title: Prospective evaluation of the frequency and clinical significance of antineutrophil cytoplasmic and anticardiolipin antibodies in community cases of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate the frequencies of antineutrophil cytoplasmic (ANCA), anticardiolipin (aCLA) and anti-beta(2)-glycoprotein 1 antibodies (abeta(2)-GP1A) in rheumatoid arthritis (RA) of limited duration in patients recruited primarily from private practitioners (80%), and to attempt to correlate the presence of these antibodies with certain clinical and/or biological criteria. Patients and methods. Patients (n = 102) with RA evolving for <5 yr (mean 2.2 yr) were recruited. A home evaluation collected clinical data [Ritchie articular index, Health Assessment Questionnaire (HAQ) index, extra-articular manifestations] and blood for biological analyses [C-reactive protein (CRP), rheumatoid factor, ANCA, aCLA, abeta(2)-GP1A]. ANCA were detected by indirect immunofluorescence on neutrophils and their specificity was determined by enzyme-linked immunosorbent assay (ELISA) and confirmed by immunoblotting; aCLA and abeta(2)-GP1A were detected by ELISA.
  
  
  RESULTS
  Patients had mild RA (Ritchie = 11/78 +/- 9.6; HAQ = 0.79/3 +/- 0.7), probably due to the recruitment procedure. ANCA, aCLA and abeta(2)-GP1A frequencies were 18.5, 7 and 0%, respectively. Titres of ANCA and aCLA were low. A perinuclear ANCA staining pattern was exclusively observed and lactoferrin was shown to be the major antigen recognized. No relationship was found between ANCA and aCLA and/or rheumatoid factor, or any clinical manifestations. ANCA were more common in RA of longer duration (cut-off: 4 yr; P = 0.05) and aCLA were correlated with the CRP level (P = 0.05).
  
  
  CONCLUSIONS
  In RA of recent onset, ANCA and aCLA were detected at low titres and frequencies, and were not associated with any clinical manifestations. A longitudinal study is needed to determine whether their early appearance is predictive of subsequent disease severity.
authors.affiliation: Service de Rhumatologie, INSERM U 519 et Institut Fédératif de Recherche Multidisciplinaire sur les Peptides, Centre Hospitalier Universitaire de Rouen, France.
authors.forename: O
authors.initials: O
authors.lastname: Vittecoq
authors.forename: F
authors.initials: F
authors.lastname: Jouen-Beades
authors.forename: K
authors.initials: K
authors.lastname: Krzanowska
authors.forename: I
authors.initials: I
authors.lastname: Bichon-Tauvel
authors.forename: J F
authors.initials: JF
authors.lastname: Menard
authors.forename: A
authors.initials: A
authors.lastname: Daragon
authors.forename: D
authors.initials: D
authors.lastname: Gilbert
authors.forename: F
authors.initials: F
authors.lastname: Tron
authors.forename: X
authors.initials: X
authors.lastname: Le Loët
mesh_terms: D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000032:analysis*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D000918:Antibody Specificity; D001172:Arthritis, Rheumatoid / Q000276:immunology*; D003710:Demography; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D019084:Fluorescent Antibody Technique, Indirect; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053482:beta 2-Glycoprotein I
chemical_list: D017153:Antibodies, Anticardiolipin; D019268:Antibodies, Antineutrophil Cytoplasmic; D006023:Glycoproteins; D053482:beta 2-Glycoprotein I