Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
We previously showed that anti-CCP2 antibodies are associated with parenchymal lung abnormalities in patients with early RA1. This study aims to examine the association between ACPA fine specificities and parenchymal lung changes in an early RA cohort.
Patients with newly diagnosed RA according to the ACR 1987 classification criteria and naïve to treatment with oral glucocorticoids or DMARDs were eligible for the study. High-resolution computed tomography (HRCT) was performed in order to assess the presence of parenchymal lung changes (ground glass changes, nodules, infiltrates or fibrosis). ImmunoCAP was used to detect RF IgA, RF IgM, anti-CCP2 IgA, anti-CCP2 IgG and ISAC microarray system2was used to detect antibodies against 10 citrullinated (Cit) peptidic antigens: CCP-1 (Filaggrin), CEP-1 (α-enolase), Vim 2-17, Vim 60-75 (Vimentin), Fib β 36-52, Fib α 573, Fib α 591, Fib α 36-50, Fib β 60-74, Fib α 621-635 (Fibrinogen).
Logistic regression analysis was performed to examine possible associations between parenchymal lung changes at the time of RA diagnosis and autoantibodies, adjusted for age and sex. Due to the potential risk for effect modification of smoking and the strong association between smoking and Cit peptides, we stratified the cohort according to ever vs. never smokers.
A total of 106 patients with available HRCT were included in the analysis. The mean (SD) age was 57 (14) years. The majority were females (69%); 73% were ever smokers while 29% were current smokers; 70% were positive for RF and 69% were positive for anti-CCP2. Parenchymal lung changes were found in 58 patients (54.7%). Higher age, RF IgA, CCP2 IgG, ever smoking and pack-years above 24 were significant predictors of parenchymal lung changes (table 1). Some ACPA fine specificities, especially against Cit Fib and Cit Vim peptides, were associated to parenchymal lung changes in ever smokers (table 2). The risk of having parenchymal changes increased parallel to the increase of the number of ACPA specificities (table 2). Having five or more ACPA specificities at the time of diagnosis increased the risk of having lung abnormalities in ever smokers by 6.6 times (OR=5.8, 95% CI=1.6-27.3).
The presence of RF IgA, anti-CCP2 IgG, antibodies to Cit Fib and Cit Vim peptides were strongly associated to parenchymal lung changes in ever smokers with early RA. The more ACPA fine specificities, the higher the risk of having parenchymal lung changes at the time of RA diagnosis.
- Reynisdottir G, et al., Arthritis Rheumatol 2014
- Hansson M, et al., Arthritis Res Ther 2012
To cite this abstract in AMA style:Joshua V, Chatzidionysiou K, Reynisdottir G, Hensvold AH, Mathsson-Alm L, Hansson M, Nogueira L, Eklund A, Serre G, Grunewald J, Catrina AI. Association Between Fine Specificity of Anti-Citrullinated Peptide Antibodies and High Resolution Computed Tomography Parenchymal Lung Changes in Patients with Early RA [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/association-between-fine-specificity-of-anti-citrullinated-peptide-antibodies-and-high-resolution-computed-tomography-parenchymal-lung-changes-in-patients-with-early-ra/. Accessed July 23, 2019.
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