Anti-cyclic citrullinated peptide antibodies in primary Sjogren's syndrome may be associated with non-erosive synovitis

Abstract

Introduction The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data.

Anticyclic Citrullinated Peptide Antibodies in Patients with Rheumatic Diseases other than Rheumatoid Arthritis: Clinical or Pathogenic Significance?

“…The most striking datum of Payet's study was represented by the very high prevalence of anti-CCP in CTD (17.5% vs 5.1% found in our series), with a peak in patients with SS (33%), strongly different from that found in our cohort (8.6%) and in 2 other previously published studies (7.5% and 9.9%) 9,10 . Notably, all anti-CCP-positive patients with SS described by Payet had joint involvement, with evidence of synovitis in the great majority (82%).…”

“…Notably, all anti-CCP-positive patients with SS described by Payet had joint involvement, with evidence of synovitis in the great majority (82%). This agrees with Atzeni's investigation 10 , which reported a close association between anti-CCP and synovitis in SS. Interestingly, in our cohort, all SS patients with circulating anti-CCP were diagnosed with SS associated with RA.…”

Anticyclic Citrullinated Peptide Antibodies as Markers of Erosive Arthritis in Antisynthetase Syndrome: Table 1.

“…To date there are several reports evaluating the meaning of anti-CCP antibodies in connective tissue diseases other than RA; in systemic sclerosis (SSc) 2 and systemic lupus erythematosus (SLE) 3 these antibodies are markers of erosive arthritis, as we suggest in antisynthetase syndrome. In contrast, in Sjögren's syndrome 4 this association is lacking, although anti-CCP seem to be closely associated with the occurrence of synovitis.…”

Subgroups of Sjögren syndrome patients according to serological profiles

“…This group could be either classified as having RA with secondary SS, or as pSS with anti-CCP and non-erosive arthritis. Although one cannot rule out the possibility that pSS patients with anti-CCP antibodies may progress to RA, a common observation is that non-erosive arthritis prevails in anti-CCP antibody-positive SS patients [51,53,54], whereas in RA anti-CCP is a marker of persistent, erosive disease [56].…”

“…[51,52]. On the contrary, an Italian study of 141 pSS patients found a positive association of anti-CCP antibodies with non-erosive synovitis in multivariate analysis [53]. In all three cohorts SS patients fulfilling the ACR classification criteria for RA had been excluded from the analysis.…”