Is ACPA positivity the main driver for rheumatoid arthritis treatment? Pros and cons

被引:23
作者
Alivernini, Stefano [1 ]
Galeazzi, Mauro [2 ]
Peleg, Hagit [3 ]
Tolusso, Barbara [1 ]
Gremese, Elisa [1 ]
Ferraccioli, Gianfranco [1 ]
Naparstek, Yaakov [3 ]
机构
[1] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli, Inst Rheumatol, Via Giuseppe Moscati 31, I-00168 Rome, Italy
[2] Univ Siena, Dept Med Sci Surg & Neurosci, Rheumatol Unit, Siena, Italy
[3] Hadassah Hebrew Univ, Dept Med, Med Ctr, POB 12000, Jerusalem, Israel
关键词
Rheumatoid arthritis; Anti-citrullinated peptide antibodies; Biomarker; CYCLIC CITRULLINATED PEPTIDE; ANTICITRULLINATED PROTEIN ANTIBODIES; RADIOGRAPHIC PROGRESSION; AMERICAN-COLLEGE; DISEASE-ACTIVITY; BONE LOSS; B-CELL; AUTOANTIBODIES; DIAGNOSIS; CRITERIA;
D O I
10.1016/j.autrev.2017.09.002
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
071005 [微生物学]; 100108 [医学免疫学];
摘要
Rheumatoid Arthritis (RA) is an autoimmune chronic disease that is characterized by the positivity of various antibodies, the most specific being autoantibodies against citrullinated antigens (ACPA). Despite ACPA are not arthritogenic by themselves, ACPA positive individuals have high risk of RA development and ACPA positivity is associated with severe erosive phenotype and higher mortality rate compared to seronegative RA. Moreover, ACPA status is associated with favorable response to biologics targeting pathways involving autoantibody producing cells as B lymphocytes. In the current review we have discussed the pros and cons on the available scientific evidences, regarding the diagnostic, prognostic and management implications of ACPAs in RA. (C) 2017 Elsevier B.V. All rights reserved.
引用
收藏
页码:1096 / 1102
页数:7
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