Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is an autoimmune/inflammatory disease affecting 0.5 to 1% of adults worldwide and frequently leads to joint destruction and disability. Early diagnosis and early and effective therapy may prevent joint damage and lead to better long-term results. Therefore, reliable biomarkers and outcome measures are needed. Refinement of the understanding of molecular pathways involved in disease pathogenesis have been achieved by combining knowledge on RA-associated genes, environmental factors and the presence of serological elements. The presence of autoantibodies is a distinctive feature of RA. Rheumatoid Factor and Anti-Citrullinated Protein Antibodies are the two most remarkable autoantibodies in RA and provide different clinical and pathophysiological information. They precede the onset of disease symptoms and predict a more severe disease course, indicating a pathogenetic role in RA. Therefore, they promote a more accurate prognosis and contribute for a better disease management. Several RA-associated autoantibody systems have been identified: Anti-Carbamylated Antibodies, Anti-BRAF, Anti-Acetylated, Anti-PAD4 antibodies and others. Hopefully, the characterization of a comprehensive array of novel autoantibody systems in RA will provide unique pathogenic insights of relevance for the development of diagnostic and prognostic approaches compatible with an effective personalized medicine.

Blood Lymphocyte Subsets for Early Identification of Non-Remission to TNF Inhibitors in Rheumatoid Arthritis

“…RF and ACPA are autoantibodies locally produced in the inflamed synovium by B cells. Clinical usefulness of these autoantibodies as diagnostic and prognostic factors of disease are now widely accepted (21). Moreover, B cells mediate T-cell activation via the expression of costimulatory molecules and by secreting pro-inflammatory cytokines, particularly TNFα (22).…”

Autoantibodies as Diagnostic Markers and Mediator of Joint Inflammation in Arthritis

“…Studies have shown that RF is a pathogenic autoantibody that plays a key role in the pathophysiology of RA [56]. In normal conditions, transient production of low-affinity IgM-RF is regularly induced by immune complexes and polyclonal B cell activators, such as bacterial lipopolysaccharide and Epstein-Barr virus [57]. The main role proposed for RF in RA is to form immune complexes, fix complement, and release chemokines, such as C5a, thus recruiting inflammatory cells (neutrophils) into the joints.…”

“…RF plays a pivotal role in the differential diagnosis and prognosis of RA patients [57]. It has been shown that RF is useful in predicting the development of RA, as the detection of IgM-RF can be used as a marker of inflammatory activity [61].…”

Role of Infections in the Pathogenesis of Rheumatoid Arthritis: Focus on Mycobacteria

“…Rheumatoid arthritis (RA) is a chronic autoimmune disease, with a reported prevalence ranging between 0.5–1% worldwide [ 1 , 2 , 3 ]. RA is characterized by a systemic auto-immune disease, causing joint pain, swelling, and stiffness.…”