Circulating anti-citrullinated peptide antibodies, cytokines and genotype as biomarkers of response to disease-modifying antirheumatic drug therapy in early rheumatoid arthritis

被引：33

作者：

Ally, Mahmood M. T. M. ^{[1
,2
]}

Hodkinson, Bridget ^{[3
]}

Meyer, Pieter W. A. ^{[2
,4
]}

Musenge, Eustasius ^{[5
]}

Tintinger, Gregory R. ^{[1
,2
]}

Tikly, Mohammed ^{[3
]}

Anderson, Ronald ^{[2
]}

机构：

[1] Univ Pretoria, Fac Hlth Sci, Dept Internal Med, ZA-0001 Pretoria, South Africa

[2] Univ Pretoria, Fac Hlth Sci, Dept Immunol, Med Res Council Unit Inflammat & Immun, ZA-0001 Pretoria, South Africa

[3] Univ Witwatersrand, Chris Hani Baragwanath Acad Hosp, Fac Hlth Sci, Div Rheumatol, ZA-2013 Johannesburg, South Africa

[4] Natl Hlth Lab Serv, Tshwane Acad Div, ZA-0001 Pretoria, South Africa

[5] Univ Witwatersrand, Fac Hlth Sci, Sch Publ Hlth, Biostat & Epidemiol Div, ZA-2193 Johannesburg, South Africa

来源：

BMC MUSCULOSKELETAL DISORDERS | 2015年 / 16卷

基金：

英国医学研究理事会;

关键词：

Anticyclic citrullinated peptide antibodies; Cytokines; Shared epitope; Disease modifying antirheumatic drugs; Rheumatoid arthritis; BIOCHIP ARRAY TECHNOLOGY; TNF-ALPHA THERAPY; CCP ANTIBODY; METHOTREXATE THERAPY; CLINICAL-EFFICACY; PROGNOSTIC TOOL; SERUM-LEVELS; PREDICTORS; INFLIXIMAB; AUTOANTIBODY;

D O I：

10.1186/s12891-015-0587-1

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

Background: To measure circulating anti-citrullinated peptide antibodies (ACPA) and cytokines pre- and 6 months post-therapy as a strategy to predict and optimize responses to traditional disease-modifying antirheumatic drugs (DMARDs) in early RA, which is an unmet need in developing countries. Patients and methods: A cohort of 140 predominantly (88.5 %) black female South African patients with early RA was treated with synthetic DMARDs, mostly methotrexate (MTX) alone, or in combination with low dose oral corticosteroids (CS). Circulating ACPA and a panel of circulating cytokines/chemokines/ growth factors were measured at baseline and after 6 months of therapy in relation to disease activity and Shared Epitope (SE). Results: Following 6 months of therapy, the median simplified disease activity index (SDAI) declined from a baseline of 41.4 to 16.0 (p = 0.0001) for the entire cohort, which was paralleled by significant falls in median serum ACPA levels (516.6 vs. 255.7 units/ml, p = < 0.0001) and several of the circulating cytokines (IL-4, IL-7, IL-8, G-CSF, VEGF; p < 0.0010 - p < 0.0001) which were most evident in the subgroup of patients treated with a combination of MTX and CS. Although biomarker concentrations decreased most notably in the low-disease activity group post-therapy, no significant correlations between these biomarkers and disease activity were observed, Baseline ACPA levels, but not SDAI or cytokines, were significantly higher in the subgroup of risk allele-positive patients (561.1 vs. 331.9 units/ml, p < 0.05), while no associations with ACPA and a smoking history were evident. Conclusions: The use of DMARDs in RA is associated with significant decreases in ACPA and cytokines which did not correlate with changes in SDAI, precluding the utility of serial measurement of these biomarkers to monitor early responses to therapy, but may have prognostic value.

引用

页数：9

共 58 条

[1]

Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNFα therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement [J].