors, RA
- peptidylarginine deiminase 4, PAMPs
- plasmacytoid dendritic cells, PMN
- polymorphonuclear leukocytes, PRRs
- post-active COVID-19 syndrome, PAD-4
- primary Sjögren's syndrome, SLE
- pyrin domain containing 3, ORF
- reactive oxygen species, rt-PCR
- receptor binding domain, RF
- regulatory T cells, VDJ
- retinoic acid-inducible gene I, ROS
- reverse transcription polymerase chain reaction, S
- rheumatoid arthritis, RBD
- rheumatoid factor, RIG-I
- severe acute respiratory coronavirus 2, SjS
- signal transducer and activator of transcription, TCR
- single-stranded ribonucleic acid, STAT
- spike, SAD
- systemic autoimmune disease, SARS-Cov2
- systemic lupus erythematosus, SSc
- systemic sclerosis, ssRNA
- transmembrane serine protease 2, TNF
- tumor necrosis factor, Treg
- variable, diversity and joining Ig genes
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Affiliation(s)
- Regina Larionova
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - K Byvaltsev
- Institute of Fundamental Medicine, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Оlga Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Elena Takha
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Sergei Petrov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Gevorg Kazarian
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Anna Valeeva
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Eduard Shuralev
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
- Kazan State Academy of Veterinary Medicine Named After N.E. Bauman, Kazan, Russia
| | - Malik Mukminov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Yves Renaudineau
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Laboratory of Immunology, CHU Purpan Toulouse, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | - Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
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Yang X, Cai Y, Xue B, Zhang B. Diagnostic value of anti-cyclic citrullinated peptide antibody combined with rheumatoid factor in rheumatoid arthritis in Asia: a meta-analysis. J Int Med Res 2021; 49:3000605211047714. [PMID: 34590880 PMCID: PMC8489771 DOI: 10.1177/03000605211047714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This meta-analysis explored the diagnostic value of anti-cyclic citrullinated peptide antibody (anti-CCP) and rheumatoid factor (RF) for rheumatoid arthritis (RA) in the Asian population. Methods Embase, Medline, Cochrane Library, Chinese Science and Technology Periodicals, China National Knowledge Infrastructure, and China Wanfang Databases were searched from 1 January 2000 to 1 February 2021 to collect studies on the combined detection of anti-CCP and RF for diagnosing RA. The sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), and negative likelihood ratio (−LR) were combined and analyzed. Summary receiver operating characteristic (SROC) curves were drawn. Results Twenty-four published papers were analyzed, including 21 combined in series and 8 combined in parallel. In the tandem analysis, the sensitivity = 0.64 [95% confidence interval (CI): 0.58–0.70], specificity = 0.97 (95%CI: 0.95–0.98), +LR = 19.70 (95%CI: 12.74–30.46), −LR = 0.37 (95%CI: 0.31–0.43), DOR = 53.43 (95%CI: 34.46–82.40), and area under the SROC curve = 0.89. In the parallel combination, the sensitivity = 0.87 (95%CI: 0.80–0.92), specificity = 0.76 (95%CI: 0.67–0.84), +LR = 3.68 (95%CI: 2.62–5.17), −LR = 0.17 (95%CI: 0.11–0.26), DOR = 21.56 (95%CI: 11.63–39.99), and area under the SROC curve = 0.89. Conclusion Anti-CCP and RF combined detection improves the diagnostic efficiency of RA, providing a potential strategy for early clinical screening in the Asian population. This trial was retrospectively registered in the INPLASY/Research Registry (https: //inplasy.com/) with the registration number INPLASY202180106.
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Affiliation(s)
- Xiaochun Yang
- Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yue Cai
- Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Bin Xue
- Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Bo Zhang
- Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Arleevskaya M, Takha E, Petrov S, Kazarian G, Novikov A, Larionova R, Valeeva A, Shuralev E, Mukminov M, Bost C, Renaudineau Y. Causal risk and protective factors in rheumatoid arthritis: A genetic update. J Transl Autoimmun 2021; 4:100119. [PMID: 34522877 PMCID: PMC8424591 DOI: 10.1016/j.jtauto.2021.100119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 02/08/2023] Open
Abstract
The characterization of risk and protective factors in complex diseases such as rheumatoid arthritis (RA) has evolved from epidemiological studies, which test association, to the use of Mendelian randomization approaches, which test direct relationships. Indeed, direct associations with the mucosal origin of RA are retrieved with periodontal disease (Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans predominantly), interstitial lung involvement, tobacco smoking and air pollutants. Next, factors directly associated with an acquired immune response include genetic factors (HLA DRB1, PTPN22), capacity to produce anti-modified protein antibodies (AMPA), and relatives with a history of autoimmune diseases. Finally, factors can be also classified according to their direct capacity to interfere with the IL-6/CRP/sIL-IL6R proinflammatory pathway as risk factor (body fat, cardiometabolic factors, type 2 diabetes, depressive syndrome) or either as protective factors by controlling of sIL-6R levels (higher education level, and intelligence). Although some co-founders have been characterized (e.g. vitamin D, physical activity, cancer) the direct association with sex-discrepancy, pregnancy, and infections among other factors remains to be better explored.
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Affiliation(s)
- M Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - E Takha
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - S Petrov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - G Kazarian
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - A Novikov
- Sobolev Institute of Mathematics, Siberian Branch of Russian Academy of Science, Russia
| | - R Larionova
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - A Valeeva
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - E Shuralev
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia.,Kazan State Academy of Veterinary Medicine Named After N.E. Bauman, Kazan, Russia
| | - M Mukminov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - C Bost
- CHU Toulouse, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | - Y Renaudineau
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia.,CHU Toulouse, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
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11
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Arleevskaya MI, Larionova RV, Brooks WH, Bettacchioli E, Renaudineau Y. Toll-Like Receptors, Infections, and Rheumatoid Arthritis. Clin Rev Allergy Immunol 2020; 58:172-181. [PMID: 31144208 DOI: 10.1007/s12016-019-08742-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Toll-like receptors (TLR) that belong to the group of protein recognition receptor (PPR) provide an innate immune response following the sensing of conserved pathogen-associated microbial patterns (PAMPs) and changes in danger-associated molecular patterns (DAMPs) that are generated as a consequence of cellular injury. Analysis of the TLR pathway has moreover offered new insights into the pathogenesis of rheumatoid arthritis (RA). Indeed, a dysfunctional TLR-mediated response characterizes RA patients and participates in establishment of a chronic inflammatory state. Such an inappropriate TLR response has been attributed (i) to the report of important alterations in the microbiota and abnormal responses to infectious agents as part of RA; (ii) to the abnormal presence of TLR-ligands in the serum and synovial fluid of RA patients; (iii) to the overexpression of TLR molecules; (iv) to the production of a large panel of pro-inflammatory cytokines downstream of the TLR pathway; and (v) to genetic variants and epigenetic factors in susceptible RA patients promoting a hyper TLR response. As a consequence, the development of promising therapeutic strategies targeting TLRs for the treatment and prevention of RA is emerging.
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Affiliation(s)
| | - R V Larionova
- Central Research Laboratory, Kazan Federal University, Kazan, Russia
| | - Wesley H Brooks
- Department of Chemistry, University of South Florida, Tampa, FL, USA
| | - Eléonore Bettacchioli
- Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Regional Universitaire (CHU) de Brest, Brest, France
| | - Yves Renaudineau
- Central Research Laboratory, Kazan Federal University, Kazan, Russia. .,Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Regional Universitaire (CHU) de Brest, Brest, France.
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12
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Cohen S, Tuckwell K, Katsumoto TR, Zhao R, Galanter J, Lee C, Rae J, Toth B, Ramamoorthi N, Hackney JA, Berman A, Damjanov N, Fedkov D, Jeka S, Chinn LW, Townsend MJ, Morimoto AM, Genovese MC. Fenebrutinib versus Placebo or Adalimumab in Rheumatoid Arthritis: A Randomized, Double-Blind, Phase II Trial (ANDES Study). Arthritis Rheumatol 2020; 72:1435-1446. [PMID: 32270926 PMCID: PMC7496340 DOI: 10.1002/art.41275] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/26/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate fenebrutinib, an oral and highly selective non-covalent inhibitor of Bruton's tyrosine kinase (BTK), in patients with active rheumatoid arthritis (RA). METHODS Patients with RA and inadequate response to methotrexate (cohort 1, n=480) were randomized to fenebrutinib (50 mg once daily, 150 mg once daily, 200 mg twice daily), 40 mg adalimumab every other week, or placebo. Patients with RA and inadequate response to tumor necrosis factor inhibitors (cohort 2, n=98) received fenebrutinib (200 mg twice daily) or placebo. Both cohorts continued methotrexate therapy. RESULTS In cohort 1, American College of Rheumatology scores (ACR50) at week 12 were similar for fenebrutinib 50 mg once daily and placebo, and higher for fenebrutinib 150 mg once daily (28%) and 200 mg twice daily (35%) than placebo (15%) (p=0.017; p=0.0003). Fenebrutinib 200 mg twice daily and adalimumab (36%) were comparable (p=0.81). In cohort 2, more patients achieved ACR50 with fenebrutinib 200 mg twice daily (25%) than placebo (12%) (p=0.072). The most common adverse events for fenebrutinib included nausea, headache, anemia, and upper respiratory tract infections. Fenebrutinib had significant effects on myeloid and B cell biomarkers (CCL4 and rheumatoid factor). Fenebrutinib and adalimumab caused overlapping as well as distinct changes in B cell and myeloid biomarkers. CONCLUSION Fenebrutinib demonstrated efficacy comparable to adalimumab in patients with an inadequate response to methotrexate, and safety consistent with existing immunomodulatory therapies for RA. These data support targeting both B and myeloid cells via this novel mechanism for potential efficacy in the treatment of RA.
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Affiliation(s)
| | | | | | - Rui Zhao
- Genentech, Inc.South San FranciscoCalifornia
| | | | - Chin Lee
- Genentech, Inc.South San FranciscoCalifornia
| | - Julie Rae
- Genentech, Inc.South San FranciscoCalifornia
| | - Balazs Toth
- Genentech, Inc.South San FranciscoCalifornia
| | | | | | | | | | | | - Slawomir Jeka
- Collegium Medicum Jan Biziel University Hospital no 2BydgoszczPoland
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13
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Kashyap B, Saha R, Sarkar K, Singh N. Comparative analysis of rheumatoid factor levels by immune turbidimetry and latex agglutination assays among anti-cyclic citrullinated peptide-positive rheumatoid arthritis patients. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2020. [DOI: 10.4103/injms.injms_104_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Xu L, Li H, Yang S, Zeng W, Gan S, Chen X, Duan L, Hu H. Interference in the indirect antiglobulin test and direct antiglobulin test from rheumatoid factor. J Int Med Res 2019; 48:300060519892386. [PMID: 31854210 PMCID: PMC7782952 DOI: 10.1177/0300060519892386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The indirect antiglobulin test (IAT) and direct antiglobulin test (DAT) have
been used as common tests for transfusion. Recently, we have found that in
addition to causing false increases, rheumatoid factor (RF) can also cause
false decreases in immunoassays for hepatitis B surface antigen and B-type
natriuretic peptide. However, it remains unclear whether RF also interferes
with the IAT and DAT. Methods IAT models were produced by mixing IAT-positive plasma and RF-positive
plasma, then one-step and two-step IATs were adopted for detection. DAT
models were produced by mixing DAT-positive red blood cells (RBCs) and
RF-positive plasma, followed by detection with the DAT. The DAT models were
diluted using the same RF-positive plasma, and the DAT was performed
again. Results The rate of decrease of the two-step IAT (40.63%) was significantly higher
than that of the one-step IAT (31.51%). Both the rate of decrease (76.67%)
and increase (16.67%) of the results of the 60 DAT models were significantly
higher than those of the IAT models after two-fold dilution. Conclusions The RF can lead to both false decreases and false increases in IAT and DAT.
And the interference effects are related to the RF content relative to the
IgG-sensitized RBCs.
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Affiliation(s)
- Lei Xu
- Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hao Li
- Department of Blood Transfusion, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sishi Yang
- Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenjuan Zeng
- Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shan Gan
- Department of Blood Transfusion, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xin Chen
- Department of Blood Transfusion, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ling Duan
- Department of Blood Transfusion, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongbing Hu
- Department of Blood Transfusion, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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15
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Autoantibodies as Diagnostic Markers and Mediator of Joint Inflammation in Arthritis. Mediators Inflamm 2019; 2019:6363086. [PMID: 31772505 PMCID: PMC6854956 DOI: 10.1155/2019/6363086] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/14/2019] [Indexed: 12/11/2022] Open
Abstract
Rheumatoid arthritis is a systemic, polygenic, and multifactorial syndrome characterized by erosive polyarthritis, damage to joint architecture, and presence of autoantibodies against several self-structures in the serum and synovial fluid. These autoantibodies (anticitrullinated protein/peptide antibodies (ACPAs), rheumatoid factors (RF), anticollagen type II antibodies, antiglucose-6 phosphate isomerase antibodies, anticarbamylated protein antibodies, and antiacetylated protein antibodies) have different characteristics, diagnostic/prognostic value, and pathological significance in RA patients. Some of these antibodies are present in the patients' serum several years before the onset of clinical disease. Various genetic and environmental factors are associated with autoantibody production against different autoantigenic targets. Both the activating and inhibitory FcγRs and the activation of different complement cascades contribute to the downstream effector functions in the antibody-mediated disease pathology. Interplay between several molecules (cytokines, chemokines, proteases, and inflammatory mediators) culminates in causing damage to the articular cartilage and bones. In addition, autoantibodies are proven to be useful disease markers for RA, and different diagnostic tools are being developed for early diagnosis of the clinical disease. Recently, a direct link was proposed between the presence of autoantibodies and bone erosion as well as in the induction of pain. In this review, the diagnostic value of autoantibodies, their synthesis and function as a mediator of joint inflammation, and the significance of IgG-Fc glycosylation are discussed.
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16
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Falkenburg WJ, von Richthofen HJ, Koers J, Weykamp C, Schreurs MW, Bakker-Jonges LE, Haagen IA, Lems WF, Hamann D, van Schaardenburg D, Rispens T. Clinically relevant discrepancies between different rheumatoid factor assays. ACTA ACUST UNITED AC 2018; 56:1749-1758. [DOI: 10.1515/cclm-2017-0988] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/14/2017] [Indexed: 01/12/2023]
Abstract
Abstract
Background:
Accurate measurements of rheumatoid factors (RFs), autoantibodies binding IgG, are important for diagnosing rheumatoid arthritis (RA) and for predicting disease course. Worldwide, various RF assays are being used that differ in technique and target antigens. We studied whether assay choice leads to clinically important discrepancies in RF status and level.
Methods:
RF measurements using four commercial RF assays were compared in 32 RF+ samples. Using enzyme-linked immunosorbent assays (ELISAs), the influence of the target antigen source – human IgG (hIgG) versus rabbit IgG (rIgG) – on measured RF levels was investigated in arthralgia patients and RA patients.
Results:
Substantial discrepancies were found between RF levels measured in the four commercial assays. Six samples (19%) with RF levels below or slightly above the cutoff in the rIgG-based Phadia assay were RF+ in three assays using hIgG as the target antigen, some with very high levels. Direct ELISA comparisons of RF reactivity against hIgG and rIgG estimated that among 173 ACPA+ arthralgia patients, originally RF negative in rIgG-based assays, up to 10% were single positive against hIgG. Monoclonal RFs binding to hIgG and rIgG or hIgG only supported these findings. In a cohort of 69 early RA patients, virtually all RF responses reacted with both targets, although levels were still variable.
Conclusions:
The use of RF assays that differ in technique and target antigen, together with the different specificities of RF responses, leads to discrepancies in RF status and levels. This has important consequences for patient care if RA diagnosis and disease progression assessments are based on RF test results.
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Affiliation(s)
- Willem J.J. Falkenburg
- Amsterdam Rheumatology and Immunology Center , Reade, Amsterdam , The Netherlands
- Department of Immunopathology, Sanquin Research , Amsterdam , The Netherlands
| | | | - Jana Koers
- Department of Immunopathology, Sanquin Research , Amsterdam , The Netherlands
| | - Cas Weykamp
- Queen Beatrix Hospital , Winterswijk , The Netherlands
| | - Marco W.J. Schreurs
- Department of Immunology, Laboratory Medical Immunology , Erasmus MC University Medical Center Rotterdam , Rotterdam , The Netherlands
| | | | - Inez-Anne Haagen
- Department of Hematology and Clinical Chemistry Laboratories, Onze Lieve Vrouwe Gasthuis , Amsterdam , The Netherlands
| | - Willem F. Lems
- Amsterdam Rheumatology and Immunology Center , Reade, Amsterdam , The Netherlands
- Amsterdam Rheumatology and Immunology Center , VU University Medical Center , Amsterdam , The Netherlands
| | - Dörte Hamann
- Department of Immunopathology and Blood Coagulation, Sanquin Diagnostic Services , Amsterdam , The Netherlands
| | - Dirkjan van Schaardenburg
- Amsterdam Rheumatology and Immunology Center , Reade, Amsterdam , The Netherlands
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center , Amsterdam , The Netherlands
| | - Theo Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
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17
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Kim D, Mun S, Lee J, Park A, Seok A, Chun YT, Kang HG. Proteomics analysis reveals differential pattern of widespread protein expression and novel role of histidine-rich glycoprotein and lipopolysaccharide-binding protein in rheumatoid arthritis. Int J Biol Macromol 2017; 109:704-710. [PMID: 29246875 DOI: 10.1016/j.ijbiomac.2017.12.075] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/29/2022]
Abstract
Rheumatoid factor (RF) is an auto-antibody against antigen-antibody immune complexes. RF is valuable as a biomarker for the screening of autoimmune and infectious diseases. However, it is suggested that RF would be a more powerful biomarker when used complementarily with RF-correlated proteins. In this study, we utilized a proteomic approach to analyze global protein expression in RF-low and RF-high subjects using high-performance liquid chromatography tandem mass spectrometry. Histidine-rich glycoprotein (HRG) and lipopolysaccharide-binding protein (LBP) were found to be differentially expressed between RF-low and RF-high subjects (cut-off > 2-fold, p < 0.05), which was validated by enzyme-linked immunosorbent assay. To evaluate whether both proteins allow discriminating rheumatoid arthritis patients from healthy controls, receiver-operating characteristic (ROC) curves were analyzed. Areas under the ROC curves of HRG and LBP were 0.861 and 0.888, respectively. The correlation between RF and HRG was statistically significant (p = 0.003), and LBP was also correlated with RF (p = 0.044), as indicated by correlation analysis. HRG and LBP are reportedly involved in RF-producing and RF-correlated diseases. Thus, we propose that HRG and LBP could be useful screening markers for RF-correlated diseases.
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Affiliation(s)
- Doojin Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam 13135, Republic of Korea
| | - Sora Mun
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Republic of Korea
| | - Jiyeong Lee
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam 13135, Republic of Korea
| | - Arum Park
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Republic of Korea
| | - AeEun Seok
- Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Republic of Korea
| | - Yeon-Tae Chun
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam 13135, Republic of Korea
| | - Hee-Gyoo Kang
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Seongnam 13135, Republic of Korea; Department of Senior Healthcare, BK21 Plus Program, Graduate School, Eulji University, Seongnam 13135, Republic of Korea.
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18
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Arleevskaya MI, Shafigullina AZ, Filina YV, Lemerle J, Renaudineau Y. Associations between Viral Infection History Symptoms, Granulocyte Reactive Oxygen Species Activity, and Active Rheumatoid Arthritis Disease in Untreated Women at Onset: Results from a Longitudinal Cohort Study of Tatarstan Women. Front Immunol 2017; 8:1725. [PMID: 29259607 PMCID: PMC5723296 DOI: 10.3389/fimmu.2017.01725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 11/22/2017] [Indexed: 02/02/2023] Open
Abstract
To evaluate the effects of infectious episodes at early stages of rheumatoid arthritis (eRA) development, 59 untreated eRA patients, 77 first-degree relatives, from a longitudinal Tatarstan women cohort, were included, and compared to 67 healthy women without rheumatoid arthritis (RA) in their family history. At inclusion, informations were collected regarding both the type and incidence of infectious symptom episodes in the preceding year, and granulocyte reactive oxygen species (ROS) were studied at the basal level and after stimulation with serum-treated zymosan (STZ). In the eRA group, clinical [disease activity score (DAS28), health assessment questionnaire] and biological parameters associated with inflammation (erythrocyte sedimentation rate, C-reactive protein) or with RA [rheumatoid factor, anticyclic citrullinated peptide (anti-CCP2) antibodies] were evaluated. An elevated incidence of infection events in the previous year characterized the eRA and relative groups. In addition, a history of herpes simplex virus (HSV) episodes was associated with disease activity, while an elevated incidence of anti-CCP2 autoantibody characterized eRA patients with a history of viral upper respiratory tract infection symptoms (V-URI). Granulocyte ROS activity in eRA patients was quantitatively [STZ peak and its area under the curve (AUC)] and qualitatively (STZ time of peak) altered, positively correlated with disease activity, and parameters were associated with viral symptoms including HSV exacerbation/recurrence, and V-URI. In conclusion, our study provides arguments to consider a history of increased viral infection symptoms in RA at the early stage and such involvement needs to be studied further.
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Affiliation(s)
| | | | - Yulia V. Filina
- State Medical Academy, Kazan, Russia
- Kazan Federal University, Kazan, Russia
| | - Julie Lemerle
- Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Régional Universitaire (CHU) de Brest, Brest, France
| | - Yves Renaudineau
- State Medical Academy, Kazan, Russia
- Laboratory of Immunology and Immunotherapy, INSERM U1227, Hôpital Morvan, Centre Hospitalier Régional Universitaire (CHU) de Brest, Brest, France
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19
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Nakken B, Papp G, Bosnes V, Zeher M, Nagy G, Szodoray P. Biomarkers for rheumatoid arthritis: From molecular processes to diagnostic applications-current concepts and future perspectives. Immunol Lett 2017; 189:13-18. [DOI: 10.1016/j.imlet.2017.05.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/10/2017] [Accepted: 05/15/2017] [Indexed: 12/31/2022]
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20
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Gazeau P, Alegria GC, Devauchelle-Pensec V, Jamin C, Lemerle J, Bendaoud B, Brooks WH, Saraux A, Cornec D, Renaudineau Y. Memory B Cells and Response to Abatacept in Rheumatoid Arthritis. Clin Rev Allergy Immunol 2017; 53:166-176. [DOI: 10.1007/s12016-017-8603-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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21
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Birtane M, Yavuz S, Taştekin N. Laboratory evaluation in rheumatic diseases. World J Methodol 2017; 7:1-8. [PMID: 28396844 PMCID: PMC5366934 DOI: 10.5662/wjm.v7.i1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/21/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
Autoantibodies can help clinicians to allow early detection of autoimmune diseases and their clinical manifestations, to determine effective monitoring of prognosis and the treatment response. From this point, they have a high impact in rheumatic disease management. When used carefully they allow rapid diagnosis and appropriate treatment. However, as they may be present in healthy population they may cause confusion for interpreting the situation. False positive test results may lead to wrong treatment and unnecessary anxiety for patients. Autoantibody positivity alone does not make a diagnosis. Similarly, the absence of autoantibodies alone does not exclude diagnosis. The success of the test is closely related to sensitivity, specificity and likelihood ratios. So, interpretation of these is very important for a proper laboratory evaluation. In conclusion, in spite of the remarkable advances in science and technology, a deeply investigated anamnesis and comprehensive physical examination still continue to be the best diagnostic method. The most correct approach is that clinicians apply laboratory tests to confirm or exclude preliminary diagnosis based on anamnesis and physical examination. This review will discuss these issues.
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22
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Arleevskaya MI, Kravtsova OA, Lemerle J, Renaudineau Y, Tsibulkin AP. How Rheumatoid Arthritis Can Result from Provocation of the Immune System by Microorganisms and Viruses. Front Microbiol 2016; 7:1296. [PMID: 27582741 PMCID: PMC4987382 DOI: 10.3389/fmicb.2016.01296] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 08/05/2016] [Indexed: 12/12/2022] Open
Abstract
The pathogenesis of rheumatoid arthritis (RA), similar to development of a majority of inflammatory and autoimmune disorders, is largely due to an inappropriate or inadequate immune response to environmental challenges. Among these challenges, infectious agents are the undisputed leaders. Since the 1870s, an impressive list of microorganisms suspected of provoking RA has formed, and the list is still growing. Although a definite causative link between a specific infectious agent and the disease has not been established, several arguments support such a possibility. First, in the absence of a defined pathogen, the spectrum of triggering agents may include polymicrobial communities or the cumulative effect of several bacterial/viral factors. Second, the range of infectious episodes (i.e., clinical manifestations caused by pathogens) may vary in the process of RA development from preclinical to late-stage disease. Third, infectious agents might not trigger RA in all cases, but trigger it in a certain subset of the cases, or the disease onset may arise from an unfortunate combination of infections along with, for example, psychological stress and/or chronic joint tissue microtrauma. Fourth, genetic differences may have a role in the disease onset. In this review, two aspects of the problem of “microorganisms and RA” are debated. First, is there an acquired immune deficiency and, in turn, susceptibility to infections in RA patients due to the too frequent and too lengthy infections, which at last break the tolerance of self antigens? Or, second, is there a congenital deficiency in tolerance and inflammation control, which may occur even with ordinary infection frequency and duration?
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Affiliation(s)
- Marina I Arleevskaya
- Central Research Laboratory, Department of Clinical Laboratory Diagnostics, Kazan State Medical Academy Kazan, Russia
| | - Olga A Kravtsova
- Department of Biochemistry and Biotechnology, Kazan Federal University Kazan, Russia
| | - Julie Lemerle
- Laboratory of Immunology and Immunotherapy, CHU Morvan Brest, France
| | - Yves Renaudineau
- Laboratory of Immunology and Immunotherapy, CHU Morvan Brest, France
| | - Anatoly P Tsibulkin
- Central Research Laboratory, Department of Clinical Laboratory Diagnostics, Kazan State Medical Academy Kazan, Russia
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Hong IH, Choi JY, Kim AY, Lee EM, Kim JH, Park JH, Choi SW, Jeong KS. Anti-rheumatoid arthritic effect of fermented Adlay and Achyranthes japonica Nakai on collagen-induced arthritis in mice. FOOD AGR IMMUNOL 2016. [DOI: 10.1080/09540105.2016.1202207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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24
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Reliable and cost-effective serodiagnosis of rheumatoid arthritis. Rheumatol Int 2016; 36:751-8. [DOI: 10.1007/s00296-016-3433-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
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Terao C, Asai K, Hashimoto M, Yamazaki T, Ohmura K, Yamaguchi A, Takahashi K, Takei N, Ishii T, Kawaguchi T, Tabara Y, Takahashi M, Nakayama T, Kosugi S, Sekine A, Fujii T, Yamada R, Mimori T, Matsuda F, Bessho K. Significant association of periodontal disease with anti-citrullinated peptide antibody in a Japanese healthy population - The Nagahama study. J Autoimmun 2015; 59:85-90. [PMID: 25819755 DOI: 10.1016/j.jaut.2015.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/01/2015] [Accepted: 03/08/2015] [Indexed: 11/16/2022]
Abstract
Anti-citrullinated peptide antibody (ACPA) is a highly specific autoantibody to rheumatoid arthritis (RA). Recent studies have revealed that periodontal disease (PD) is closely associated with RA and production of ACPA in RA. Analyses of associations between PD and ACPA production in a healthy population may deepen our understandings. Here, we analyzed a total of 9554 adult healthy subjects. ACPA and IgM-rheumatoid factor (RF) was quantified and PD status was evaluated using the number of missing teeth (MT), the Community Periodontal Index (CPI) and Loss of Attachment (LA) for these subjects. PD status was analyzed for its association with the positivity and categorical levels of ACPA and RF conditioned for covariates which were shown to be associated with PD, ACPA or RF. As a result, all of MT, CPI and LA showed suggestive or significant associations with positivity (p = 0.024, 0.0042 and 0.037, respectively) and levels of ACPA (p ≤ 0.00031), but none of the PD parameters were associated with those of RF. These association patterns were also observed when we analyzed 6206 non-smokers of the participants. The significant associations between PD parameters and positivity and levels of ACPA in healthy population support the fundamental involvement of PD with ACPA production.
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Affiliation(s)
- Chikashi Terao
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Keita Asai
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Toru Yamazaki
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Akihiko Yamaguchi
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Katsu Takahashi
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Noriko Takei
- The Lion Foundation for Dental Health, Tokyo 130-0004, Japan
| | - Takanori Ishii
- The Lion Foundation for Dental Health, Tokyo 130-0004, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Meiko Takahashi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto 606-8501, Japan
| | - Akihiro Sekine
- EBM Research Center, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Kazuhisa Bessho
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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Terao C, Ohmura K, Ikari K, Kawaguchi T, Takahashi M, Setoh K, Nakayama T, Kosugi S, Sekine A, Tabara Y, Taniguchi A, Momohara S, Yamanaka H, Yamada R, Matsuda F, Mimori T. Effects of smoking and shared epitope on the production of anti-citrullinated peptide antibody in a Japanese adult population. Arthritis Care Res (Hoboken) 2015; 66:1818-27. [PMID: 24942650 DOI: 10.1002/acr.22385] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 06/10/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Anti-citrullinated peptide antibody (ACPA) and rheumatoid factor (RF) are markers to rheumatoid arthritis (RA). Smoking and shared epitope (SE) in HLA-DRB1 are associated with the production of these autoantibodies in RA. Detailed distribution and characterization of ACPA and RF in the general population have remained unclear. We aimed to evaluate positivity of ACPA and RF in a general Japanese population and to detect correlates, including genetic components. METHODS ACPA and RF were quantified in 9,804 Japanese volunteers ages 30-75 years. Logistic regression analyses were performed to evaluate the effects of candidates of correlates on the autoantibody positivity. A genome-wide association study (GWAS) was performed using 394,239 single nucleotide polymorphisms for 3,170 participants, and HLA-DRB1 alleles were imputed based on the GWAS data. RESULTS A total of 1.7% and 6.4% of subjects were positive for ACPA and RF, respectively, and the 2 markers showed a significant correlation (P = 2.0 × 10(-23) ). Old age was associated with ACPA positivity (P = 0.00062). Sex, smoking, SE, and other candidates of correlates did not have significant effects. Interaction between smoking and SE positivity was not apparent, but smoking showed a significant association with high levels of ACPA (P = 0.0019). CONCLUSION ACPA and RF could be detected in 1.7% and 6.4% of the Japanese adult population without RA, respectively. ACPA and RF were suggested to share mechanisms even in healthy populations. Old age was associated with increasing ACPA positivity. While positivity of ACPA and RF was not associated with SE and smoking, an association between high ACPA and smoking was observed.
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Shi M, Zhou Y, Cao L, Ding C, Ji Y, Jiang Q, Liu X, Li X, Hou X, Peng H, Shi W. Expression of enterovirus 71 capsid protein VP1 in Escherichia coli and its clinical application. Braz J Microbiol 2014; 44:1215-22. [PMID: 24688514 PMCID: PMC3958190 DOI: 10.1590/s1517-83822014005000016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 04/04/2013] [Indexed: 05/28/2023] Open
Abstract
The VPl gene of enterovirus 71 (EV71) was synthesized, construct a recombinant plasmid pET15b/VP1 and expressed in E. coli BL21. The recombinant VP1 protein could specifically react with EV71-infected patient sera without the cross-reaction with serum antibodies of coxsackievirus A16 (CA16), A4, A5, B3 and B5 as well as echovirus 6. In acute and convalescent phases, IgM and IgG antibodies of 182 serum samples were detected by ELISA with recombinant VP1 protein as a coated antigen. The results showed that the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of IgM antibodies in serum samples for the diagnosis of EV71 infection were 90.1, 98.4, 98.8 and 88.7%, respectively; similarly, those of IgG antibodies in serum samples were 82.4, 89.1, 91.5 and 78.1%, respectively. Five of 80 samples (6.25%) from CA16-infected patients were detected positive by ELISA with recombinant VP1 protein in which indicated the cross reactions and 0 of 5 samples from patients infected with other enteroviruses including CA4, CA5, CB3, CB5 and echovirus 6. Therefore, the recombinant VP1 protein of EV7l may provide a theoretical reference for establishing an effective antibody screening of IgM for EV71-infected patients with clinically suspected hand, foot, and mouth disease (HFMD).
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Affiliation(s)
- Mei Shi
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Yaping Zhou
- Changzhou 21st Century Biotech Research Institute, Changzhou, Jiangsu, P.R. China
| | - Limin Cao
- Changzhou 21st Century Biotech Research Institute, Changzhou, Jiangsu, P.R. China
| | - Cuijun Ding
- Department of Clinical Laboratory, Changzhou Children's Hospital, Changzhou, Jiangsu, P.R. China
| | - Yun Ji
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Qinbo Jiang
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Xiping Liu
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Xiang Li
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Xueling Hou
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Hongjun Peng
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
| | - Weifeng Shi
- Department of Clinical Laboratory, The Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, P.R. China
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Moelants EA, Mortier A, Van Damme J, Proost P, Loos T. Peptidylarginine deiminases: physiological function, interaction with chemokines and role in pathology. DRUG DISCOVERY TODAY. TECHNOLOGIES 2013; 9:e227-314. [PMID: 24063741 DOI: 10.1016/j.ddtec.2012.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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D'agostino LE, Ventimiglia F, Verna JA, Colina ADL, Aguirre Y, Arturi A, Capparelli A. Correlation between DAS-28 and neopterin as a biochemical marker of immune system activation in early rheumatoid arthritis. Autoimmunity 2012; 46:44-9. [DOI: 10.3109/08916934.2012.722143] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Besada E, Nikolaissen C, Nossent H. Should rheumatoid factor in rheumatoid arthritis be sent to Davy Jones’s Locker? Scand J Rheumatol 2012; 41:85-8. [DOI: 10.3109/03009742.2011.617316] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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32
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Martínez-Morillo M, Grados D, Tejera B, Olivé A. Pannus reumatoide: una nomenclatura equívoca. Med Clin (Barc) 2011; 137:330; author reply 331. [DOI: 10.1016/j.medcli.2010.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/07/2010] [Indexed: 11/29/2022]
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Rheumatoid factor measurement--continuing problems 70 years after discovery. Clin Rheumatol 2011; 30:1215-20. [PMID: 21455659 DOI: 10.1007/s10067-011-1716-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 01/08/2011] [Accepted: 02/13/2011] [Indexed: 10/18/2022]
Abstract
There have been long-standing unpublished differences in rheumatoid factor (RF) results, based on the Royal College of Pathologists of Australasia external quality assurance program. This study compared RF results between two commonly used commercial instruments. Serum samples were exchanged between a laboratory using a Beckman Immage immunonephelometer and another using a Roche Modular immunoturbidimeter. The World Health Organization (WHO) reference standard for RF (W1066) was then used to compare the two methods. The Roche immunoturbidimeter appears to have superior sensitivity. Furthermore, there is significant bias between the two instruments as levels of RF increase. Results from the WHO RF reference preparation correlated most closely with the results from the Roche immunoturbidimeter. Standardization for RF measurement is not optimal and has not been achieved between these two commonly used instruments. This may have clinical implications for patient management.
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Szyszko EA, Skarstein K, Jonsson R, Brokstad KA. Distinct phenotypes of plasma cells in spleen and bone marrow of autoimmune NOD.B10.H2b mice. Autoimmunity 2011; 44:415-26. [PMID: 21332424 DOI: 10.3109/08916934.2010.545847] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Long-lived plasma cells (PCs) residing in the bone marrow (BM) are important producers of protective antibodies. However, when reacting against self-antigens, these PCs produce autoantibodies that contribute to progression of autoimmune diseases such as Sjögren's syndrome (SS). By using a murine model of primary SS, the NOD.B10.H2b mice, we characterized phenotype and generation of PCs at different stages of the pSS disease progression. In general, the PC population found in the NOD.B10.H2b mice expressed high amounts of MHCII, IgG, and BrdU. We further demonstrate the presence of both short- and long-lived PCs in autoimmune spleen and in autoimmune BM. A long-lived PC subset was also found in the spleen and BM of non-autoimmune BALB/c mice, which have not been treated with any immunological agent. Quantitative investigation of splenic and BM PCs revealed that in the NOD.B10.H2 mice, splenic PCs migrate not only to the BM but possibly also to the sites of inflammation. Finally, BM in the aged NOD.B10.H2b mice (40-week-old) presented significantly higher quantities of long-lived PCs than BM of BALB/c mice.
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Affiliation(s)
- Ewa A Szyszko
- Broegelmann Research Laboratory, The Gade Institute, University of Bergen, Norway.
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35
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Rational Use of Laboratory Testing in the Initial Evaluation of Soft Tissue and Joint Complaints. Prim Care 2010; 37:673-89, v. [DOI: 10.1016/j.pop.2010.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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36
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Van Steendam K, Tilleman K, De Ceuleneer M, De Keyser F, Elewaut D, Deforce D. Citrullinated vimentin as an important antigen in immune complexes from synovial fluid of rheumatoid arthritis patients with antibodies against citrullinated proteins. Arthritis Res Ther 2010; 12:R132. [PMID: 20609218 PMCID: PMC2945022 DOI: 10.1186/ar3070] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 06/10/2010] [Accepted: 07/07/2010] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is an inflammatory disease, which results in destruction of the joint. The presence of immune complexes (IC) in serum and synovial fluid of RA patients might contribute to this articular damage through different mechanisms, such as complement activation. Therefore, identification of the antigens from these IC is important to gain more insight into the pathogenesis of RA. Since RA patients have antibodies against citrullinated proteins (ACPA) in their serum and synovial fluid (SF) and since elevated levels of citrullinated proteins are detected in the joints of RA patients, citrullinated antigens are possibly present in IC from RA patients. METHODS IC from serum of healthy persons, serum of RA patients and IC from synovial fluid of RA patients and Spondyloarthropathy (SpA) patients were isolated by immunoprecipitation. Identification of the antigens was performed by SDS-PAGE, mass spectrometry and immunodetection. The presence of citrullinated proteins was evaluated by anti-modified citrulline (AMC) staining. RESULTS Circulating IC in the serum of RA patients and healthy controls contain fibrinogenβ and fibronectin, both in a non-citrullinated form. Additionally, in IC isolated from RA SF, fibrinogenγ and vimentin were identified as well. More importantly, vimentin and a minor portion of fibrinogenβ were found to be citrullinated in the isolated complexes. Moreover these citrullinated antigens were only found in ACPA+ patients. No citrullinated antigens were found in IC from SF of SpA patients. CONCLUSIONS Citrullinated fibrinogenβ and citrullinated vimentin were found in IC from SF of ACPA+ RA patients, while no citrullinated antigens were found in IC from SF of ACPA- RA patients or SpA patients or in IC from serum of RA patients or healthy volunteers. The identification of citrullinated vimentin as a prominent citrullinated antigen in IC from SF of ACPA+ RA patients strengthens the hypothesis that citrullinated vimentin plays an important role in the pathogenesis of RA.
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37
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Kinloch AJ, Lundberg KE, Moyes D, Venables PJ. Pathogenic role of antibodies to citrullinated proteins in rheumatoid arthritis. Expert Rev Clin Immunol 2010; 2:365-75. [PMID: 20476908 DOI: 10.1586/1744666x.2.3.365] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the last 10 years, the discovery that antibodies to citrullinated proteins are highly specific for rheumatoid arthritis has led to a model of pathogenesis that ties together the genetic and environmental risk factors for susceptibility and severity of disease. The authors propose that the chronic inflammation is driven by two phases of an immune response. The first phase is the priming of autoimmunity, which may occur many years before the onset of disease and is caused by environmental factors, such as smoking and infectious agents, in the context of disease susceptibility alleles. This may occur in sites outside the joint, such as the respiratory tract. The second phase is the induction of arthritis, which is associated with the generation of citrullinated proteins within the joint, which is then perpetuated as the erosive disease by a local chronic immune response. The identity of candidate synovial citrullinated antigen(s), whether fibrin, vimentin, alpha-enolase, collagen type II or others yet to be described, may be the key to the pathogenesis of the destructive disease characteristic of rheumatoid arthritis. There is emerging evidence that citrullination may already be modified by established therapy in rheumatoid arthritis, but more specific inhibitors of deimination may provide new agents for future treatments.
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Affiliation(s)
- Andrew J Kinloch
- Kennedy Institute of Rheumatology, Charing Cross Campus, Imperial College London, London W6 8LH, UK.
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38
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Abstract
Inflammatory arthritis presents in a variety of diseases, from rheumatoid arthritis to hepatitis. Antibodies to autoantigens or to microbial constituents are commonly associated with these conditions. In some cases, the antibodies have diagnostic and prognostic relevance. It cannot as yet be determined definitively that any of them mediate joint damage, although the evidence from animal models indicates that this mechanism is likely. The purpose of this article is to give an overview of the spectrum of antibodies found in a variety of inflammatory arthritides. The relevant animal models are also discussed.
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Affiliation(s)
- Ann Duskin
- Department of Medicine, Pennsylvania Hospital, Philadelphia, PA, USA
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39
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Ito T, Kitahara K, Umemura T, Ota M, Shimozuru Y, Kawa S, Bahram S. A novel heterophilic antibody interaction involves IgG4. Scand J Immunol 2010; 71:109-14. [PMID: 20384862 DOI: 10.1111/j.1365-3083.2009.02353.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IgG4 has been implicated in a diverse set of complex pathologies - e.g. autoimmune pancreatitis (AIP), idiopathic membranous nephropathy - and carries unique features including lack of activation of the classical complement pathway and a dynamic Fab-arm exchange. We recently showed that the rheumatoid factor (RF)-like activity of IgG4 is achieved through a hitherto unknown, Fc-Fc (and not Fab-Fc as is the case in classical RF; CRF) interaction; hence the name, novel RF (NRF). Here, we further explore the resemblance/difference between CRF and NRF. As heterophilic interactions of human IgM RF (CRF) are well known, we checked whether this is the case for IgG4. Human IgG4 showed variable reactivity to animal IgGs: reacting intensely with rabbit and mouse IgGs, but weakly with others. The binding to rabbit IgG was not through the Fab (as in CRF) but via the Fc piece, as was recently shown for human IgG (NRF). This binding correlates with the IgG4 concentration per se and could therefore be of diagnostic usage and incidentally explain some observed interferences in biological assays. In conclusion, here is defined a novel heterophilic antibody interaction and is established the universality of the unique Fc-Fc binding, both involving IgG4.
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Affiliation(s)
- T Ito
- Department of Medicine, Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
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40
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Berthelot JM, le Goff B, Maugars Y. Thymic Hassall's Corpuscles, Regulatory T-Cells, and Rheumatoid Arthritis. Semin Arthritis Rheum 2010; 39:347-55. [DOI: 10.1016/j.semarthrit.2008.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 07/03/2008] [Accepted: 08/25/2008] [Indexed: 12/26/2022]
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Stanich JA, Carter JD, Whittum-Hudson J, Hudson AP. Rheumatoid arthritis: Disease or syndrome? Open Access Rheumatol 2009; 1:179-192. [PMID: 27789990 PMCID: PMC5074722 DOI: 10.2147/oarrr.s7680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Rheumatoid arthritis (RA) has been described in the medical literature for over two hundred years, but its etiology remains unknown. RA displays phenotypic heterogeneity, and it is a relatively prevalent clinical entity: it affects approximately 1% of the population, resulting in enormous pathologic sequelae. Earlier studies targeting the cause(s) of RA suggested potential infectious involvement, whereas more recent reports have focused on a genetic origin of the disease. However, neither infection nor genetics, nor any other single factor is currently accepted as causative of RA. In this article we review studies relating to the etiology of RA, and those of several related matters, and we conclude that the literature indeed does provide insight into the causes underlying the initiation of RA pathogenesis. Briefly, given the remarkable phenotypic variation of RA, especially in its early stages, as well as a number of other characteristics of the condition, we contend that RA is not a discrete clinical entity with a single etiological source. Rather, we argue that it represents a common clinical endpoint for various starting points, each of which is largely guided by as yet poorly understood aspects of the genetic background of the affected individual. Adoption of this alternative view of the origin of RA will have significant consequences for future research and for development of new therapeutic interventions for this burdensome condition.
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Affiliation(s)
- Jessica A Stanich
- Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - John D Carter
- Division of Rheumatology, Department of Internal Medicine, University of South Florida School of Medicine, Tampa, FL, USA
| | - Judith Whittum-Hudson
- Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Alan P Hudson
- Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI, USA
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42
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Engelmann R, Müller-Hilke B. [Antibodies against citrullinated peptides in clinical practice and research]. Z Rheumatol 2009; 68:485-90. [PMID: 19578861 DOI: 10.1007/s00393-009-0494-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Since their original description ten years ago, antibodies against citrullinated peptide antigens (ACPA) have become increasingly important in the diagnosis of rheumatoid arthritis (RA). They are now considered superior to the rheumatoid factor because they can be detected earlier in the course of the disease and are more specific while showing a comparable sensitivity. However, they seem to be less suitable for monitoring specific responses to therapies and for predicting extra-articular manifestations as well as disease activity. Recent research activities center around using ACPA to further elucidate the pathogenesis of RA.
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Affiliation(s)
- R Engelmann
- Institut für Immunologie der Medizinischen Fakultät, Universität Rostock, 18057 Rostock
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43
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da Mota LMH, dos Santos Neto LL, de Carvalho JF. Autoantibodies and other serological markers in rheumatoid arthritis: predictors of disease activity? Clin Rheumatol 2009; 28:1127-34. [DOI: 10.1007/s10067-009-1223-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2009] [Accepted: 06/17/2009] [Indexed: 01/06/2023]
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Nilsson KE, Andrén M, Diaz de Ståhl T, Kleinau S. Enhanced susceptibility to low-dose collagen-induced arthritis in CR1/2-deficient female mice--possible role of estrogen on CR1 expression. FASEB J 2009; 23:2450-8. [PMID: 19351702 DOI: 10.1096/fj.08-125849] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The influence of complement receptor 1 and 2 (CR1/2) was investigated on the susceptibility to low-dose collagen-induced arthritis (CIA) in wild-type (WT) and CR1/2-deficient DBA/1 mice. Significantly enhanced CIA was observed in female CR1/2-deficient mice compared with WT female mice, while male mutant and WT mice showed similar arthritis development. The enhanced CIA was accompanied with higher complement levels and a prolonged IgM anti-collagen type II response. When investigating whether estrogen contributed to the different arthritis susceptibility, we found that ovariectomy rendered WT females more sensitive to low-dose CIA and to the same extent as CR1/2-deficient females, while CR1/2-deficient mice were unaffected by ovariectomy. Notably, the ovariectomized WT mice displayed reduced CR1(+) B220(+) B-cell numbers and CR1 expression compared with sham-operated WT mice, suggesting a stimulatory effect of estrogen on CR1. In accordance, a significant correlation was observed between reduced CR1 expression in B cells and increased age in healthy female blood donors but not in male donors. Our findings demonstrate an important role of CR1/2 in suppressing CIA in female mice under low-antigen conditions. The data suggest that estrogen promote CR1 expression in B cells. These findings provide insight to the increased frequency of rheumatoid arthritis in postmenopausal women.
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Affiliation(s)
- Kajsa E Nilsson
- Department of Cell and Molecular Biology, Uppsala University, SE-75 124 Uppsala, Sweden
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Positional cloning of the Igl genes controlling rheumatoid factor production and allergic bronchitis in rats. Proc Natl Acad Sci U S A 2008; 105:14005-10. [PMID: 18779593 DOI: 10.1073/pnas.0803956105] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Rheumatoid factors (RF), autoantibodies that bind the Fc region of IgG, are one of the major diagnostic marker in rheumatoid arthritis (RA) but occur with lower frequency also in other infectious and inflammatory conditions. Through positional cloning of the previously described quantitative trait locus (QTL) Rf1 in congenic and advanced intercrossed rats, we identified the Ig lambda light chain locus as a locus that regulates the production of RF in rats. The congenic rats produce RF-Ig lambda and have significant higher levels of RF-IgG and RF-IgM in serum, while the DA rat has an impaired RF production and does not produces RF-Ig lambda. Thus, we could investigate the role of RF in pristane-induced arthritis (PIA) as well as ovalbumin-induced airway inflammation. We show that there was no difference in the development and severity of PIA between congenic and parental DA rats, suggesting that RF using lambda light chains have no impact on PIA. However, the RF producing congenic rats developed a more severe airway inflammation as indicated in the significantly increased number of eosinophils in bronchoalveolar lavage fluid as well as total IgE in serum. In addition, RF congenic rats had a significantly enhanced immune response toward OVA due to increased OVA-Igk but not OVA-Igl antibodies, suggesting a possible involvement of RF in the regulation of the humoral immune response.
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Sigurdsson S, Padyukov L, Kurreeman FAS, Liljedahl U, Wiman AC, Alfredsson L, Toes R, Rönnelid J, Klareskog L, Huizinga TWJ, Alm G, Syvänen AC, Rönnblom L. Association of a haplotype in the promoter region of the interferon regulatory factor 5 gene with rheumatoid arthritis. ACTA ACUST UNITED AC 2007; 56:2202-10. [PMID: 17599733 DOI: 10.1002/art.22704] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine whether genetic variants of the interferon regulatory factor 5 (IRF-5) and Tyk-2 genes are associated with rheumatoid arthritis (RA). METHODS Five single-nucleotide polymorphisms (SNPs) in IRF5 and 3 SNPs in Tyk2 were analyzed in a Swedish cohort of 1,530 patients with RA and 881 controls. A replication study was performed in a Dutch cohort of 387 patients with RA and 181 controls. All patient sera were tested for the presence of autoantibodies against cyclic citrullinated peptides (anti-CCP). RESULTS Four of the 5 SNPs located in the 5' region of IRF5 were associated with RA, while no association was observed with the Tyk2 SNPs. The minor alleles of 3 of the IRF5 SNPs, which were in linkage disequilibrium and formed a relatively common haplotype with a frequency of approximately 0.33, appeared to confer protection against RA. Although these disease associations were seen in the entire patient group, they were mainly found in RA patients who were negative for anti-CCP. A suggestive association of IRF5 SNPs with anti-CCP-negative RA was also observed in the Dutch cohort. CONCLUSION Given the fact that anti-CCP-negative RA differs from anti-CCP-positive RA with respect to genetic and environmental risk factor profiles, our results indicate that genetic variants of IRF5 contribute to a unique disease etiology and pathogenesis in anti-CCP-negative RA.
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Duquerroy S, Stura EA, Bressanelli S, Fabiane SM, Vaney MC, Beale D, Hamon M, Casali P, Rey FA, Sutton BJ, Taussig MJ. Crystal structure of a human autoimmune complex between IgM rheumatoid factor RF61 and IgG1 Fc reveals a novel epitope and evidence for affinity maturation. J Mol Biol 2007; 368:1321-31. [PMID: 17395205 PMCID: PMC4625532 DOI: 10.1016/j.jmb.2007.02.085] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 02/19/2007] [Accepted: 02/21/2007] [Indexed: 01/07/2023]
Abstract
Rheumatoid factors (RF) are autoantibodies that recognize epitopes in the Fc region of immunoglobulin (Ig) G and that correlate with the clinical severity of rheumatoid arthritis (RA). Here we report the X-ray crystallographic structure, at 3 A resolution, of a complex between the Fc region of human IgG1 and the Fab fragment of a monoclonal IgM RF (RF61), derived from an RA patient and with a relatively high affinity for IgG Fc. In the complex, two Fab fragments bind to each Fc at epitopes close to the C terminus, and each epitope comprises residues from both Cgamma3 domains. A central role in the unusually hydrophilic epitope is played by the side-chain of Arg355, accounting for the subclass specificity of RF61, which recognizes IgG1,-2, and -3 in preference to IgG4, in which the corresponding residue is Gln355. Compared with a previously determined complex of a lower affinity RF (RF-AN) bound to IgG4 Fc, in which only residues at the very edge of the antibody combining site were involved in binding, the epitope bound by RF61 is centered in classic fashion on the axis of the V(H):V(L) beta-barrel. The complementarity determining region-H3 loop plays a key role, forming a pocket in which Arg355 is bound by two salt-bridges. The antibody contacts also involve two somatically mutated V(H) residues, reinforcing the suggestion of a process of antigen-driven maturation and selection for IgG Fc during the generation of this RF autoantibody.
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Affiliation(s)
- Stephane Duquerroy
- Virologie Moléculaire et Structurale, CNRS UMR 2472-INRA UMR 1157, 91198 Gif-sur-Yvette, France
- Unité de Virologie Structurale and URA 3015 CNRS, Département de Virologie, Institut Pasteur, 25 rue du Dr. Roux, 75724 Paris Cedex 15, France
- Université Paris-Sud, Orsay Cedex, F-91405, France
| | - Enrico A. Stura
- Département d'Ingénierie et d'Études des Protéines, CEA de Saclay, 91191 Gif-sur-Yvette Cedex, France
| | - Stéphane Bressanelli
- Virologie Moléculaire et Structurale, CNRS UMR 2472-INRA UMR 1157, 91198 Gif-sur-Yvette, France
| | - Stella M. Fabiane
- The Randall Division of Cell and Molecular Biophysics, King's College London, London SE1 1UL, UK
| | - Marie C. Vaney
- Virologie Moléculaire et Structurale, CNRS UMR 2472-INRA UMR 1157, 91198 Gif-sur-Yvette, France
| | - Dennis Beale
- Technology Research Group, The Babraham Institute, Cambridge CB2 4AT, UK
| | - Maureen Hamon
- Technology Research Group, The Babraham Institute, Cambridge CB2 4AT, UK
| | - Paolo Casali
- Center for Immunology, School of Biological Sciences and School of Medicine, University of California, Irvine, CA 92657, USA
| | - Felix A. Rey
- Virologie Moléculaire et Structurale, CNRS UMR 2472-INRA UMR 1157, 91198 Gif-sur-Yvette, France
- Unité de Virologie Structurale and URA 3015 CNRS, Département de Virologie, Institut Pasteur, 25 rue du Dr. Roux, 75724 Paris Cedex 15, France
| | - Brian J. Sutton
- The Randall Division of Cell and Molecular Biophysics, King's College London, London SE1 1UL, UK
- corresponding author:
| | - Michael J. Taussig
- Technology Research Group, The Babraham Institute, Cambridge CB2 4AT, UK
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Dimitrov JD, Roumenina LT, Doltchinkova VR, Vassilev TL. Iron Ions and Haeme Modulate the Binding Properties of Complement Subcomponent C1q and of Immunoglobulins. Scand J Immunol 2007; 65:230-9. [PMID: 17309777 DOI: 10.1111/j.1365-3083.2006.01893.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The complement system and circulating antibodies play a major role in the defence against infection. They act at the sites of inflammation, where the harsh microenvironment and the oxidative stress lead to the release of free iron ions and haeme. The aim of this study was to analyse the consequences of the exposure of C1q and immunoglobulins to iron ions or haeme. The changes in target recognition by C1q and in the rheumatoid factor activity of the immunoglobulins were investigated. The exposure of C1q to ferrous ions increased its binding to IgG and to IgM. In contrast, haeme inhibited C1q binding to all studied targets, especially to IgG1 and C-reactive protein. Thus, the haeme released as a result of tissue damage and oxidative stress may act as a negative feedback regulator of an inappropriate complement triggering as seen in ischaemia-reperfusion tissue injury. The results also show that iron ions and haeme were able to reveal rheumatoid factor activity of IgG. The modulation of the C1q-target binding as well as the revealing of rheumatoid factor activity of IgG by exposure to redox-active agents released at the sites of inflammation may have important consequences for the understanding of the immunopathological mechanisms of inflammatory and autoimmune diseases.
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Affiliation(s)
- J D Dimitrov
- Department of Immunology, Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.
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O'Hara RM, Benoit SE, Groves CJ, Collins M. Cell-surface and cytokine biomarkers in autoimmune and inflammatory diseases. Drug Discov Today 2007; 11:342-7. [PMID: 16580976 DOI: 10.1016/j.drudis.2006.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Revised: 01/09/2006] [Accepted: 02/20/2006] [Indexed: 11/20/2022]
Abstract
Increasing emphasis is being placed on biomarkers as indicators of disease states in patients with autoimmune and inflammatory disorders, such as rheumatoid arthritis, multiple sclerosis and systemic lupus erythematosus. Careful description of the expression of cell-surface markers and cytokines produced by T and B lymphocytes can lead to a more complete characterization of disease activity in patient populations, and serve as an indicator of the patient's response to therapy.
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Affiliation(s)
- Richard M O'Hara
- Department of Inflammation, Wyeth Research, 200 CambridgePark Drive, Cambridge, MA 02140, USA.
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50
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Turesson C, Jacobsson LTH, Sturfelt G, Matteson EL, Mathsson L, Rönnelid J. Rheumatoid factor and antibodies to cyclic citrullinated peptides are associated with severe extra-articular manifestations in rheumatoid arthritis. Ann Rheum Dis 2006; 66:59-64. [PMID: 16901955 PMCID: PMC1798395 DOI: 10.1136/ard.2006.054445] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To study antibodies to cyclic citrullinated peptides (anti-CCP) and rheumatoid factor in patients with active, severe extra-articular rheumatoid arthritis (ExRA) compared with controls without ExRA. METHODS 35 consecutive patients with severe ExRA manifestations according to predefined criteria were studied. 70 patients with rheumatoid arthritis, but no ExRA manifestations, individually matched for age, sex and disease duration, served as controls. Patients were included when ExRA was diagnosed, before any new treatment was started. Anti-CCPs were detected with ELISA, rheumatoid factor was quantified using nephelometry and anti-nuclear antibodies (ANA) were investigated using indirect immune fluorescence. RESULTS Anti-CCPs were detected in 77% of patients with ExRA versus 56% of controls without ExRA (p = 0.03). Anti-CCP levels also tended to be higher in patients with ExRA (p = 0.09). Rheumatoid factor was detected in 94% v 71% of patients and controls, respectively (p = 0.006), and rheumatoid factor levels were higher in patients with ExRA (median interquartile range (IQR) 245 IU/ml (94-604) v 73 IU/ml (not detected-165); p = 0.001). Levels and occurrence of ANA did not differ between patients with ExRA and controls. Patients with ExRA had higher swollen joint counts and C reactive protein levels, but no correlations were found between anti-CCP or rheumatoid factor levels and these measures within the ExRA group. CONCLUSION Rheumatoid factor is strongly associated with severe ExRA manifestations in patients with rheumatoid arthritis, and a similar but weaker association exists for anti-CCPs. This suggests a role for rheumatoid factor and anti-CCP in the pathogenesis of ExRA.
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Affiliation(s)
- C Turesson
- Department of Rheumatology, Malmö University Hospital, Södra Förstadsgatan 101, S-205 02 Malmö, Sweden.
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