Anti-cyclic citrullinated peptide antibody titers decrease in rheumatoid arthritis patients treated with tocilizumab: A pilot study.

Abstract

Objectives: To analyze the effects of tocilizumab on peripheral B-cell subpopulation and its ability to produce anti-cyclic citrullinated peptide (CCP) antibody in patients with rheumatoid arthritis (RA).Methods: Thirteen consecutive RA patients initiated with tocilizumab were enrolled in our prospective study. Anti-CCP antibody titers and clinical parameters were evaluated during treatment. Peripheral blood B-cell subsets were analyzed using flow cytometry according to the Human Immunology Project.Results: Disease activity was significantly improved and anti-CCP antibody titers significantly decreased at week 24 compared to baseline. The percentages of post-switch memory B cells in CD19+ cells transiently increased at week 12, but there was no significant difference in any of the investigated B-cell subpopulations at week 24 compared to baseline. The ratios of post-switch memory to naïve B cells (post-switch/naïve) correlated negatively with anti-CCP antibody titers regardless of the time-points.Conclusion: Our study indicated that tocilizumab has a potential to reduce anti-CCP antibody production presumably by affecting post-switch/naïve ratio, and that anti-CCP antibody titers reflect B-cell distribution/subpopulation. As anti-CCP antibodies are produced in lymph nodes or ectopic lymphoid structures in synovial tissues, not in circulation, transient increment of post-switch memory B cells after tocilizumab treatment may reflect the altered balance of B-cell distribution between circulation and arthritic joints, resulting in suppressed production of anti-CCP antibody in situ.

• Authors: Atsushi Noguchi, Shinsuke Yasuda, Ryo Hisada, Masaru Kato, Kenji Oku, Toshiyuki Bohgaki, Miho Suzuki, Yoshihiro Matsumoto, Tatsuya Atsumi
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 30 Issue 2 Pg. 276-281 (Mar 2020) ISSN: 1439-7609 [Electronic] England
• PMID: 30789096 (Publication Type: Journal Article)

Chemical References

• Anti-Citrullinated Protein Antibodies
• Antibodies, Monoclonal, Humanized
• Biomarkers
• Immunosuppressive Agents
• tocilizumab

Topics

• Adult
• Anti-Citrullinated Protein Antibodies (blood)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Arthritis, Rheumatoid (blood, drug therapy)
• Biomarkers (blood)
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged