The value of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis: do they imply new risk factors?
Rheumatoid arthritis (RA) is a systemic autoimmune disease that causes chronic inflammation of the joints and several extra-articular manifestations that account for increased morbimortality of these patients. The involvement of B cells in RA pathophysiology was recognized early, with the discovery of rheumatoid factor antibody. Recently, a number of autoantibodies against citrullinated proteins have been described, of which anti-cyclic citrullinated peptide (anti-CCP) is the most specific for RA. A cohort of 937 patients with RA was studied to determine the clinical correlates of anti-CCP antibodies. The presence of anti-CCP antibodies correlated with worse joint involvement and several extra-articular manifestations, i.e., higher incidence of ischemic heart disease independent of classic cardiovascular factors and higher mortality rate. A multivariate logistic regression model showed that only anti-CCP antibodies were independently associated with the development of ischemic heart disease in patients with RA. The clinical value of anti-citrullinated protein antibodies and the relevance of anti-CCP antibodies in daily clinical practice are reviewed.
López-Longo
Francisco Javier
FJ
Department of Rheumatology, University Hospital Gregorio Maranon, Madrid, Spain.
Sánchez-Ramón
Silvia
S
Carreño
Luis
L
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D000091344:Filaggrin Proteins; D006801:Humans; D007381:Intermediate Filament Proteins / Q000276:immunology; D007596:Joints / Q000503:physiopathology; D016015:Logistic Models; D017202:Myocardial Ischemia / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology; D010456:Peptides, Cyclic / Q000276:immunology*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
D001323:Autoantibodies; D015415:Biomarkers; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide