Abstract | Background/Purpose: Materials and Methods: We evaluated relationships between ACPA, the shared epitope (SE), RF isotypes and incident RA in a prospective cohort of 90 ACPA(+) individuals without baseline arthritis identified through health-fair testing (i.e. Healthfair). We also evaluated ACPA and RF isotypes and time-to-diagnosis of RA in a retrospective cohort of 215 individuals with RA from the Department of Defense Serum Repository (DoDSR). Results: Twenty-six of 90 (29%) of ACPA(+) Healthfair participants developed incident RA. Baseline or incident dual RF- IgA and RF- IgM positivity was associated with increased risk for incident RA (HR 3.09; 95% CI 1.15 to 8.29) although RFs were negative in ~50% of individuals with incident RA. SE was associated with increased risk of RA (HR 2.87, 95% CI 1.22-6.76). In the DoDSR cohort, triple positivity for ACPA, RF- IgA and RF- IgM was present a median of 1-2 years prior to RA diagnosis, with some sex-specific differences. Conclusion: These findings can be used to counsel individuals at-risk for future RA and to design clinical trials for RA prevention. The findings also suggest that RF could be a surrogate outcome as a success of an immunologic intervention in RA prevention. Additional studies are needed to understand the biologic of different patterns of autoantibody elevations in RA evolution.
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Authors | Dylan T Bergstedt, Wyatt J Tarter, Ryan A Peterson, Marie L Feser, Mark C Parish, Christopher C Striebich, M Kristen Demoruelle, LauraKay Moss, Elizabeth A Bemis, Jill M Norris, V Michael Holers, Jess D Edison, Geoffrey M Thiele, Ted R Mikuls, Kevin D Deane |
Journal | Frontiers in immunology
(Front Immunol)
Vol. 13
Pg. 916277
( 2022)
ISSN: 1664-3224 [Electronic] Switzerland |
PMID | 35812446
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2022 Bergstedt, Tarter, Peterson, Feser, Parish, Striebich, Demoruelle, Moss, Bemis, Norris, Holers, Edison, Thiele, Mikuls and Deane. |
Chemical References |
- Autoantibodies
- Epitopes
- Immunoglobulin A
- Immunoglobulin Isotypes
- Immunoglobulin M
- Rheumatoid Factor
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Topics |
- Arthritis, Rheumatoid
- Autoantibodies
- Epitopes
- Female
- Humans
- Immunoglobulin A
- Immunoglobulin Isotypes
- Immunoglobulin M
- Male
- Prospective Studies
- Retrospective Studies
- Rheumatoid Factor
- United States
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