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Abstract Number: 504

Clinical Significance of Multiple Autoantibody Specificities in Rheumatoid Arthritis: The Role of Anti-Citrullinated Alpha-Enolase and Anti-Interferon Inducible Protein 16 Antibodies

Alessia Alunno1, Onelia Bistoni1, Federico Pratesi2, Valeria Caneparo3, Fabiana Topini1, Ilaria Puxeddu2, Marco De Andrea4, Santo Landolfo4, Paola Migliorini2 and Roberto Gerli1, 1Department of Medicine, Rheumatology Unit, University of Perugia, Perugia, Italy, 2Department of Clinical and Experimental Medicine, Clinical Immunology Unit, University of Pisa, Pisa, Italy, 3Department of Translational Medicine, Virology Unit, Novara Medical School, Novara, Italy, 4Department of Public Health and Pediatric Sciences, Viral Pathogenesis Unit, Turin Medical School, Torino, Italy

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: autoantibodies, Prognostic factors and rheumatoid arthritis (RA), Pulmonary Involvement

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Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster I: Clinical Characteristics/Presentation/Prognosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Anti-cyclic citrullinated peptide (anti-CCP) auto-antibodies (auto-Abs) represent the current gold standard for the diagnosis of rheumatoid arthritis (RA). However, growing evidence suggests that a variety of other citrullinated or not citrullinated self-proteins may act as autoantigens and lead to the production of auto-Abs. The identification of diagnostic and/or prognostic value of such novel auto-Abs is under intense investigation. We recently demonstrated that RA patients display higher prevalence of auto-Abs against the interferon-inducible protein 16 (anti-IFI16) but these auto-Abs do not have a good diagnostic value (1). Recent data showed that auto-Abs against citrullinated alpha-enolase (anti-CEP1) are associated with erosive RA (2). The purpose of this study was to investigate the possible prognostic value of anti-CEP-1 and anti-IFI16 as well as the clinical implication of their association with anti-CCP in a cohort or RA patients.

Methods: Two-hundred and fifty-two RA patients were enrolled and serum samples were obtained. Auto-Abs were assessed as follows: anti-CCP EDIA 2nd generation ELISA kit (Eurodiagnostica); anti-CEP-1 IgG ELISA kit (Euroimmun). In a subgroup of 113 patients also anti-IFI16 auto-Abs were assessed with an in-house ELISA kit (1). Clinical and serological records of patients were collected and statistical analysis was performed with SPSS 21.0 software.

Results: One hundred and twenty patients (44%) displayed anti-CEP-1 and, among these, 97 patients (87%) also displayed anti-CCP. Logistic regression analysis revealed an association between both auto-Abs and RA-associated pulmonary disease (odds ratio-OR=2.9; 95%CI= 1.06-7.9; p=0.04). We also confirmed that anti-CEP-1 are associated with erosive RA, but, of interest, to a greater extent compared to anti-CCP (anti-CEP-1: OR=4.12; p=0.04; anti-CCP: OR=2.1; p=0.03). The analysis that included anti-IFI16 revealed that a small proportion of patients display all the three auto-Abs (9%), but the triple positivity was significantly associated with male gender (OR=3.5; p=0.02), the presence of rheumatoid nodules (OR=5,3; p=0.015) and pulmonary involvement (OR=2,6; p=0.007). Anti-IFI16 were associated to male gender independently of the presence of the other two auto-Abs.

Conclusion: Our study suggests that anti-CEP-1 auto-Abs may participate to the development of RA-associated pulmonary manifestation together with anti-CCP and that the assessment of multiple auto-Abs in daily practice may help clinician to stratify RA patients in order to identify those at higher risk to develop extra-articular manifestations. References 1-Alunno A et al. Arthritis Care Res 2016;68:440-5 2-Fisher BA et al. Ann Rheum Dis 2011;70:1095-1098


Disclosure: A. Alunno, None; O. Bistoni, None; F. Pratesi, None; V. Caneparo, None; F. Topini, None; I. Puxeddu, None; M. De Andrea, None; S. Landolfo, None; P. Migliorini, None; R. Gerli, None.

To cite this abstract in AMA style:

Alunno A, Bistoni O, Pratesi F, Caneparo V, Topini F, Puxeddu I, De Andrea M, Landolfo S, Migliorini P, Gerli R. Clinical Significance of Multiple Autoantibody Specificities in Rheumatoid Arthritis: The Role of Anti-Citrullinated Alpha-Enolase and Anti-Interferon Inducible Protein 16 Antibodies [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/clinical-significance-of-multiple-autoantibody-specificities-in-rheumatoid-arthritis-the-role-of-anti-citrullinated-alpha-enolase-and-anti-interferon-inducible-protein-16-antibodies/. Accessed .
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