The anti-cyclic citrullinated peptide response in tuberculosis patients is not citrulline-dependent and sensitive to treatment.

Abstract

INTRODUCTION:

Patients with tuberculosis (TB) frequently produce anti-citrullinated protein antibodies (ACPA). The objective of this study is to characterize the citrulline-dependence of the ACPA reactivity in sera of patients with mycobacterium infections.

METHODS:

Serum samples of 134 patients with untreated mycobacterium infections (122 TB, 12 nontuberculous mycobacterium) were tested for antibodies against both the citrullinated (Cit) and the non-citrullinated (Arg) form of 2 cyclic synthetic peptides. In 33 patients, a follow-up sample was tested six months after starting anti-mycobacterial drugs.

RESULTS:

A substantial proportion of patients with mycobacterial infections demonstrated antibodies against 0401Cit, 0401Arg, 0722Cit and 0722Arg. Fourteen patients demonstrated anti-0401Cit, 83 anti-0401Arg, 22 anti-0722Cit and 61 anti-0722Arg, while none of these antibodies were detected in the 20 healthy controls. All the patients but one, who were anti-0401Cit and anti-0722Cit positive, demonstrated reactivity against the respective Arg peptide. In the subset of 33 patients with a follow-up test six months after starting treatment, the mean levels of antibodies to 0401Cit, 0401Arg, 0722Cit and 0722Arg significantly decreased after treatment. All the patients who were anti-0401Cit and anti-0722Cit positive turned negative after treatment. The presence of anti-0401Cit/Arg and anti-0722Cit/Arg was found to be significantly correlated with the presence of HIV.

CONCLUSIONS:

ACPA may be found in patients with TB. In most of the cases, the reactivity is citrulline independent. A positive cyclic citrullinated peptide (CCP) test in these patients should therefore be interpreted with care, and preferably followed by a control ELISA with a non-citrullinated antigen.

• Authors: Ori Elkayam, Refael Segal, Daniele Bendayan, Robert van Uitert, Carla Onnekink, Ger Jm Pruijn
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 12 Issue 1 Pg. R12 ( 2010) ISSN: 1478-6362 [Electronic] England
• PMID: 20100318 (Publication Type: Journal Article)

Chemical References

• Antitubercular Agents
• Autoantibodies
• Peptides, Cyclic
• Proteins
• cyclic citrullinated peptide
• Citrulline

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antitubercular Agents (therapeutic use)
• Autoantibodies (blood)
• Citrulline (metabolism)
• Enzyme-Linked Immunosorbent Assay
• Female
• HIV Infections (blood, complications, immunology)
• Humans
• Male
• Middle Aged
• Peptides, Cyclic (immunology)
• Proteins (immunology, metabolism)
• Tuberculosis (blood, complications, immunology)
• Young Adult