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Differing specificities and isotypes of anti-citrullinated peptide/protein antibodies in palindromic rheumatism and rheumatoid arthritis

  • Cabrera-Villalba, Sonia1
  • Gomara, María José2
  • Cañete, Juan D.1
  • Ramírez, Julio1
  • Salvador, Georgina3
  • Ruiz-Esquide, Virginia1
  • Hernández, Maria Victoria1
  • Inciarte-Mundo, José1
  • Haro, Isabel2
  • Sanmartí, Raimon1
  • 1 Servicio de Reumatología Hospital Clínic de Barcelona, Unidad de Artritis, Villarroel 170, Barcelona, 08036, Spain , Barcelona (Spain)
  • 2 Unidad de Síntesis y Aplicaciones Biomédicas de Péptidos, IQAC-CSIC, Barcelona, Spain , Barcelona (Spain)
  • 3 Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, Spain , Terrassa, Barcelona (Spain)
Published Article
Arthritis Research & Therapy
Springer Science and Business Media LLC
Publication Date
Jun 15, 2017
DOI: 10.1186/s13075-017-1329-6
Springer Nature


BackgroundTo analyze differences in the recognition of anti-citrullinated peptide/protein antibody (ACPA) citrullinated epitopes and isotypes in patients with palindromic rheumatism (PR) and rheumatoid arthritis (RA).MethodsACPA fine specificities (citrullinated peptides of enolase, fibrin, and vimentin) and isotypes (IgG, IgM, and IgA) were analyzed in 54 patients with longstanding PR and 54 patients with established RA.ResultsCCP2 tested positive in 66.7% of patients with PR and RA. The ACPA distribution of fine specificities and isotypes differed between PR and RA patients. PR patients had a lower frequency of fine ACPA specificities than RA patients, which was significant in the case of a peptide derived from vimentin (PR 24.1% vs. 59.3% RA; p < 0.001). The mean number of ACPA specificities was lower in PR than in RA patients, and only 25.9% of PR patients recognized ≥2 additional specificities compared with 46.3% of RA patients. Significantly less isotype usage, especially IgA, was observed in PR patients.ConclusionThe ACPA immune response differed in patients with PR and RA, with fewer fine specificities and isotype usage in patients with PR. Some patients with PR may have impaired maturation of the B-cell response against citrullinated peptides with no progression to RA.

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