Specific autoantibodies precede the symptoms of rheumatoid arthritis: A study of serial measurements in blood donors

Wiley - Tập 50 Số 2 - Trang 380-386 - 2004
Markus M. J. Nielen1, Dirkjan van Schaardenburg2, H. W. Reesink3, Rob J. van de Stadt1, Irene van der Horst‐Bruinsma4, Margret H. M. T. De Koning1, Moud R. Habibuw3, Jan P. Vandenbroucke5, Ben A. C. Dijkmans2
1Jan van Breemen Institute, Amsterdam, The Netherlands
2Jan van Breemen Institute and Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
3Sanquin Blood Bank Northwest Region, Amsterdam, The Netherlands
4Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
5Leiden University Medical Center, Leiden, The Netherlands.

Tóm tắt

AbstractObjectiveAutoantibodies have been demonstrated in single serum samples from healthy subjects up to 10 years before they developed rheumatoid arthritis (RA). However, the time course for the development of antibodies before onset of clinical RA is unknown, nor is it known which antibody, or combinations of antibodies, might be most sensitive or specific for predicting future development of the disease. The present study was undertaken to investigate this.MethodsPatients with RA who had been blood donors before the onset of disease symptoms were enrolled. Frozen serum samples from each donor were retrieved, together with 2 serum samples from controls matched for age, sex, and date of donation. All samples were tested for IgM rheumatoid factor (IgM‐RF) and anti–cyclic citrullinated peptide (anti‐CCP) antibodies.ResultsSeventy‐nine patients with RA (62% female; mean age at onset of symptoms 51 years) were included. A median of 13 samples (range 1–51) per patient were available; the earliest samples had been collected a median of 7.5 years (range 0.1–14.5) before the onset of symptoms. Thirty‐nine patients (49%) were positive for IgM‐RF and/or anti‐CCP on at least one occasion before the development of RA symptoms, a median of 4.5 years (range 0.1–13.8) before symptom onset. Of the 2,138 control samples, 1.1% were positive for IgM‐RF, and 0.6% were positive for anti‐CCP.ConclusionApproximately half of patients with RA have specific serologic abnormalities several years before the onset of symptoms. A finding of an elevated serum level of IgM‐RF or anti‐CCP in a healthy individual implies a high risk for the development of RA. We conclude that IgM‐RF and anti‐CCP testing with appropriately high specificity may assist in the early detection of RA in high‐risk populations.

Từ khóa


Tài liệu tham khảo

10.1002/art.1780270805

10.1016/S0140-6736(87)91672-2

10.1136/ard.59.6.468

10.1016/S0140-6736(97)01300-7

10.1016/S0140-6736(98)08513-4

10.1002/1529-0131(200106)44:6<1248::AID-ART215>3.0.CO;2-8

10.1002/1529-0131(200108)44:8<1736::AID-ART308>3.0.CO;2-I

10.1002/1529-0131(200009)43:9<1927::AID-ANR3>3.0.CO;2-B

10.1002/1529-0131(199808)41:8<1481::AID-ART19>3.0.CO;2-O

10.1093/rheumatology/31.6.365

Aho K, 1991, Rheumatoid factors antedating clinical rheumatoid arthritis, J Rheumatol, 18, 1282

10.1002/art.1780350810

10.1136/ard.59.2.149

10.1002/art.1780311004

10.1136/ard.45.8.684

10.1172/JCI1316

10.1186/ar93

10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3

Jansen LMA, 2002, Rheumatoid factor and antibodies to cyclic citrullinated peptide differentiate rheumatoid arthritis from undifferentiated polyarthritis in patients with early arthritis, J Rheumatol, 29, 2074

10.1002/art.1780310302

10.1136/ard.46.9.674

10.1093/rheumatology/39.7.742

ChorusAMJ.Reuma in Nederland: de cijfers. Actualisering 2000. TNO‐rapport 2001: 27.

Kessel A, 2000, Use of antikeratin antibodies to distinguish between rheumatoid arthritis and polyarthritis associated with hepatitis C infection, J Rheumatol, 27, 610

Aho K, 1992, Antinuclear antibodies heralding the onset of systemic lupus erythematosus, J Rheumatol, 19, 1377

10.1016/S0140-6736(94)92521-6

10.1006/jaut.1996.0096

10.1056/NEJMoa012350

10.1136/ard.44.8.519

Thông tin
Thông tin xuất bản

Wiley

Tập 50 Số 2

380-386

Thông tin tác giả