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14-3-3 η Protein as a Potential Biomarker in Juvenile Idiopathic Arthritis. Pediatr Rep 2021; 13:65-71. [PMID: 33504004 PMCID: PMC7844622 DOI: 10.3390/pediatric13010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/05/2020] [Accepted: 12/30/2020] [Indexed: 11/19/2022] Open
Abstract
The 14-3-3η (eta) protein was evaluated as a biomarker in a cohort of patients with juvenile idiopathic arthritis (JIA), as well as disease- and healthy-controls, to determine its potential clinical utility. In this case-control study, levels of 14-3-3η protein were evaluated in archival specimens from patients with JIA, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA), as well as healthy pediatric controls. Just over 200 patients were evaluated, using specimens banked between 1990 and 2011. Comparisons were made to complete blood cell count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and anti-nuclear antibody (ANA) positivity. 14-3-3η at levels 0.2 ng/mL or higher was considered positive. Fisher's exact tests, odds ratios, 95% confidence intervals, and p-values were reported. 14-3-3η positivity was seen in all included JIA subtypes. The rate of positivity was the highest in RF-positive (pos) polyarticular JIA. In the disease and healthy controls, lower rates of positivity were observed. The frequency of 14-3-3η positivity among RF-positive and RF-negative (neg) polyarticular JIA patients, especially at values ≥0.5 ng/mL (associated with poor outcomes in adults), was also highest. Several JIA patients with 14-3-3η positivity developed RF and anti-CCP positivity later in their disease. Significant levels of 14-3-3η can be found in approximately 30% of RF-pos and RF-neg patients with polyarticular JIA. This protein may represent a new biomarker for polyarticular JIA, particularly RF-neg polyarticular JIA.
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Lopez-Oliva I, de Pablo P, Dietrich T, Chapple I. Gums and joints: is there a connection? Part two: the biological link. Br Dent J 2019; 227:611-617. [PMID: 31605072 DOI: 10.1038/s41415-019-0723-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rheumatoid arthritis (RA) and periodontitis (PD) are inflammatory diseases characterised by an exacerbated immune-inflammatory reaction that leads to the destruction of bone and other connective tissues that share numerous similarities. Although a significant and independent association between these two conditions has been described, the pathophysiological processes that may explain this relationship remain unknown and multiple theories have been proposed. This review presents the most important theories currently proposed to explain the biological link between RA and PD.
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Affiliation(s)
- Isabel Lopez-Oliva
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
| | - Paola de Pablo
- Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
| | - Iain Chapple
- Periodontal Research Group, Birmingham Dental School, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK.
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Mahmud SA, Binstadt BA. Autoantibodies in the Pathogenesis, Diagnosis, and Prognosis of Juvenile Idiopathic Arthritis. Front Immunol 2019; 9:3168. [PMID: 30693002 PMCID: PMC6339949 DOI: 10.3389/fimmu.2018.03168] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/24/2018] [Indexed: 12/26/2022] Open
Abstract
Autoantibody production occurs in juvenile idiopathic arthritis (JIA) and numerous other autoimmune diseases. In some conditions, the autoantibodies are clearly pathogenic, whereas in others the roles are less defined. Here we review various autoantibodies associated with JIA, with a particular focus on antinuclear antibodies and antibodies recognizing citrullinated self-antigens. We explore potential mechanisms that lead to the development of autoantibodies and the use of autoantibody testing in diagnosis and prognosis. Finally, we compare and contrast JIA-associated autoantibodies with those found in adults with rheumatoid arthritis (RA).
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Affiliation(s)
- Shawn A Mahmud
- Division of Pediatric Rheumatology, Department of Pediatrics, and the Center for Immunology, University of Minnesota, Minneapolis, MN, United States
| | - Bryce A Binstadt
- Division of Pediatric Rheumatology, Department of Pediatrics, and the Center for Immunology, University of Minnesota, Minneapolis, MN, United States
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Liu Y, Liu C, Li L, Zhang F, Li Y, Zhang S. High levels of antibodies to citrullinated α-enolase peptide-1 (CEP-1) identify erosions and interstitial lung disease (ILD) in a Chinese rheumatoid arthritis cohort. Clin Immunol 2019; 200:10-15. [PMID: 30611755 DOI: 10.1016/j.clim.2019.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/23/2018] [Accepted: 01/02/2019] [Indexed: 12/31/2022]
Abstract
We evaluated the clinical performance of anti-CEP-1 in a Chinese rheumatoid arthritis (RA) cohort. A total of 264 subjects were tested, including 101 RA patients, 38 juvenile idiopathic arthritis (JIA) patients, 46 disease control (DC) and 79 healthy controls (HC). The presence of anti-CEP-1 in patients with RA, JIA, DCs and HC were 61.4%, 13.2%, 15.2% and 5.1%, respectively. Anti-CCP2 demonstrated the highest positive likelihood ratio of 10.11 in the diagnosis of RA, followed by RF (8.88) and anti-CEP-1 (5.82). Anti-CEP-1 positive RA patients displayed significantly higher DAS28 compared to anti-CEP-1 negative RA patients (p = .045). Significant associations were identified between anti-CEP-1 and joint erosions at anti-CEP-1 value of >124.78 U/ml (p = .0026) and between anti-CEP-1 and ILD at anti-CEP-1 value of >185.91 U/ml (p = .0222). Our findings indicate that anti-CEP-1 may not be able to replace anti-CCP2 for routine diagnosis for RA, but they may be helpful for subtyping of the disease.
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Affiliation(s)
- Yudong Liu
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
| | - Chenxi Liu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Liubing Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Fengchun Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Yongzhe Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Shulan Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
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5
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Inflammatory Profiles of the Interleukin Family and Network in Cerebral Hemorrhage. Cell Mol Neurobiol 2018; 38:1321-1333. [PMID: 30027390 DOI: 10.1007/s10571-018-0601-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/06/2018] [Indexed: 12/19/2022]
Abstract
Cerebral hemorrhage is a series of devastating cerebrovascular diseases with high mortality, morbidity and recurrence rate. Localized and systemic immuno-reactions are involved. Aggregation of immunocytes, which were both recruited from the peripheral circulation and resident in the central nervous system, is induced and activated by hematoma-related blood components. Subsequently, various cytokines, chemokines, free radicals and toxic chemicals are secreted to participant host defense responses. Among these, neuro-inflammation plays critical roles in both the pathologic processes of secondary injuries and recovery of neural damages. Numerous treatment strategies have been proposed, aiming at controlling the balance between anti- and proinflammation. Here, we summarized our current understanding and potential clinical applications for cytokines of the interleukin family in the pathogenesis of hemorrhagic stroke. In addition, we conducted protein-protein network, gene ontology and KEGG analysis on the interleukins using online bioinformatic tools to further elaborate the comprehensive mechanisms of interleukins in cerebral hemorrhage.
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Gunasekera S, Fernandes-Cerqueira C, Wennmalm S, Wähämaa H, Sommarin Y, Catrina AI, Jakobsson PJ, Göransson U. Stabilized Cyclic Peptides as Scavengers of Autoantibodies: Neutralization of Anticitrullinated Protein/Peptide Antibodies in Rheumatoid Arthritis. ACS Chem Biol 2018; 13:1525-1535. [PMID: 29630823 DOI: 10.1021/acschembio.8b00118] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The occurrence of autoantibodies is a hallmark of rheumatoid arthritis, specifically those autoantibodies targeting proteins containing the arginine-derived amino acid citrulline. There is strong evidence showing that the occurrence of anticitrullinated protein/peptide antibodies (ACPA) are involved in disease progression, and ACPA was recently shown to induce pain in animals. Here, we explore a novel concept useful for research, diagnostics, and possibly therapy of autoimmune diseases, namely, to directly target and neutralize autoantibodies using peptide binders. A high-affinity peptide-based scavenger of ACPA was developed by grafting a citrullinated epitope derived from human fibrinogen into a naturally occurring stable peptide scaffold. The best scavenger comprises the truncated epitope α-fibrinogen, [Cit573]fib(566-580), grafted into the scaffold sunflower trypsin inhibitor-1, SFTI-1. The final peptide demonstrates low nanomolar apparent affinity and superior stability.
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Affiliation(s)
- Sunithi Gunasekera
- Division of Pharmacognosy, Department of Medicinal Chemistry, Uppsala University, Biomedical Centre, Box 574, SE-75123 Uppsala, Sweden
| | - Cátia Fernandes-Cerqueira
- Rheumatology Unit, Department of Medicine—Solna, Karolinska Institutet, Karolinska University Hospital, Rheumatology Clinic D2:01, 171 76 Solna, Stockholm, Sweden
| | - Stefan Wennmalm
- Royal Institute of Technology-KTH, Applied Physics, Experimental Biomolecular Physics, Scilifelab, Tomtebodavägen 23, 171 65 Solna, Stockholm, Sweden
| | - Heidi Wähämaa
- Rheumatology Unit, Department of Medicine—Solna, Karolinska Institutet, Karolinska University Hospital, Rheumatology Clinic D2:01, 171 76 Solna, Stockholm, Sweden
| | | | - Anca I. Catrina
- Rheumatology Unit, Department of Medicine—Solna, Karolinska Institutet, Karolinska University Hospital, Rheumatology Clinic D2:01, 171 76 Solna, Stockholm, Sweden
| | - Per-Johan Jakobsson
- Rheumatology Unit, Department of Medicine—Solna, Karolinska Institutet, Karolinska University Hospital, Rheumatology Clinic D2:01, 171 76 Solna, Stockholm, Sweden
| | - Ulf Göransson
- Division of Pharmacognosy, Department of Medicinal Chemistry, Uppsala University, Biomedical Centre, Box 574, SE-75123 Uppsala, Sweden
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Yazar H, Özdemir F, Köse E. Effect of Centrifuge Temperature on Routine Coagulation Tests. Acta Haematol 2018; 139:158-163. [PMID: 29550825 DOI: 10.1159/000486271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/12/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study investigated the effects of cooled and standard centrifuges on the results of coagulation tests to examine the effects of centrifugation temperature. METHODS Equal-volume blood samples from each patient were collected at the same time intervals and subjected to standard (25°C) and cooled centrifugation (2-4°C). Subsequently, the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer values were determined in runs with the same lot numbers in the same coagulation device using the Dia-PT R (PT and INR), Dia-PTT-liquid (aPTT), Dia-FIB (fibrinogen), and Dia-D-dimer kits, respectively. RESULTS The study enrolled 771 participants. The PT was significantly (p < 0.018) higher in participants on anticoagulant therapy. The respective median values of the test parameters determined using the standard and cooled centrifuges were as follows: PT 10.30 versus 10.50 s; PT (INR) 1.04 versus 1.09 s; APTT 28.90 versus 29.40 s; fibrinogen 321.5 versus 322.1 mg/dL; and D-dimer 179.5 versus 168.7 µg FEU/mL. There were significant differences (p < 0.001) in the parameters between the values obtained with the standard and cooled centrifuges. CONCLUSIONS Centrifuge temperature can have a significant effect on the results of coagulation tests. However, broad and specific disease-based studies are needed.
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Affiliation(s)
- Hayrullah Yazar
- Department of Medical Biochemistry, Sakarya University Faculty of Medicine, Adapazan, Turkey
| | - Fatma Özdemir
- Department of Clinical Biochemistry, Sakarya University, Training and Research Hospital, Adapazan, Turkey
| | - Elif Köse
- Department of Public Health, Sakarya University, Training and Research Hospital, Adapazan, Turkey
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Galea J, Ogungbenro K, Hulme S, Patel H, Scarth S, Hoadley M, Illingworth K, McMahon CJ, Tzerakis N, King AT, Vail A, Hopkins SJ, Rothwell N, Tyrrell P. Reduction of inflammation after administration of interleukin-1 receptor antagonist following aneurysmal subarachnoid hemorrhage: results of the Subcutaneous Interleukin-1Ra in SAH (SCIL-SAH) study. J Neurosurg 2018; 128:515-523. [PMID: 28298024 DOI: 10.3171/2016.9.jns16615] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event with long-term morbidity and mortality. Patients who survive the initial bleeding are likely to suffer further early brain injury arising from a plethora of pathological processes. These may result in a worsening of outcome or death in approximately 25% of patients and may contribute to longer-term cognitive dysfunction in survivors. Inflammation, mediated by the cytokine interleukin-1 (IL-1), is an important contributor to cerebral ischemia after diverse forms of brain injury, including aSAH. Its effects are attenuated by its naturally occurring antagonist, IL-1 receptor antagonist (IL-1Ra [anakinra]). The authors hypothesized that administration of additional subcutaneous IL-1Ra would reduce inflammation and associated plasma markers associated with poor outcome following aSAH. METHODS This was a randomized, open-label, single-blinded study of 100 mg subcutaneous IL-1Ra, administered twice daily in patients with aSAH, starting within 3 days of ictus and continuing until 21 days postictus or discharge from the neurosurgical center, whichever was earlier. Blood samples were taken at admission (baseline) and at Days 3-8, 14, and 21 postictus for measurement of inflammatory markers. The primary outcome was difference in plasma IL-6 measured as area under the curve between Days 3 and 8, corrected for baseline value. Secondary outcome measures included similar area under the curve analyses for other inflammatory markers, plasma pharmacokinetics for IL-1Ra, and clinical outcome at 6 months. RESULTS Interleukin-1Ra significantly reduced levels of IL-6 and C-reactive protein (p < 0.001). Fibrinogen levels were also reduced in the active arm of the study (p < 0.002). Subcutaneous IL-1Ra was safe, well tolerated, and had a predictable plasma pharmacokinetic profile. Although the study was not powered to investigate clinical effect, scores of the Glasgow Outcome Scale-extended at 6 months were better in the active group; however, this outcome did not reach statistical significance. CONCLUSIONS Subcutaneous IL-1Ra is safe and well tolerated in aSAH. It is effective in reducing peripheral inflammation. These data support a Phase III study investigating the effect of IL-1Ra on outcome following aSAH. Clinical trial registration no.: EudraCT: 2011-001855-35 ( www.clinicaltrialsregister.eu ).
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Affiliation(s)
- James Galea
- 1Ninewells Hospital and Medical School, University of Dundee
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Kayode Ogungbenro
- 3Centre for Applied Pharmacokinetic Research, Manchester Pharmacy School
| | - Sharon Hulme
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Hiren Patel
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Sylvia Scarth
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Margaret Hoadley
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Karen Illingworth
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | | | - Nikolaos Tzerakis
- 5University Hospital of North Midlands, Royal Stoke University Hospital, Stoke-on-Trent,United Kingdom
| | - Andrew T King
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | - Andy Vail
- 6Centre for Biostatistics, Institution of Population Health, University of Manchester
| | - Stephen J Hopkins
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
| | | | - Pippa Tyrrell
- 2Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, Salford
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Laustriat G, Ruyssen-Witrand A, Constantin A, Barnetche T, Adoue D, Cantagrel A, Degboé Y. Anti-citrullinated peptides antibodies in systemic sclerosis: Meta-analysis of frequency and meaning. Joint Bone Spine 2017; 85:147-153. [PMID: 29183860 DOI: 10.1016/j.jbspin.2017.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/05/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Diagnosis of systemic sclerosis (SSc) is partially determined by the presence of specific autoantibodies often associated with specific clinical features. Recent studies report the presence of ACPA in SSc. We aimed to evaluate the prevalence of ACPA in SSc and to assess their influence on clinical presentation of SSc. METHODS A systematic literature search was performed using PubMed and Cochrane databases' publications between 1999 and March 2017. Search terms were: "systemic sclerosis [MeSH] AND (ACPA OR anti-CCP OR rheumatoid factor OR cohort OR value diagnostic)". In a first step, we selected cohorts with >50 SSc patients with ACPA identification, for ACPA frequency determination. In a second step, we included studies that analysed clinical profiles according to ACPA status. Meta-analyses were performed when at least two studies were available. RESULTS First, we identified 13 observational studies with a total of 1231 SSc patients. The mean prevalence of ACPA in SSc was 9.2%. Secondly, we identified nine studies reporting clinical aspects according to ACPA status. Our meta-analyses showed a significant association between ACPA positivity and the presence of arthritis (odds ratio (OR)=22.48 [10.71-47.21]), joint erosions seen on X-rays (OR=14.79 [6.38-34.28]), pulmonary fibrosis (OR=2.75 [1.21-6.24]), oesophagus involvement (OR=2.72 [1.05-7.07]), and diffuse skin involvement (OR=2.21 [1.21-4.03]). CONCLUSIONS The prevalence of ACPA in scleroderma is 9.2%. Our meta-analysis shows an increased risk for erosive arthritis, pulmonary fibrosis, oesophagus involvement and diffuse skin involvement, in patients with ACPA-positive SSc. ACPA should be systematically included in SSc assessment.
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Affiliation(s)
- Guillaume Laustriat
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France
| | - Adeline Ruyssen-Witrand
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France; Pharmaco-épidémiologie, évaluation de l'utilisation et du risque médicamenteux, Inserm UMR 1027, faculté de médecine, 37, allées Jules-Guesde, 31000 Toulouse, France
| | - Arnaud Constantin
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France; CPTP, Inserm UMR 1043, CHU Purpan, BP 3028, 31024 Toulouse cedex 3, France
| | - Thomas Barnetche
- Service de rhumatologie, FHU Acronim, CHU Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - Daniel Adoue
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France; Service d'immunologie clinique, IUCT, oncopole, CHU de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Alain Cantagrel
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France; CPTP, Inserm UMR 1043, CHU Purpan, BP 3028, 31024 Toulouse cedex 3, France
| | - Yannick Degboé
- Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, TSA 40 031, 31059 Toulouse cedex 9, France; CPTP, Inserm UMR 1043, CHU Purpan, BP 3028, 31024 Toulouse cedex 3, France.
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Kumar PS. From focal sepsis to periodontal medicine: a century of exploring the role of the oral microbiome in systemic disease. J Physiol 2017; 595:465-476. [PMID: 27426277 PMCID: PMC5233655 DOI: 10.1113/jp272427] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/01/2016] [Indexed: 12/19/2022] Open
Abstract
The oral microbiome is established within a few minutes after birth and consists of stable multi-species communities that engage in a dynamic equilibrium with the host immune system. Dental caries, endodontic infections and periodontal diseases are bacterially driven diseases that are caused by dysbiotic microbiomes. Over a century ago, the focal infection theory implicated these infections in the aetiology of several systemic diseases, ranging from arthritis to neurodegenerative diseases. However, a lack of concrete evidence, combined with the urgency with which clinicians embraced this approach without regard for appropriate case selection, led to its demise within 30 years. In the last decade of the 20th century, the concept of periodontal medicine was introduced to explain the correlations that were being observed between periodontitis and cardiovascular disease, rheumatoid arthritis, Alzheimer's disease, pulmonary disease, pre-term delivery of low birth weight infants and metabolic disease. It was proposed that periodontal pathobionts played a causal role in the initiating or exacerbating certain diseases either by direct invasion or by stimulating a florid immune-inflammatory response that extended into the systemic circulation. This review will examine the strength of current evidence in establishing a causal link between oral pathobionts and systemic disease.
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Affiliation(s)
- Purnima S. Kumar
- Division of Periodontology, College of DentistryThe Ohio State UniversityColumbusOHUSA
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11
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Moore TL. Immune Complexes in Juvenile Idiopathic Arthritis. Front Immunol 2016; 7:177. [PMID: 27242784 PMCID: PMC4873492 DOI: 10.3389/fimmu.2016.00177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/25/2016] [Indexed: 11/13/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) reflects a group of clinically heterogeneous, autoimmune disorders in children characterized by chronic arthritis and hallmarked by elevated levels of circulating immune complexes (CICs) and associated complement activation by-products in their sera. Immune complexes (ICs) have been detected in patients’ sera with JIA utilizing a variety of methods, including the anti-human IgM affinity column, C1q solid-phase assay, polyethylene glycol precipitation, Staphylococcal Protein A separation method, anti-C1q/C3 affinity columns, and FcγRIII affinity method. As many as 75% of JIA patients have had IC detected in their sera. The CIC proteome in JIA patients has been examined to elucidate disease-associated proteins that are expressed in active disease. Evaluation of these ICs has shown the presence of multiple peptide fragments by SDS-PAGE and 2-DE. Subsequently, all isotypes of rheumatoid factor (RF), isotypes of anti-cyclic citrullinated peptide (CCP) antibodies, IgG, C1q, C4, C3, and the membrane attack complex (MAC) were detected in these IC. Complement activation and levels of IC correlate with disease activity in JIA, indicating their role in the pathophysiology of the disease. This review will summarize the existing literature and discuss the role of possible protein modification that participates in the generation of the immune response. We will address the possible role of these events in the development of ectopic germinal centers that become the secondary site of plasma cell development in JIA. We will further address possible therapeutic modalities that could be instituted as a result of the information gathered by the presence of ICs in JIA.
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Affiliation(s)
- Terry L Moore
- Division of Adult and Pediatric Rheumatology, Saint Louis University Medical Center, SSM Cardinal Glennon Children's Hospital , St. Louis, MO , USA
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12
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Racial and ethnic differences in women's preferences for features of contraceptive methods. Contraception 2016; 93:406-11. [DOI: 10.1016/j.contraception.2015.12.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 11/17/2022]
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13
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Clement CC, Moncrieffe H, Lele A, Janow G, Becerra A, Bauli F, Saad FA, Perino G, Montagna C, Cobelli N, Hardin J, Stern LJ, Ilowite N, Porcelli SA, Santambrogio L. Autoimmune response to transthyretin in juvenile idiopathic arthritis. JCI Insight 2016; 1:85633. [PMID: 26973882 DOI: 10.1172/jci.insight.85633] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatological condition. Although it has been proposed that JIA has an autoimmune component, the autoantigens are still unknown. Using biochemical and proteomic approaches, we identified the molecular chaperone transthyretin (TTR) as an antigenic target for B and T cell immune responses. TTR was eluted from IgG complexes and affinity purified from 3 JIA patients, and a statistically significant increase in TTR autoantibodies was observed in a group of 43 JIA patients. Three cryptic, HLA-DR1-restricted TTR peptides, which induced CD4+ T cell expansion and IFN-γ and TNF-α production in 3 out of 17 analyzed patients, were also identified. Misfolding, aggregation and oxidation of TTR, as observed in the synovial fluid of all JIA patients, enhanced its immunogenicity in HLA-DR1 transgenic mice. Our data point to TTR as an autoantigen potentially involved in the pathogenesis of JIA and to oxidation and aggregation as a mechanism facilitating TTR autoimmunity.
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Affiliation(s)
- Cristina C Clement
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
| | - Halima Moncrieffe
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Aditi Lele
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ginger Janow
- Department of Pediatric Rheumatology, Montefiore Medical Center, New York, New York, USA
| | - Aniuska Becerra
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Francesco Bauli
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
| | - Fawzy A Saad
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
| | - Giorgio Perino
- Department of Pathology, Hospital for Special Surgery, New York, New York, USA
| | - Cristina Montagna
- Department of Genetics, Albert Einstein College of Medicine, New York, New York, USA
| | - Neil Cobelli
- Department of Orthopedic Surgery, Montefiore Medical Center, New York, New York, USA
| | - John Hardin
- Department of Orthopedic Surgery, Montefiore Medical Center, New York, New York, USA
| | - Lawrence J Stern
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Norman Ilowite
- Department of Pediatric Rheumatology, Montefiore Medical Center, New York, New York, USA
| | - Steven A Porcelli
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, New York, USA
| | - Laura Santambrogio
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA.,Department of Orthopedic Surgery, Montefiore Medical Center, New York, New York, USA.,Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, New York, USA
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14
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Okano T, Inui K, Tada M, Sugioka Y, Mamoto K, Wakitani S, Koike T, Nakamura H. Levels of interleukin-1 beta can predict response to tocilizumab therapy in rheumatoid arthritis: the PETITE (predictors of effectiveness of tocilizumab therapy) study. Rheumatol Int 2015; 36:349-57. [DOI: 10.1007/s00296-015-3379-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
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15
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Evaluation of anti-cyclic citrullinated peptide antibodies may be beneficial in RF-negative juvenile idiopathic arthritis patients. Clin Rheumatol 2015; 35:601-7. [PMID: 25994613 DOI: 10.1007/s10067-015-2971-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 03/30/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
Despite the high diagnostic and prognostic performance in adult rheumatoid arthritis, the role of antibodies to cyclic citrullinated peptide (anti-CCP) in juvenile idiopathic arthritis (JIA) is controversial. Occurrence of anti-CCP was mainly seen in rheumatoid factor (RF)-positive polyarthritis patients. In the present study, our aim was to investigate the prevalence and significance of anti-CCP for subjects with JIA in our population. We evaluated anti-CCP reactivity in the sera of 70 patients with various subtypes of JIA in a prospective cohort study. Anti-CCP titres were correlated with the evolution of joint involvement and the presence of joint damage. Nine JIA patients were seropositive for anti-CCP with respect to the cut-off value of the test. In our cohort, 34 patients had a polyarticular joint disease, most of them being RF-negative (30/34, 88 %). All four RF-positive polyarthritis patients had high anti-CCP concentrations and an aggressive erosive disease. In the RF-negative JIA patients, anti-CCP reactivity was in lower titres but significantly associated with polyarticular joint involvement (p = 0.016) and also with the presence of joint damage (p < 0.001). Presence of anti-CCP, at both low and high concentration, was significantly associated with a more severe articular disease in our JIA patients. Investigating anti-CCP should clearly be taken into consideration even among patients with JIA subtypes other than RF-positive polyarthritis.
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16
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Wang Y, Pei F, Wang X, Sun Z, Hu C, Dou H. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody for juvenile idiopathic arthritis. J Immunol Res 2015; 2015:915276. [PMID: 25789331 PMCID: PMC4350619 DOI: 10.1155/2015/915276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/01/2015] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To estimate the diagnostic accuracy of the anti-CCP test in JIA and to evaluate factors associated with higher accuracy. METHODS Two investigators performed an extensive search of the literature published between January 2000 and January 2014. The included articles were assessed by the Quality Assessment of Diagnostic Accuracy Studies tool. The meta-analysis was performed using a summary ROC (SROC) curve and a bivariate random-effect model to estimate sensitivity and specificity across studies. RESULTS The bivariate meta-analysis yielded a pooled sensitivity and specificity of 10% (95% confidence interval (CI): 6.0%-15.0%) and 99.0% (95% CI: 98.0%-100.0%). The area under the SROC curve was 0.96. Sensitivity estimates were highly heterogeneous, which was partially explained by the higher sensitivity in the rheumatoid factor-positive polyarthritis (RF+ PA) subtype (48.0%; 95% CI: 31.0%-65.0%) than in the other subtypes (17.0%; 95% CI: 14.0%-20.0%) and the higher sensitivity of the Inova assay (17.0%; 95% CI: 14.0%-20.%%) than the other assays (0.05%; 95% CI: 2.0%-11.0%). CONCLUSIONS Anti-CCP antibody test has a high specificity for the diagnosis of JIA. The sensitivity of this test is low and varies across populations but is higher in RF+ PA than in other JIA subtypes.
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Affiliation(s)
- Yan Wang
- Department of Laboratory Medicine, General Hospital of Jinan Military Area, Jinan, Shandong 250031, China
| | - Fengyan Pei
- Department of Laboratory Medicine, Jinan Central Hospital, Jinan, Shandong 250013, China
| | - Xingjuan Wang
- Department of Laboratory Medicine, General Hospital of Jinan Military Area, Jinan, Shandong 250031, China
| | - Zhiyu Sun
- Department of Laboratory Medicine, General Hospital of Jinan Military Area, Jinan, Shandong 250031, China
| | - Chengjin Hu
- Department of Laboratory Medicine, General Hospital of Jinan Military Area, Jinan, Shandong 250031, China
| | - Hengli Dou
- Division of Chest Disease, The Fourth Hospital of Jinan, Jinan, Shandong 250031, China
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17
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Pretorius E, Kell DB. Diagnostic morphology: biophysical indicators for iron-driven inflammatory diseases. Integr Biol (Camb) 2014; 6:486-510. [PMID: 24714688 DOI: 10.1039/c4ib00025k] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Most non-communicable diseases involve inflammatory changes in one or more vascular systems, and there is considerable evidence that unliganded iron plays major roles in this. Most studies concentrate on biochemical changes, but there are important biophysical correlates. Here we summarize recent microscopy-based observations to the effect that iron can have major effects on erythrocyte morphology, on erythrocyte deformability and on both fibrinogen polymerization and the consequent structure of the fibrin clots formed, each of which contributes significantly and negatively to such diseases. We highlight in particular type 2 diabetes mellitus, ischemic thrombotic stroke, systemic lupus erythematosus, hereditary hemochromatosis and Alzheimer's disease, while recognizing that many other diseases have co-morbidities (and similar causes). Inflammatory biomarkers such as ferritin and fibrinogen are themselves inflammatory, creating a positive feedback that exacerbates disease progression. The biophysical correlates we describe may provide novel, inexpensive and useful biomarkers of the therapeutic benefits of successful treatments.
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Affiliation(s)
- Etheresia Pretorius
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia 0007, South Africa.
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18
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Abstract
Porphyromonas gingivalis is a leading pathogen in chronic periodontitis, a disease process involving progressive destruction of the tissues that support the teeth. Recently, the organism has been reported to produce a unique bacterial enzyme, P. gingivalis peptidyl-arginine deiminase (PPAD), which has the ability to convert arginine residues in proteins to citrulline. Protein citrullination alters protein structure and function; hence, PPAD may be involved in deregulation of the host’s signalling network and immune evasion. Further, accumulating evidence suggests a role for autoimmunity against citrullinated proteins in the development of rheumatoid arthritis (RA). As inflammatory conditions in the lungs of cigarette smokers contribute to the breakdown of immune tolerance to citrullinated epitopes, chronic exposure to citrullinated proteins at periodontitis sites may also predispose susceptible individuals to the development of autoantibodies and the initiation of RA. In this review, we discuss evidence that PPAD may represent a mechanistic link between periodontitis and RA, diseases that are known to be significantly associated at the epidemiological level.
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19
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Berntson L, Nordal E, Fasth A, Aalto K, Herlin T, Nielsen S, Rygg M, Zak M, Rönnelid J. Anti-type II collagen antibodies, anti-CCP, IgA RF and IgM RF are associated with joint damage, assessed eight years after onset of juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2014; 12:22. [PMID: 24944545 PMCID: PMC4061516 DOI: 10.1186/1546-0096-12-22] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/06/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Early appearance of antibodies specific for native human type II collagen (anti-CII) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (RA). The objective of this study was to investigate the occurrence of anti-CII, IgM RF, IgA RF and anti-CCP in serum samples obtained early after diagnosis, and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (JIA). METHODS The Nordic JIA database prospectively included JIA patients followed for eight years with data on remission and joint damage. From this database, serum samples collected from 192 patients, at a median of four months after disease onset, were analysed for IgG anti-CII, IgM RF, IgA RF and IgG anti-CCP. Joint damage was assessed based on Juvenile Arthritis Damage Index for Articular damage (JADI-A), a validated clinical instrument for joint damage. RESULTS Elevated serum levels of anti-CII occurred in 3.1%, IgM RF in 3.6%, IgA RF in 3.1% and anti-CCP in 2.6% of the patients. Occurrence of RF and anti-CCP did to some extent overlap, but rarely with anti-CII. The polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. Anti-CII occurred in younger children, usually without overlap with the other autoantibodies and was associated with high levels of C-reactive protein (CRP) early in the disease course. All four autoantibodies were significantly associated with joint damage, but not with active disease at the eight-year follow up. CONCLUSIONS Anti-CII, anti-CCP, IgA RF and IgM RF detected early in the disease course predicted joint damage when assessed after eight years of disease. The role of anti-CII in JIA should be further studied.
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Affiliation(s)
- Lillemor Berntson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Ellen Nordal
- Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway,Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Anders Fasth
- Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden
| | - Kristiina Aalto
- Department of Pediatrics, Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | - Susan Nielsen
- University Clinic of Pediatrics II, Rigshospitalet, Copenhagen, Denmark
| | - Marite Rygg
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway,Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Marek Zak
- University Clinic of Pediatrics II, Rigshospitalet, Copenhagen, Denmark
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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20
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Finnegan S, Robson J, Scaife C, McAllister C, Pennington SR, Gibson DS, Rooney ME. Synovial membrane protein expression differs between juvenile idiopathic arthritis subtypes in early disease. Arthritis Res Ther 2014; 16:R8. [PMID: 24410838 PMCID: PMC3979044 DOI: 10.1186/ar4434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 12/31/2013] [Indexed: 12/12/2022] Open
Abstract
Introduction Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood with a prevalence of around 1 in 1,000. Without appropriate treatment it can have devastating consequences including permanent disability from joint destruction and growth deformities. Disease aetiology remains unknown. Investigation of disease pathology at the level of the synovial membrane is required if we want to begin to understand the disease at the molecular and biochemical level. The synovial membrane proteome from early disease-stage, treatment naive JIA patients was compared between polyarticular and oligoarticular subgroups. Methods Protein was extracted from 15 newly diagnosed, treatment naive JIA synovial membrane biopsies and separated by two dimensional fluorescent difference in-gel electrophoresis. Proteins displaying a two-fold or greater change in expression levels between the two subgroups were identified by matrix assisted laser desorption ionization-time of flight mass spectrometry with expression further verified by Western blotting and immunohistochemistry. Results Analysis of variance analysis (P ≤ 0.05) revealed 25 protein spots with a two-fold or greater difference in expression levels between polyarticular and oligoarticular patients. Hierarchical cluster analysis with Pearson ranked correlation revealed two distinctive clusters of proteins. Some of the proteins that were differentially expressed included: integrin alpha 2b (P = 0.04); fibrinogen D fragment (P = 0.005); collagen type VI (P = 0.03); fibrinogen gamma chain (P = 0.05) and peroxiredoxin 2 (P = 0.02). The identified proteins are involved in a number of different processes including platelet activation and the coagulation system. Conclusions The data indicate distinct synovial membrane proteome profiles between JIA subgroups at an early stage in the disease process. The identified proteins also provide insight into differentially perturbed pathways which could influence pathological events at the joint level.
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21
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Tugal-Tutkun I, Quartier P, Bodaghi B. Disease of the year: juvenile idiopathic arthritis-associated uveitis--classification and diagnostic approach. Ocul Immunol Inflamm 2014; 22:56-63. [PMID: 24410427 DOI: 10.3109/09273948.2013.871565] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease and the most common systemic association of uveitis in children. JIA is subdivided into seven clinically more homogeneous subtypes, using the International League of Associations for Rheumatology (ILAR) classification system: systemic arthritis, oligoarthritis, rheumatoid factor (RF)-negative polyarthritis, RF-positive polyarthritis, psoriatic arthritis, enthesitis-related arthritis, and undifferentiated arthritis. Uveitis is very rare in patients with systemic onset JIA and in patients with juvenile-onset rheumatoid arthritis. Patients with early-onset antinuclear antibody (ANA)-positive oligoarticular JIA have the highest risk of developing chronic iridocyclitis. Ocular involvement in enthesitis-related arthritis is characterized by recurrent acute symptomatic iridocyclitis. The diagnosis and differential diagnosis of JIA are based on history, physical examination, and laboratory investigations, including complete blood count, acute-phase reactants, ANA, RF, HLA-B27, and musculoskeletal imaging studies. Recent studies have revealed distinct gene expression profiles that may be useful in the diagnosis, classification, and follow-up of JIA patients.
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Affiliation(s)
- Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine , Istanbul , Turkey
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22
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Kang M, Sohn TY, Kim SH, Lee HR, Kang HJ, Kim KN. The Clinical Significance of Anti-cyclic Citrullinated Peptide Antibodies in Juvenile Rheumatoid Arthritis. JOURNAL OF RHEUMATIC DISEASES 2014. [DOI: 10.4078/jrd.2014.21.5.236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Min Kang
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Tae-Young Sohn
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sung-Hye Kim
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hae-Ran Lee
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hee-Jung Kang
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang-Nam Kim
- Department of Pediatric and Adolescent Medicine, College of Hallym University Sacred Heart Hospital, Anyang, Korea
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23
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Maresz KJ, Hellvard A, Sroka A, Adamowicz K, Bielecka E, Koziel J, Gawron K, Mizgalska D, Marcinska KA, Benedyk M, Pyrc K, Quirke AM, Jonsson R, Alzabin S, Venables PJ, Nguyen KA, Mydel P, Potempa J. Porphyromonas gingivalis facilitates the development and progression of destructive arthritis through its unique bacterial peptidylarginine deiminase (PAD). PLoS Pathog 2013; 9:e1003627. [PMID: 24068934 PMCID: PMC3771902 DOI: 10.1371/journal.ppat.1003627] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/31/2013] [Indexed: 01/10/2023] Open
Abstract
Rheumatoid arthritis and periodontitis are two prevalent chronic inflammatory diseases in humans and are associated with each other both clinically and epidemiologically. Recent findings suggest a causative link between periodontal infection and rheumatoid arthritis via bacteria-dependent induction of a pathogenic autoimmune response to citrullinated epitopes. Here we showed that infection with viable periodontal pathogen Porphyromonas gingivalis strain W83 exacerbated collagen-induced arthritis (CIA) in a mouse model, as manifested by earlier onset, accelerated progression and enhanced severity of the disease, including significantly increased bone and cartilage destruction. The ability of P. gingivalis to augment CIA was dependent on the expression of a unique P. gingivalis peptidylarginine deiminase (PPAD), which converts arginine residues in proteins to citrulline. Infection with wild type P. gingivalis was responsible for significantly increased levels of autoantibodies to collagen type II and citrullinated epitopes as a PPAD-null mutant did not elicit similar host response. High level of citrullinated proteins was also detected at the site of infection with wild-type P. gingivalis. Together, these results suggest bacterial PAD as the mechanistic link between P. gingivalis periodontal infection and rheumatoid arthritis. Clinical and epidemiological data indicates that chronic periodontal disease (PD), one of the most prevalent infectious inflammatory disease of mankind, is linked to systemic inflammatory diseases such as cardiovascular diseases (CVD), rheumatoid arthritis (RA) and chronic obstructive pulmonary disease (COPD). Nevertheless, the causative mechanisms of association between PD and chronic inflammatory diseases are very poorly understood. Recent findings suggest a causative link between periodontal infection and rheumatoid arthritis via bacteria-dependent induction of a pathogenic response to citrullinated epitopes. In present study we show that infection with viable periodontal pathogen Porphyromonas gingivalis but not another oral bacterium (Prevotella intermedia), exacerbated CIA, as manifested by earlier onset, accelerated progression and enhanced severity of the disease, including significantly increased bone and cartilage destruction. The ability of P. gingivalis to augment CIA was dependent on the expression of a unique enzyme peptidylarginine deiminase, which converts arginine residues in proteins to citrulline. This knowledge may create new perspectives in the treatment and prevention of RA in susceptible individuals.
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Affiliation(s)
- Katarzyna J. Maresz
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Annelie Hellvard
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aneta Sroka
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Karina Adamowicz
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Ewa Bielecka
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Joanna Koziel
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Gawron
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Danuta Mizgalska
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna A. Marcinska
- Department of Human Developmental Biology, Jagiellonian University College of Medicine, Krakow, Poland
| | - Malgorzata Benedyk
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Krzysztof Pyrc
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Anne-Marie Quirke
- Kennedy Institute of Rheumatology, University of Oxford, London, United Kingdom
| | - Roland Jonsson
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Saba Alzabin
- Kennedy Institute of Rheumatology, University of Oxford, London, United Kingdom
| | - Patrick J. Venables
- Kennedy Institute of Rheumatology, University of Oxford, London, United Kingdom
| | - Ky-Anh Nguyen
- Institute of Dental Research, Westmead Centre for Oral Health and Westmead Millennium Institute, Sydney, Australia
- Department of Oral Biology, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Piotr Mydel
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
- University of Louisville School of Dentistry, Center for Oral Health and Systemic Diseases, Louisville, Kentucky, United States of America
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24
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Gilliam BE, Chauhan AK, Moore TL. Evaluation of anti-citrullinated type II collagen and anti-citrullinated vimentin antibodies in patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013; 11:31. [PMID: 23987731 PMCID: PMC3765710 DOI: 10.1186/1546-0096-11-31] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine the prevalence and significance of anti-citrullinated vimentin and anti-citrullinated type II collagen antibodies and elucidate their role in the disease process of juvenile idiopathic arthritis (JIA). METHODS Sera were obtained from 95 patients with various subtypes of JIA, 19 systemic lupus erythematosus (SLE) patients, and 10 healthy children. Antibodies were measured in the sera against citrullinated and native type II collagen and vimentin (vim1-16 and vim 59-74) by enzyme-linked immunosorbent assay. Samples were compared to anti-cyclic citrullinated peptide (anti-CCP) antibody and rheumatoid factor (RF) isotypes, and our previously measured anti-citrullinated fibrinogen and α-enolase antibodies on the same patient population, in addition to erythrocyte sedimentation rate and C-reactive protein. The relationship between the anti-citrullinated antibody profile and disease activity and joint damage were also investigated. RESULTS Twenty-three JIA patients (24%) demonstrated reactivity to anti-citrullinated type II collagen. Ten JIA patients (10.5%) demonstrated reactivity to anti-citrullinated vimentin 1-16 antibodies and 7 (7.4%) to anti-citrullinated vimentin 59-74 antibodies. One IgM RF-positive polyarticular patient was positive for all 5 of the citrullinated autoantibodies tested. Thirty-seven different subsets of patients were identified based on their anti-citrullinated autoantibody and RF isotype profile. No significant associations were noted with anti-citrullinated type II collagen and anti-citrullinated vimentin antibodies with joint damage or disease activity. Anti-citrullinated vimentin 59-74 antibodies demonstrated the highest overall specificity at 89.7%, with anti-citrullinated vimentin 1-16 and anti-citrullinated type II collagen antibodies at 86.2%. CONCLUSION This study demonstrates that antibodies to multiple citrullinated epitopes are present in the sera of patients with various subtypes of JIA. It also demonstrates the frequent occurrence of anti-citrullinated type II collagen and anti-citrullinated fibrinogen antibodies. The presence of autoantibodies to citrullinated antigens in JIA patients is highly diverse.
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Affiliation(s)
- Brooke E Gilliam
- Division of Adult and Pediatric Rheumatology, Saint Louis University School of Medicine, 1402 South Grand Blvd,, Room 211A Doisy Hall, Saint Louis, Missouri 63104, USA.
| | - Anil K Chauhan
- Division of Adult and Pediatric Rheumatology, Saint Louis University School of Medicine, 1402 South Grand Blvd., Room 211A Doisy Hall, Saint Louis, Missouri 63104, USA
| | - Terry L Moore
- Division of Adult and Pediatric Rheumatology, Saint Louis University School of Medicine, 1402 South Grand Blvd., Room 211A Doisy Hall, Saint Louis, Missouri 63104, USA,Division of Adult and Pediatric Rheumatology, Internal Medicine, Pediatrics, and Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
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25
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Wu G, Krebs CR, Lin FC, Wolberg AS, Oldenburg AL. High sensitivity micro-elastometry: applications in blood coagulopathy. Ann Biomed Eng 2013; 41:2120-9. [PMID: 23649979 DOI: 10.1007/s10439-013-0817-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 04/19/2013] [Indexed: 11/30/2022]
Abstract
Highly sensitive methods for the assessment of clot structure can aid in our understanding of coagulation disorders and their risk factors. Rapid and simple clot diagnostic systems are also needed for directing treatment in a broad spectrum of cardiovascular diseases. Here we demonstrate a method for micro-elastometry, named resonant acoustic spectroscopy with optical vibrometry (RASOV), which measures the clot elastic modulus (CEM) from the intrinsic resonant frequency of a clot inside a microwell. We observed a high correlation between the CEM of human blood measured by RASOV and a commercial thromboelastograph (TEG), (R = 0.966). Unlike TEG, RASOV requires only 150 μL of sample and offers improved repeatability. Since CEM is known to primarily depend upon fibrin content and network structure, we investigated the CEM of purified clots formed with varying amounts of fibrinogen and thrombin. We found that RASOV was sensitive to changes of fibrinogen content (0.5-6 mg/mL), as well as to the amount of fibrinogen converted to fibrin during clot formation. We then simulated plasma hypercoagulability via hyperfibrinogenemia by spiking whole blood to 150 and 200% of normal fibrinogen levels, and subsequently found that RASOV could detect hyperfibrinogenemia-induced changes in CEM and distinguish these conditions from normal blood.
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Affiliation(s)
- Gongting Wu
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, CB 3255, Chapel Hill, NC 27599, USA
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26
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Tebo AE, Jaskowski T, Davis KW, Whiting A, Clifford B, Zeft A, McNally B, Hill HR, Bohnsack J, Prahalad S. Profiling anti-cyclic citrullinated peptide antibodies in patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2012; 10:29. [PMID: 22931121 PMCID: PMC3490766 DOI: 10.1186/1546-0096-10-29] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 08/09/2012] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Anti-citrullinated protein/peptide antibodies (ACPA), have high specificity for rheumatoid arthritis (RA). Some children with juvenile idiopathic arthritis (JIA), phenotypically resemble RA and test positive for rheumatoid factor (RF) a characteristic biomarker of RA. We investigated the prevalence of ACPA and its relationship to other serologic markers associated with RA in a well-characterized JIA cohort. METHODS Cases were 334 children with JIA, 30 of whom had RF + polyarticular JIA. Sera from all cases and 50 healthy pediatric controls were investigated by ELISA at a single time point for anti-cyclic citrullinated peptide (anti-CCP) IgG, RF IgM, IgA and IgG, anti-RA33 IgG, and antinuclear antibodies (ANA). Comparisons between cases and controls were made using Chi-square or Fisher exact tests and T-tests. RESULTS The prevalence of RF was 8% among controls, and 12% among cases (ns). The prevalence of ACPA was 2% in controls and 14.3% in cases (OR 8.2, p <0.01). Children who were ACPA-positive and RF-negative (n = 23) had a significantly earlier onset-age (4.6 years vs. 12.1 years, p <0.00001) and had fewer HLA-DRB1 shared epitope alleles than those positive for both RF and ACPA (n = 25). Prevalence of anti-RA33 was not different between cases and controls. CONCLUSIONS ACPAs are detectable in 14% of children with JIA. Children with positive ACPA but negative RF are frequent, and may define a distinct subset of children with JIA. ACPA testing should be included in the classification of JIA.
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Affiliation(s)
- Anne E Tebo
- Department of Pediatrics and Human Genetics, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322, USA.
| | - Troy Jaskowski
- Associated Regional and University Pathologists Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - K Wayne Davis
- Associated Regional and University Pathologists Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - April Whiting
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Bronte Clifford
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Andrew Zeft
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | | | - Harry R Hill
- Associated Regional and University Pathologists Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA,Department of Pathology, University of Utah, Salt Lake City, UT, USA,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA,Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - John Bohnsack
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Sampath Prahalad
- Department of Pediatrics and Human Genetics, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322, USA,Children's Healthcare of Atlanta, Atlanta, GA, USA
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Gilliam BE, Moore TL. The role of anti-cyclic citrullinated peptide (CCP) antibodies in early detection of rheumatoid arthritis: an overview of the INOVA Diagnostics, Inc. QUANTA Lite CCP assays. ACTA ACUST UNITED AC 2012; 6:359-69. [PMID: 23480744 DOI: 10.1517/17530059.2012.694423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation and the presence of self-reactive autoantibodies. Since the discovery of anti-cyclic citrullinated peptide (anti-CCP) antibodies, several assays have been developed to measure these autoantibodies in RA patients. The first-generation kit offered high specificity, but sensitivity was low. The second-generation IgG anti-CCP antibody assay (CCP2) offered the same high specificity, with greatly improved sensitivity for RA. INOVA Diagnostics, Inc. offers, in addition to CCP2, a third-generation assay with higher sensitivity compared with CCP2 and also a combined IgG/IgA anti-CCP antibody assay. AREAS COVERED The review covers the use of INOVA Diagnostics, Inc. multiple anti-CCP antibody assays in early detection of RA, while also comparing these assays with other commercially available methods of measuring anti-CCP antibodies. While most of the review focuses on the significance of these autoantibodies in adult RA patients, their role in juvenile idiopathic arthritis is also discussed. EXPERT OPINION Detection of anti-CCP antibodies has emerged as one of the most important disease markers in RA patients. Several methods are available to measure anti-CCP antibodies, and isotyping and identification of citrullination targets are now the next step in further characterizing these autoantibodies.
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Affiliation(s)
- Brooke E Gilliam
- Saint Louis University School of Medicine, Division of Adult and Pediatric Rheumatology , 1402 South Grand Blvd, Saint Louis, MI 63104 , USA
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