Skip to main content
NCBI home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 2003 May;62(5):427–430. doi: 10.1136/ard.62.5.427

Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis

J Vencovsky, S Machacek, L Sedova, J Kafkova, J Gatterova, V Pesakova, S Ruzickova
PMCID: PMC1754544  PMID: 12695154

Abstract

Objective: To evaluate a contribution of selected laboratory parameters for a prediction of progressive and erosive development in patients with early rheumatoid arthritis (RA).

Methods: In a prospective study baseline levels of antibodies to cyclic citrullinated peptide (anti-CCP), IgM, IgA, and IgG rheumatoid factors (RFs) were measured by enzyme linked immunosorbent assay (ELISA) in 104 patients with RA with disease duration <2 years. Antikeratin antibodies (AKA) and antiperinuclear factor (APF) were detected by indirect immunofluorescence. Patients were divided into two groups based either on the presence or absence of erosions or according to progression of Larsen score at the end of the 24 months' follow up.

Results: Sixty seven (64%) patients developed radiographic erosions, 49 (47%) had progression in Larsen score, and 36 (35%) progressed by more than 10 Larsen units. Significant differences in erosions and progression between the two groups were detected for anti-CCP, AKA, APF, IgM RF, IgA RF, and IgG RF. Baseline Larsen score correlated significantly with anti-CCP, IgM RF, and IgA RF levels, and all measured antibodies correlated with the progression >10 units. The combination of anti-CCP and IgM RF increased the ability to predict erosive and progressive disease.

Conclusion: The data confirmed that measurement of anti-CCP, AKA, APF, and individual isotypes of RFs was useful for prediction of structural damage early in the disease course. Combined analysis of anti-CCP and IgM RF provides the most accurate prediction.

Full Text

The Full Text of this article is available as a PDF (110.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnett F. C., Edworthy S. M., Bloch D. A., McShane D. J., Fries J. F., Cooper N. S., Healey L. A., Kaplan S. R., Liang M. H., Luthra H. S. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. doi: 10.1002/art.1780310302. [DOI] [PubMed] [Google Scholar]
  2. Bampton J. L., Cawston T. E., Kyle M. V., Hazleman B. L. Measurement of rheumatoid factors by an enzyme-linked immunosorbent assay (ELISA) and comparison with other methods. Ann Rheum Dis. 1985 Jan;44(1):13–19. doi: 10.1136/ard.44.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berthelot J. M., Maugars Y., Castagné A., Audrain M., Prost A. Antiperinuclear factors are present in polyarthritis before ACR criteria for rheumatoid arthritis are fulfilled. Ann Rheum Dis. 1997 Feb;56(2):123–125. doi: 10.1136/ard.56.2.123. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Corbett M., Dalton S., Young A., Silman A., Shipley M. Factors predicting death, survival and functional outcome in a prospective study of early rheumatoid disease over fifteen years. Br J Rheumatol. 1993 Aug;32(8):717–723. doi: 10.1093/rheumatology/32.8.717. [DOI] [PubMed] [Google Scholar]
  5. Goldbach-Mansky R., Lee J., McCoy A., Hoxworth J., Yarboro C., Smolen J. S., Steiner G., Rosen A., Zhang C., Ménard H. A. Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset. Arthritis Res. 2000 Mar 31;2(3):236–243. doi: 10.1186/ar93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hassfeld W., Steiner G., Graninger W., Witzmann G., Schweitzer H., Smolen J. S. Autoantibody to the nuclear antigen RA33: a marker for early rheumatoid arthritis. Br J Rheumatol. 1993 Mar;32(3):199–203. doi: 10.1093/rheumatology/32.3.199. [DOI] [PubMed] [Google Scholar]
  7. Hayem G., Chazerain P., Combe B., Elias A., Haim T., Nicaise P., Benali K., Eliaou J. F., Kahn M. F., Sany J. Anti-Sa antibody is an accurate diagnostic and prognostic marker in adult rheumatoid arthritis. J Rheumatol. 1999 Jan;26(1):7–13. [PubMed] [Google Scholar]
  8. Kroot E. J., de Jong B. A., van Leeuwen M. A., Swinkels H., van den Hoogen F. H., van't Hof M., van de Putte L. B., van Rijswijk M. H., van Venrooij W. J., van Riel P. L. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum. 2000 Aug;43(8):1831–1835. doi: 10.1002/1529-0131(200008)43:8<1831::AID-ANR19>3.0.CO;2-6. [DOI] [PubMed] [Google Scholar]
  9. Kurki P., Aho K., Palosuo T., Heliövaara M. Immunopathology of rheumatoid arthritis. Antikeratin antibodies precede the clinical disease. Arthritis Rheum. 1992 Aug;35(8):914–917. doi: 10.1002/art.1780350810. [DOI] [PubMed] [Google Scholar]
  10. Kurki P., von Essen R., Kaarela K., Isomäki H., Palosuo T., Aho K. Antibody to stratum corneum (antikeratin antibody) and antiperinuclear factor: markers for progressive rheumatoid arthritis. Scand J Rheumatol. 1997;26(5):346–349. doi: 10.3109/03009749709065696. [DOI] [PubMed] [Google Scholar]
  11. Larsen A., Dale K., Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. doi: 10.1177/028418517701800415. [DOI] [PubMed] [Google Scholar]
  12. Lipsky P. E., van der Heijde D. M., St Clair E. W., Furst D. E., Breedveld F. C., Kalden J. R., Smolen J. S., Weisman M., Emery P., Feldmann M. Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med. 2000 Nov 30;343(22):1594–1602. doi: 10.1056/NEJM200011303432202. [DOI] [PubMed] [Google Scholar]
  13. Meyer O., Combe B., Elias A., Benali K., Clot J., Sany J., Eliaou J. F. Autoantibodies predicting the outcome of rheumatoid arthritis: evaluation in two subsets of patients according to severity of radiographic damage. Ann Rheum Dis. 1997 Nov;56(11):682–685. doi: 10.1136/ard.56.11.682. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mimori T., Suganuma K., Tanami Y., Nojima T., Matsumura M., Fujii T., Yoshizawa T., Suzuki K., Akizuki M. Autoantibodies to calpastatin (an endogenous inhibitor for calcium-dependent neutral protease, calpain) in systemic rheumatic diseases. Proc Natl Acad Sci U S A. 1995 Aug 1;92(16):7267–7271. doi: 10.1073/pnas.92.16.7267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Muñoz-Fernández S., Alvarez-Doforno R., González-Tarrio J. M., Balsa A., Richi P., Fontán G., Gijón-Baños J., Martin-Mola E. Antiperinuclear factor as a prognostic marker in rheumatoid arthritis. J Rheumatol. 1999 Dec;26(12):2572–2577. [PubMed] [Google Scholar]
  16. Schellekens G. A., Visser H., de Jong B. A., van den Hoogen F. H., Hazes J. M., Breedveld F. C., van Venrooij W. J. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum. 2000 Jan;43(1):155–163. doi: 10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3. [DOI] [PubMed] [Google Scholar]
  17. Vencovský J. Revmatoidní faktory u revmatoidní artritidy ve vyssím veku. Cas Lek Cesk. 1991 Jan 25;130(4):108–111. [PubMed] [Google Scholar]
  18. Vincent C., Serre G., Lapeyre F., Fournié B., Ayrolles C., Fournié A., Soleilhavoup J. P. High diagnostic value in rheumatoid arthritis of antibodies to the stratum corneum of rat oesophagus epithelium, so-called 'antikeratin antibodies'. Ann Rheum Dis. 1989 Sep;48(9):712–722. doi: 10.1136/ard.48.9.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Visser Henk, le Cessie Saskia, Vos Koen, Breedveld Ferdinand C., Hazes Johanna M. W. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum. 2002 Feb;46(2):357–365. doi: 10.1002/art.10117. [DOI] [PubMed] [Google Scholar]
  20. Wolfe F., Sharp J. T. Radiographic outcome of recent-onset rheumatoid arthritis: a 19-year study of radiographic progression. Arthritis Rheum. 1998 Sep;41(9):1571–1582. doi: 10.1002/1529-0131(199809)41:9<1571::AID-ART7>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
  21. Youinou P., Le Goff P., Colaco C. B., Thivolet J., Tater D., Viac J., Shipley M. Antikeratin antibodies in serum and synovial fluid show specificity for rheumatoid arthritis in a study of connective tissue diseases. Ann Rheum Dis. 1985 Jul;44(7):450–454. doi: 10.1136/ard.44.7.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. van Jaarsveld C. H., ter Borg E. J., Jacobs J. W., Schellekens G. A., Gmelig-Meyling F. H., van Booma-Frankfort C., de Jong B. A., van Venrooij W. J., Bijlsma J. W. The prognostic value of the antiperinuclear factor, anti-citrullinated peptide antibodies and rheumatoid factor in early rheumatoid arthritis. Clin Exp Rheumatol. 1999 Nov-Dec;17(6):689–697. [PubMed] [Google Scholar]
  23. van Zeben D., Breedveld F. C. Prognostic factors in rheumatoid arthritis. J Rheumatol Suppl. 1996 Mar;44:31–33. [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES