Rheumatoid factor (RF) is one of the best known serological markers in rheumatology – development of the test dates back into the 1940ies. Since this time the toolkit of serological diagnostic tests for rheumatoid arthritis (RA) has been complemented by the more specific anti-citrullinated protein antibody (ACPA) tests. However, none of the various ACPA tests has completly replaced RF until now.
The jigsaw puzzle of rheumatoid arthritis classification
In contrast, the significance of RF has been further substantiated with the definition of the 2010 ACR criteria for classification of RA. Moreover, recent studies have shown the potential of RF as a contributor to disease pathogenesis.
Linking autoantibody production to bone loss
in rheumatoid arthritis
Autoantibodies against citrullinated proteins (ACPA) are found in people with rheumatoid arthritis and are one of the strongest risk factors for bone destruction in this disease. A recent study now directly links the formation of antibodies binding to mutated citrullinated vimentin (anti-MCV) to bone loss in rheumatoid arthritis, indicating that these autoantibodies act on osteoclasts, the bone cells responsible for bone resorption.
Harre U, Georgess D, Bang H, Bozec A, Axmann R, Ossipova E et al. Induction of osteoclastogenesis and bone loss by human autoantibodies against citrullinated vimentin. J Clin Invest 2012; 122(5):1791-802. (1)
The research of U. Harre, G. Schett and their coworkers provides fundamental new insights into the interaction between bone and the immune system in the inflammatory process leading to the development of rheumatoid arthritis.
Anti-CCP hs (high sensitive)®: a new biomarker for the serological diagnosis of early rheumatoid arthritis
Timely diagnosis is of critical importance to the progression of rheumatoid arthritis (RA) because the rapid implementation of intensive treatment can inhibit damage to the joints and maintain function. In conjunction with medical history, clinical examination, and imaging procedures, serological tests form the foundation for an early diagnosis.
In addition to rheumatoid factors, autoantibodies against citrullinated antigens (ACPA) have proven to be valuable tools for the serological diagnosis of early RA. They have become a critical component of the new 2010 ACR criteria for the classification of RA, and account for three of the six points required to verify a diagnosis of RA. (more…)
Antibodies to Modified Citrullinated Vimentin Are Associated with Subclinical Atherosclerosis in Early Rheumatoid Arthritis
Rheumatoid arthritis (RA) is associated with increased morbidity and mortality due to cardiovascular disease (CVD), especially accelerated atherosclerosis (1-3). There is evidence that this already occurs early in the disease process. Well known common CVD risk factors interact with the systemic auto-inflammatory response during the disease process and speed up the development of atherosclerosis in patients suffering from rheumatoid arthritis.
Antibodies against citrullinated protein and peptide antigens (ACPA) are highly sensitive and specific markers for early rheumatoid arthritis. Antibodies to Modified Citrullinated Vimentin (anti-MCV) predict poor outcome and appear to play a major role in the pathogenesis of rheumatoid arthritis.
A recently published study by Amal El-Barbary and his co-workers may now shed light on the relationship between anti-MCV antibodies and cardiovascular co-morbidities in patients with rheumatoid arthritis (4). They investigated the correlation of anti-MCV antibodies in early RA with disease activity and cardiovascular risk factors compared to antibodies against cyclic citrullinated peptides (anti-CCP3). (more…)
Research Update: Prognosis of Outcomes for Rheumatoid Arthritis – What are the Risk Factors?
In the past, it has only been possible to explain some of the joint damage caused by rheumatoid arthritis (RA) based on known risk factors. In order to improve treatment for RA, future approaches to treatment will increasingly need to be tailored to individual patients and individually configured.
Personalized medicine in RA treatment
The goal is to develop individual treatments tailored to the needs of the individual patient, “personalized medicine” for rheumatoid arthritis diagnosis and treament (for more on the subject of personalized medicine, refer to the background article Early Detection and Personalised Medicine – What Biomarkers Tell Us on our rheumachec homepage). (more…)
Found last Week on the Internet, part 1: Up-to-date Articles on Autoimmunity and Autoimmune Diseases
Duroux-Richard I, Jorgensen C, Apparailly F. miRNAs and rheumatoid arthritis – promising novel biomarkers. Swiss Med Wkly. 2011 Mar 18;141:w13175 – doi: 10.4414/smw.2011.13175 – Free full text available! – Today, the most challenging issue in the field of rheumatoid arthritis is the identification of biomarkers for early disease diagnosis and for prediction drug response. micro(mi)-RNAs certainly represent an realistic option for optimal diagnosis an disease treatment.
Roux CH, Breuil V, Valerio L, Amoretti N, Brocq O, Albert C, Grisot C, Allam Y, Chevalier P, Pradier C, Euller-Ziegler L. Etanercept Compared to Intraarticular Corticosteroid Injection in Rheumatoid Arthritis: Double-blind, Randomized Pilot Study. J Rheumatol. 2011 Mar 16. [Epub ahead of print]. – Patients with rheumatoid arthritis who had persistent (more…)
According to a recently published study anti-MCV could be a better test for diagnosing RA than anti-CCP2
Rapid intensive treatment may prevent patients with rheumatoid arthritis (RA) from developing severe health damages and improve their state of health and quality of life. Therefore, early reliable diagnosis is a prerequisite. At present, the most helpful biomarkers to achieve this goal are antibodies against citrullinated proteins (ACPA) that can be detected in the blood of RA patients. (more…)
ACPA in rheumatism diagnostics: new and highly promising biomarkers for rheumatoid arthritis
The diagnosis and treatment of rheumatoid arthritis (RA) have made tremendous progress in the last few years. Experts are even suggesting that a paradigm shift has occurred in the field of rheumatology.
According to rheumatologists, this radical change can be seen in the completely new rheumatoid arthritis medications that have resulted in entirely new treatment options. Again and again, the paradigm shift in rheumatology is attributed to the new possibilities in rheumatoid arthritis diagnostics. Modern RA diagnostics are said to make it increasingly possible for rheumatologists to objectively determine the activity level of RA and thus to predict the progression of this autoimmune disease. (more…)
Our Point-of-Care-Test rheumachec for Diagnosing Rheumatoid Arthritis – a Highly Accessed Research Article in Arthritis Research & Therapy!
Several days ago, a colleague pointed out to me a publication in the journal Arthritis Research & Therapy that came about largely through collaboration with scientists at ORGENTEC Diagnostika. Needless to say that this article was already familiar to me – already before its initial online publication in the summer of this year, I had read excerpts from it and extensively discussed the work and the results of this evaluation study with co-workers and clients. (more…)
The EIRA Study: Vaccinations and RA Risk – no Association found!
“Common adult immunizations are not associated with an increased risk of developing rheumatoid arthritis” – that is the result of research published in the October issue of The Annals of the Rheumatic Disease, the EULAR journal. Last week that data were also presented at the American College of Rheumatology ACR Annual Scientific Meeting (took place from 6th to 11th November).
Common adult vaccinations don’t increase the risk of developing RA, recent results of the Swedish EIRA Study Group say.
“Vaccinations are among the events which have long been postulated as inciting agents for rheumatoid arthritis, as well as for many other chronic inflammatory diseases of unknown origin,” lead investigator in the study, Camilla Bengtsson, PhD, stated in her lecture last Monday at the Georgia World Congress Center in Atlanta, USA.
No increased RA risk following immunizations
“In our case-control study including incident cases of newly diagnosed rheumatoid arthritis, no increased risk of RA following immunization was observed, at least not in the five years prior to disease onset”, the epidemiologist at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden, explained in more detail, noting that the study is still ongoing. From Dr. Bengtsson’s point of view these results are indicating that immunological provocation with commonly used vaccines in their present form do not carry a risk of rheumatoid arthritis in adults. (more…)