Emerging patterns of risk factor make‐up enable subclassification of rheumatoid arthritis

Novel autoantibody markers for early and seronegative rheumatoid arthritis

“…Novel autoantibodies that are present in the RA population that is seronegative based on current serological testing, can be of added value to RA diagnostics. Furthermore, as latest research points to a subdivision of the criterion-based disease RA into 2 distinct subsets based on the presence of ACCP, and next to nothing is known about the underlying aetiology of ACCPnegative RA, the identification of disease markers for this RA population will provide more insight into the underlying aetiology and pathogenic mechanisms of this disease subtype [8,9,10,11,12]. The fact that rituximab has up till now been shown to be equally efficient in ACCP-negative and ACCP-positive RA patients indicates the relevance of an autoantibody profiling procedure in this seronegative RA patient subpopulation [13].…”

The Immunogenetic Architecture of Autoimmune Disease

“…This concept of heterogeneity or complexity is an important emerging question. A first example of such complexity is found in RA, where the strong association with the HLA-DRB1 risk alleles sharing a specific epitope at positions 70 -74 (shared epitope alleles) is specific to the subset of patients producing antibodies to citrullinated peptide antigens (ACPAs) (van der Helm-van Mil et al 2007;Padyukov et al 2011). The two forms of the disease are clinically indistinguishable at onset but ACPA positivity is the factor most predictive of future prognosis (van der Helm-van Mil et al 2007).…”

Régulation génétique de la production des auto-anticorps au cours de la polyarthrite rhumatoïde

“…Plusieurs études indépendantes ont rapporté une association entre le portage de l'allèle 1858T est la susceptibilité à la PR [17]. Cette association concerne les patients ACPA+, mais pas les patients ACPA- [1]. Au cours de la phase pré-clinique de la PR, le portage de l'allèle 1858T est significativement associé à la positivité des ACPAs [18].…”

“…Certaines MAI sont spécifiques d'organes telles le diabète de type 1, la myasthénie, les thyroïdites ou les hépatopathies auto-immunes, alors que d'autres sont systémiques telles le lupus, le syndrome de Gougerot-Sjögren, ou la polyarthrite rhumatoïde (PR). Bien que ces maladies possèdent des caractéristiques propres qui permettent de les distinguer les unes des autres, elles partagent souvent bon nombre de caractéristiques communes [1].…”