Immunopathology of rheumatoid arthritis

Abstract

Objective. We sought to determine whether circulating antikeratin antibodies (AKA) precede the onset of rheumatoid arthritis (RA).Methods. By matching the registers of 2 previous population studies with the registry of patients receiving antirheumatic drugs several years later, pre-illness serum specimens could be obtained from 39 individuals who subsequently developed RA. AKA were assayed with the standard indirect immunofluorescence technique.Results. Ten of 39 serum specimens from individuals who subsequently developed seropositive RA, and 1 of 15 sera from individuals who developed seronegative RA, were positive for IgG-class AKA by immunofluorescence assay. The AKA-positive sera were also positive for rheumatoid factors.Conclusion. The findings focus attention on the role of pre-illness immunologic events in the pathogenesis of RA.Patients with rheumatoid arthritis (RA) display a variety of abnormalities of humoral immunity. Besides rheumatoid factors (RF), antibodies against collagen (l), Epstein-Barr virus (EBVhncoded nuclear

The Epstein-Barr virus in autoimmunity

“…Sera with "anti-keratin" antibodies give laminar staining of the keratinized layers of the rat esophagus [62,161]. This antibody activity occurs in up to 69% of RA patients, is demonstrable in pre-illness sera [71] or at first diagnosis [93], and expresses a risk factor for more severe disease on follow-up [93]. A possible pertinence of this to EBV is found in our observation of anti-keratin antibodies in IM [143], and the observations of Baboonian et al [10] that antibody to the glycine/alanine peptide P62 reacts with keratin, and of Birkenfeld et al [19] that the anti-keratin reactivity of RA sera can be partially inhibited with P62.…”

The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis

“…More recent studies have suggested that the specificity for RA is not quite so optimistic [13]. Anti-CCP antibodies are present early in the disease process and may even pre-date the onset of RA by many years [14][15][16][17][18]. The presence of anti-CCP antibodies in RA is predictive of the development of erosive disease [5,16,19,20].…”

Autoantibodies to Posttranslational Modifications in Rheumatoid Arthritis

“…ACPA have been associated with human pathology [41] as well as preclinical disease since the early 90s [42] later confirmed [43, 44]. The importance of these antibodies was then recognised several years later when their presence was identified as a specific event associated with RA [45–50].…”