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Abstract Number: 2045

Specific Anti-Citrullinated Protein Antibodies Profiles Are Associated with Rheumatoid Arthritis Related Interstitial Lung Disease

Pierre-Antoine Juge1, Leonor Nogueira2, Guy Serre2, René-Marc Flipo3, Lidwine Wemeau-Stervinou4, Thierry Schaeverbeke5, Claire Dromer6, Sylvain Adam-Marchand7, Marie-Christophe Boissier8, Hilario Nunes9, Raphaël Borie10, Bruno Crestani10 and Philippe Dieude10, 1Rhumatologie, Hôpital Bichat - Claude Bernard, Paris, France, 2Unité Différenciation Épidermique et Autoimmunité Rhumatoïde, Unité Mixte de Recherche, INSERM, Toulouse, France, 3Hôpital Roger Salengro, Lille, France, 4Pneumologie, CHRU de Lille, Lille, France, 5Department of Rheumatology, Bordeaux University Hospital, BORDEAUX, France, 6Imagerie Thoracique et Cardiovasculaire, CHU Bordeaux, Bordeaux, France, 7Pneumology, Centre Hospitalier Universitaire de Tours, Tours, France, 874 rue Marcel Cachin, INSERM, Bobigny, France, 9Pulmonary diseases department, Avicenne Hospital (AP-HP), Bobigny, France, 10Université Paris-Diderot, Paris, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ACPA, anti-citrullinated protein/peptide antibodies (ACPA), interstitial lung disease and rheumatoid arthritis (RA)

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Session Information

Date: Tuesday, October 23, 2018

Session Title: Rheumatoid Arthritis – Etiology and Pathogenesis Poster III

Session Type: ACR Poster Session C

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

Background/Purpose: The identification of peripheral blood markers of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) may facilitate an earlier diagnosis and provide insight regarding the pathogenesis of this severe disease complication. Antibodies directed against citrullinated fibrinogen (AhFibA) and the α36-50Cit and β60-74Cit peptides exhibiting its immunodominant epitopes are associated with radiographic damages in RA but have not been yet studied in RA-ILD. The aim of this study was to characterize the profile of anti-α36-50Cit and anti-β60-74Cit subfamilies of AhFibA in RA-ILD.

Methods: Anti-CCP2, AhFibA and their anti-α36-50Cit and anti-β60-74Cit subfamilies were assayed by ELISA in a population of RA-ILD (n=75), RA-noILD (n=75) patients and in a control group of idiopathic pulmonary fibrosis (IPF) patients (n=75). RA was diagnosed according to ACR 1987 and/or ACR/EULAR 2010 criteria. ILD status was assessed with High-resolution computed tomography (HRCT) in all the patients.

Results: Using a 98.5% specificity level, anti-CCP2, AhFibA and their anti-α36-50Cit and anti-β60-74Cit subfamilies were detected in 66%, 65%, 36% and 62% of RA patients, respectively whereas they were not detected in the majority of IPF patients (1%) (Table 1). No significant difference was observed for the sensibility of the different antibodies for the identification of ILD among RA patients. Anti-CCP2, AhFibA and anti-β60-74Cit titers were significantly lower in RA-ILD patients compared to RA-noILD patients (Table 1) whereas there was a trend for higher anti-α36-50Cit autoantibodies (P=0.145; ns). Within AhFibA positive RA patients, anti-α36-50Cit were more frequently observed in those having ILD (66% vs 33, P=0.013). In addition, anti-α36-50Cit antibody titers correlated with those of AhFibA only in RA-ILD patients (Figure 1).

Conclusion: Specific qualitative and quantitative profiles of anti-α36-50Cit and anti-β60-74Cit autoantibodies subfamilies of AhFibA are associated with the occurrence of ILD in the context of RA.

 

 

RA-ILD

(n=75)

RA-noILD

(n=75)

IPF

(n=75)

 P value
(RA-ILD vs RA-noILD)

Positivity (n,%)
– anti CCP2

– AhFibA

– anti-β60-74Cit

– anti-α36-50Cit

.

46 (61.3)

43 (57.3)
42 (56.0)

31 (41.3)

.

53 (70.6)
54 (72.0)

51 (68.0)

23 (30.7)

.

1 (1.3)

1 (1.3)

2 (2.6)

1 (1.3)

.

ns

ns

ns

ns

Titers,

– anti CCP2 (U/mL)

– AhFibA (DO)

– anti-β60-74Cit (ΔDO)

– anti-α36-50Cit-fib (ΔDO)

.

327 (5-30669)

0.34 (0.00-2.02)

0.18 (0.00-3.45)

0.02 (0.00-3.3)

.

378 (5-36582)

0.60 (0.00-2.66)

0.51 (0.00-4.64)

0.01 (0.00-3.14)

.

5 (5-539)

0.00 (0.00-0.53)

0.00 (0.00-0.11)

0.00 (0.00-0.09)

.

0.028

0.025

0.047

ns

Positivity among AhFibA+ (n, %)

– anti-β60-74Cit

– anti-α36-50Cit

n=43

32 (74.4)

26 (60.4)

n=54

46 (85.2)

18 (33.3)

n=1

0

0

.

0.21

0.013

Table 1. Distribution of different autoantibodies in the 3 groups (RA-ILD, RA-noILD, IFP). Positivity rate is expressed in number of patients (%), Titers are expressed as median (min-max).

Figure 1. Correlation between AhFibA titers with anti-β60-74Cit or anti-α36-50Citautoantibody titers in RA-noILD population (A and B) and in RA-ILD population (C and D).


Disclosure: P. A. Juge, None; L. Nogueira, None; G. Serre, None; R. M. Flipo, None; L. Wemeau-Stervinou, None; T. Schaeverbeke, None; C. Dromer, None; S. Adam-Marchand, None; M. C. Boissier, None; H. Nunes, None; R. Borie, None; B. Crestani, None; P. Dieude, None.

To cite this abstract in AMA style:

Juge PA, Nogueira L, Serre G, Flipo RM, Wemeau-Stervinou L, Schaeverbeke T, Dromer C, Adam-Marchand S, Boissier MC, Nunes H, Borie R, Crestani B, Dieude P. Specific Anti-Citrullinated Protein Antibodies Profiles Are Associated with Rheumatoid Arthritis Related Interstitial Lung Disease [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/specific-anti-citrullinated-protein-antibodies-profiles-are-associated-with-rheumatoid-arthritis-related-interstitial-lung-disease/. Accessed January 30, 2023.
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