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RESEARCH - Simultaneous development of acute phase response and autoantibodies in preclinical RA

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Ann Rheum Dis. 2005 Aug 3; [Epub ahead of print]

Simultaneous development of acute phase response and autoantibodies in

preclinical rheumatoid arthritis.

Nielen MM, van Schaardenburg D, Reesink HW, Twisk JW, van de Stadt RJ, van

der Horst-Bruinsma IE, de Koning MH, Habibuw MR, Dijkmans BA.

Jan van Breemen Institute, Amsterdam, Netherlands.

BACKGROUND: The preclinical phase of rheumatoid arthritis (RA) is

characterized by specific autoantibodies and slightly elevated markers of

inflammation, but the sequence of these events is unknown. OBJECTIVE: To

investigate the temporal relationship between the onset of inflammation (as

measured by secretory phospholipase A2 (sPLA2) and C- reactive protein

(CRP)) and the presence of autoantibodies (IgM rheumatoid factor (IgM-RF)

and antibodies against citrullinated peptides (anti-CCP)) in the preclinical

phase of RA. METHODS: Of 79 RA patients who had been blood donor before the

onset of disease, a median of 13 serum samples per patient was available.

sPLA2 was measured in patient and matched control samples and related to

previous measurements of CRP, IgM-RF and anti-CCP. The temporal relationship

between the increased markers of inflammation and autoantibodies was

analyzed with time- lag analysis. RESULTS: Both the IgM-RF concentration and

the anti-CCP concentration were significantly associated (p<0.001) with the

concentrations of sPLA2, CRP and the combination of sPLA2 and CRP at the

same time point. However, we found no stronger association between the two

autoantibody tests and the three inflammation parameters 1, 2 and 3 years

before or after in comparison with the measurements at the same time, in the

group as a whole as well as in subgroups of IgM-RF and anti-CCP positive

patients.

CONCLUSION: Both the acute phase response and autoantibody formation often

develop years before the first symptoms of rheumatoid arthritis occur, and

these phenomena are probably closely connected in time.

PMID: 16079166

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6079166 & dopt=Abstract

Not an MD

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Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

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