title: Anti-cyclic citrullinated peptide antibodies in systemic lupus erythematosus patients with articular involvement: a predictive marker for erosive disease?
abstract: A small number of systemic lupus erythematosus (SLE) patients develop an erosive disease. Some studies have suggested an association between anti-cyclic citrullinated (anti-CCP) antibodies and this pattern of arthritis, but their exact significance in SLE patients remains unclear. The aim of this study was to evaluate the prevalence of anti-CCP antibodies in SLE patients with different subsets of articular disease.  Among 521 SLE patients followed in this center from 1976 to 2011, those with articular involvement (n=298) were selected to take part in the study. We searched for anti-CCP2 IgG antibodies in 198 patients using a commercial enzyme linked immunosorbent assay (Immunoscan RA, Eurodiagnostica). In 174 patients the results for rheumatoid factor (RF) by nephelometry were retrospectively collected. C reactive protein (CRP) was obtained from clinical records. Patients were classified into 3 groups: erosive, non-erosive deforming, non-erosive non-deforming arthritis. Results of the different tests were compared among the groups. P&lt;0.05 was considered statistically significant. Anti-CCP antibodies were significantly associated with erosive disease. We also found that RF positivity and increased CRP were more frequent in erosive arthritis and erosive or non-deforming arthritis, respectively, than in non-erosive non-deforming arthritis.  This study supports the evidence that anti-CCP antibodies could be a useful marker of erosive disease in SLE patients. Increase in RF and CRP could be an additional means of identifying lupus patients with arthritis at risk of a worse prognosis.
authors.affiliation: Rheumatology and Clinical Immunology Unit, Spedali Civili and University of Brescia, Italy. mara.taraborelli@libero.it
authors.forename: M
authors.initials: M
authors.lastname: Taraborelli
authors.forename: F
authors.initials: F
authors.lastname: Inverardi
authors.forename: M
authors.initials: M
authors.lastname: Fredi
authors.forename: A
authors.initials: A
authors.lastname: Ceribelli
authors.forename: I
authors.initials: I
authors.lastname: Cavazzana
authors.forename: A
authors.initials: A
authors.lastname: Tincani
authors.forename: F
authors.initials: F
authors.lastname: Franceschini
mesh_terms: D000328:Adult; D000918:Antibody Specificity; D001168:Arthritis / Q000097:blood / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D001323:Autoantibodies / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D005260:Female; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000473:pathology; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000473:pathology; D006801:Humans; D007596:Joints / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000473:pathology; D008297:Male; D010456:Peptides, Cyclic / Q000276:immunology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide