title: Anti-cyclic citrullinated peptide-2 (CCP2) autoantibodies and extra-articular manifestations in Greek patients with rheumatoid arthritis.
abstract: The objective of our study was to establish whether there is an association between rheumatoid arthritis with extra-articular manifestations (exRA) and anti-cyclic citrullinated peptide 2 (anti-CCP2) antibodies in Greeks. A retrospective study of 220 Greek patients with RA, 95 with exRA and 125 without extra-articular manifestations (cRA). Serum anti-CCP2 antibodies and IgM rheumatoid factor (RF) were measured. CCP2(+) were 65.3% of exRA and 58.4% of cRA patients. RF(+) were 69.5% of exRA and 60.0% of cRA patients. Among exRA patients, 37.9% had high serum anti-CCP2 antibody levels (>100 IU/ml) compared to 21.6% cRA patients (p = 0.008). Serositis and pulmonary fibrosis were found to be associated with high levels of anti-CCP2 antibodies (52.9 vs 26.6%, p = 0.02 and 63.6 vs 26.8%, p = 0.008, respectively). Serum RF levels were 265.0 +/- 52.0 IU/ml (mean +/- SEM) in exRA and 205.1 +/- 40.6 (mean +/- SEM) in cRA (NS). High serum RF levels (>268 IU/ml) were more likely to have sicca syndrome. In Greek patients with rheumatoid arthritis (RA), high serum anti-CCP2 antibodies are associated with serositis and pulmonary fibrosis. Therefore, anti-CCP2 antibodies have prognostic significance in patients with RA.
authors.affiliation: Department of Medicine/Rheumatology, University Hospital of Larisa, Larisa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Alexiou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Germenis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Koutroumpas
authors.forename: Anastasia
authors.initials: A
authors.lastname: Kontogianni
authors.forename: Katerina
authors.initials: K
authors.lastname: Theodoridou
authors.forename: Lazaros I
authors.initials: LI
authors.lastname: Sakkas
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000208:ethnology / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D005258:Felty Syndrome / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D006115:Greece / Q000208:ethnology; D006801:Humans; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology*; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000276:immunology; D012218:Rheumatoid Nodule / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D012700:Serositis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D014657:Vasculitis / Q000175:diagnosis / Q000209:etiology / Q000276:immunology
chemical_list: D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor