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Different properties of ACPA and IgM-RF derived from a large dataset: further evidence of two distinct autoantibody systems.

AbstractINTRODUCTION:
The aim of this study was to examine seroconversion and the relationship with age and inflammation of autoantibodies in a large group of patients attending an outpatient rheumatology clinic.
METHODS:
Levels of antibodies to citrullinated proteins/peptides (ACPAs) and IgM rheumatoid factor (IgM-RF) were determined in 22,427 samples collected from 18,658 patients. The diagnosis was derived from a diagnosis registration system. The degree of seroconversion in repeated samples and the correlation of levels with age and inflammatory markers were determined for ACPA and IgM-RF in rheumatoid arthritis (RA) and non-RA patients.
RESULTS:
Seventy-one percent of RA patients (n = 1,524) were ACPA-positive and 53% were IgM-RF-positive; in non-RA patients (n = 2,245), the corresponding values were 2% and 4%, respectively. In patients with at least two samples (n = 3,769), ACPA status was more stable than IgM-RF status in RA patients. ACPA- or IgM-RF-negative non-RA patients seldom became positive. ACPA positivity was unrelated to age in both RA and non-RA patients. IgM-RF positivity was unrelated to age in RA patients; however, it increased with age in non-RA patients. The correlation between autoantibody levels and inflammatory markers was low in general and was somewhat higher for IgM-RF than for ACPA.
CONCLUSIONS:
ACPA status is more stable in time and with increasing age than IgM-RF status, further establishing its role as a disease-specific marker. ACPA and IgM-RF levels are only moderately correlated with markers of inflammation.
AuthorsJennie Ursum, Wouter H Bos, Rob J van de Stadt, Ben A C Dijkmans, Dirkjan van Schaardenburg
JournalArthritis research & therapy (Arthritis Res Ther) Vol. 11 Issue 3 Pg. R75 ( 2009) ISSN: 1478-6362 [Electronic] England
PMID19460147 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Autoantibodies
  • Biomarkers
  • Immunoglobulin M
  • Citrulline
  • Rheumatoid Factor
Topics
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid (blood, diagnosis, immunology)
  • Autoantibodies (biosynthesis, blood)
  • Biomarkers (blood)
  • Citrulline (blood, immunology)
  • Databases, Factual
  • Female
  • Humans
  • Immunoglobulin M (biosynthesis, blood)
  • Male
  • Middle Aged
  • Rheumatoid Factor (biosynthesis, blood)

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