Early rheumatoid arthritis: Clinical and immunological aspects


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Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease that is characterized by a systemic inflammatory and destructive joint lesion that is manifested by the involvement of various organs and systems into the pathological process. Whether the variants of the course and outcomes of RA may be predicted early is the most important inadequately studied problem. HLA-DRB1* genotypes affect disease severity; however, different alleles encoding the identical amino acid sequence have a varying association with the disease and their combinations can differently increase the risk of RA. Total epitope (SE) is associated not only with the risk of RA as a whole, but also with the development of the severe course of the disease to a greater extent. A number of studies have demonstrated that if a patient has concurrently antibodies to cyclic citrullinated peptide (CCP) and rheumatoid factor, as well as HLA-DRB1 alleles, the likelihood of rapid X-ray progression is 10 times greater than that in a patient without these markers. The paper considers the course of early RA depending on the combined determination of immunological and immunogenetic markers (SE and CCP antibodies). Each of them makes a substantial contribution to the development of a destructive process in early RA, which necessitates the assessment of a combination of the factors.

About the authors

Natal'ya Viktorovna Demidova

Email: Natasha-demidova@mail.ru

Irina Anatol'evna Guseva

Email: epid@irramn.ru

Dmitriy Evgen'evich Karateev

Email: Karateev@irramn.ru

N V Demidova

Institute of Rheumatology, Russian Academy of Medical Sciences

Institute of Rheumatology, Russian Academy of Medical Sciences

I A Guseva

Institute of Rheumatology, Russian Academy of Medical Sciences

Institute of Rheumatology, Russian Academy of Medical Sciences

D E Karateyev

Institute of Rheumatology, Russian Academy of Medical Sciences

Institute of Rheumatology, Russian Academy of Medical Sciences

References

  1. Насонова В. А., Фоломеева О. М., Эрдес Ш. Ревматические болезни в России в начале XXI века. Науч.-практ. ревматол. 2003; 1: 6-10.
  2. Эрдес Ш., Фоломеева О. М. Проблема ревматических заболеваний в России. Рус. мед. журн. 2004; 20: 1121-1122.
  3. Насонов Е. Л. Фармакотерапия ревматоидного артрита с позиций доказательной медицины: новые рекомендации. Рус. мед. журн. 2002; 10 (6): 294-301.
  4. Беневоленская Л. И. Клинико-генетические аспекты гетерогенности ревматоидного артрита. Клин. ревматол. 1994; 3: 2-4.
  5. Emery P., Breedveld F. C., Dougados M. et al. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann. Rheum. Dis. 2002; 61 (4): 290-297.
  6. Scott D. L. The diagnosis and prognosis of early arthritis: rationale for new prognostic criteria. Arthr. and Rheum. 2002; 46 (2): 286-290.
  7. Quinn M. A., Conaghan P. G., Emery P. The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence? Rheumatology (Oxford) 2001; 40: 1211-1220.
  8. Астапенко М. Г. Характеристика суставного синдрома при ревматоидном артрите. В кн.: Насонова В. А. (ред.). Ревматоидный артрит. М.; 1983. 73-74.
  9. Paulus H. Monitoring radiographic changes in early rheumatoid arthritis. J. Rheumatol. 1996; 23: 801-805.
  10. Насонова В. А. Ревматоидный артрит с системными проявлениями - диагноз и прогноз. Тер. арх. 1983; 7: 3-6.
  11. Behrend T. Verlaufaformen der chronischen Polyarthritis. Z. Rheum. 1985; 44: 7-13.
  12. Van Leeuwen M., van der Putte S. C., van der Heide A. Clinical significance of interleukin-6 measurement in early rheumatoid arthritis: relation with laboratory and clinical variables and radiographic progression in a three year prospective study. Ann. Rheum. Dis. 1995; 54: 674-677.
  13. Van Schaardenburg D., Breedveld F. Elderly-onset rheumatoid arthritis. Semin. Arthr. Rheum. 1994; 23: 367-378.
  14. Thotbecke G., Shan R., Leu C. et al. Involvement of endogenous tumor necrosis factor a and transforming growth factor b during induction if collagen type 2 arthritis in mice. Proc. Natl. Acad. Sci. USA 1992; 89: 7375-7379.
  15. Paimela L., Palosuo T., Helve T., Ano K. Prognostic value of quantitative measurement of rheumatoid factor in early rheumatoid arthritis. Br. J. Rheumatol. 1995; 34: 1146-1150.
  16. Reisine S. Predictors of work disability in rheumatoid arthritis patients. Arthr. and Rneum. 1995; 38 (2): 1630-1637.
  17. Van der Heide D., Van Riel P., van Leuween M. et al. Prognostic factor for radiographic damage and physical disability in early rheumatoid arthritis: a prospective follow-up study of 147 patients. Br. J. Rheumatol. 1992; 31: 519-525.
  18. Wolfe F., Cathey M. The assessment and prediction of functional disability in rheumatoid arthritis. J. Rheumatol. 1991; 18: 1298-1306.
  19. Van Zebeh D., HazesT. et al. Factors predictions outcome of rheumatoid arthritis: results of follow-up study. J. Rheumatol. 1993; 20: 1288-1296.
  20. Барнс К. Г. Ревматоидный артрит. В кн.: Корей Х. Л. Ф. (ред.). Клиническая ревматология: Пер. с англ. М.: Медицина; 1990. 53-85.
  21. Corbett M., Dalton S., Young A. et al. Factors predicting death, survival and functional outcome in a prospective study of early rheumatoid disease over fifteen years. Brit. J. Rheumatol. 1993; 32 (8): 717-723.
  22. Van der Heijde D. F. M., van Riel P. L. C. M., van Rijswijk M. N., van der Putte L. B. A. Influence of prognostic features on the final outcome in rheumatoid arthritis: a review of the literature. Semin. Arthr. Rheum. 1988; 17 (4): 284-292.
  23. Bruynesteyn K., Landewe R., van der Linden S., van der Heijde D. Radiography as primary outcome in rheumatoid arthritis: acceptable sample size for trials with 3 months follow up. Ann. Rheum. Dis. 2004; 63: 1413-1418.
  24. Caruso Y., Santandrea S., Sarzi Puttini P. et al. Clinical, laboratory and radiographic fetures in early rheumatoid arthritis. J. Rheumatol. 1990; 10: 1263-1267.
  25. Matsuda Y., Yamanaka H., Higami K., Kashiwazaki S. Time lag between active joint inflammation and radiological progression in patients with early rheumatoid arthritis. J. Rheumatol. 1998; 25 (3): 427-432.
  26. Hannonen P., Mottenen T., Hakola M., Oka M. Sulfasalazine in early rheumatoid arthritis. A 48 week double-blind, prospective, placebo-controlled study. Arthr. and Rheum. 1993; 36 (2): 1501-1509.
  27. van der Horst-Bruinsma I. E., Speyer I., Visser H. et al. Diagnosis and course of early onset arthritis: results of a special early arthritis clinic compared to routine patient care. Br. J. Rheumatol. 1998; 37: 1084-1088.
  28. Каратеев Д. Е., Иванова М. М. Базисная терапия ревматоидного артрита и исход болезни: ретроспективная оценка данных многолетнего наблюдения. Науч.-практ. ревматол. 2001; 1: 5-12.
  29. Brahee D. D., Pierre-Jerome C., Kettner N. W. Clinical and radiological manifestations of the rheumatoid wrist. A comprehensive review. J. Manipul. Physiol. Ther. 2003; 26 (5): 323- 329.
  30. Emery P. Practical aspects of treatment RA, when, how, what is the evidence? Ann. Rheum. Dis. 2003; 62 (2): SP 0001.
  31. Чичасова Н. В. Ревматоидный артрит: клинико-лабораторные и клинико-морфологические сопоставления, прогноз: дис. ... д-ра мед. наук. М.; 2004.
  32. Molenaar E. T., Lems W. F., Dijkmans B. A. et al. Levels of markers of bone resorption are moderately increased in patients with inactive rheumatoid arthritis. Rheumatology (Oxford) 2000; 39: 742-744.
  33. Stastny P. Mixed lymphocyte cultures in rheumatoid arthritis. J. Clin. Invest. 1976; 57: 1148-1157.
  34. Беневоленская Л. И., Мякоткин В. А., Ондрашик М., Гемер Б. Клинико-генетические аспекты ревматических заболеваний. М.: Медицина; 1989. 99-141.
  35. Яковлева Д. Б., Беневоленская Л. И., Орлов-Морозов А. В., Калинина Н. М. HLA-DR при ревматоидном артрите. Tep. apx. 1981; 5: 184.
  36. Мякоткин В. А., Мошнина М. А., Крылов М. Ю. и др. Поиск генов предрасположенности к ревматоидному артриту. Вестн. PAMH 2003; 7: 27-30.
  37. Fries J. F., Wolfe F., Apple R. et al. HLA-DRB1 genotype associations in 793 white patients from rheumatoid arthritis inception cohort: frequency, severity and treatment bias. Arthr. and Rheum. 2002; 40: 2320-2329.
  38. Gonzakz- Gay M. A., Hajeer A. H., Garsia-Porrua C. et al. Patients chosen for treatment with cyclosporine because of severe rheumatoid arthritis are more likely to carry HLA-DRB1 shared epitope alleles, and have earlier disease onset. J. Rheumatol. 2002; 29: 271-275.
  39. O'Dell J. R., Nepom B. S., Haire C. et al. HLA-DRB1 typing in rheumatoid arthritis: predicting response to specific treatment. Arthr. and Rheum. 1998; 57 (4): 209-213.
  40. Meyer J. M., Evans T. I., Small R. E. et al. HLA-DRB1 genotype influences risk for and severity of rheumatoid arthritis. J. Rheumatol. 1999; 26: 1024-1034.
  41. Reviron D., Perdtigerv A., Toussirot E et al. Influence of shared epitope-negative HLA-DRB1 alleles on genetic susceptibility to rheumatoid arthritis. Arthr. and Rheum. 2001; 44 (3): 535- 540.
  42. Zanelli E., Vos Koen E., Visser H. et al. HLA-DQ-associated predisposition to and dominant HLA-DR-associated protection against rheumatoid arthritis. J. Rheumatol. 2001; 40: 133-139.
  43. Van Zeben D., Rook G. A. W., Hazes J. M. W. Early agalactosylation of IgG in associated with a more progressive disease course in patients with rheumatoid arthritis: Results of a follow-up study. Br. J. Rheumatol. 1994; 33: 36-43.
  44. Насонов Е. Л., Насонова В. А. (ред.). Ревматология: Нац. руководство. М.: ГЭОТФР-Медиа; 2008. 293-295.
  45. Александрова Е. Н., Чемерис Н. А., Каратеев Д. Е. и др. Антитела к циклическому цитруллинированному пептиду при ревматоидном артрите. Тер. арх. 2004; 12: 64-68.
  46. Hill A. J., Southwood S., Sette A. et al. Cutting edge: the conversation of arginine to citrulline allows for a high-affinity peptide interaction with the rheumatoid arthritis associated HLA-DRB1*0401 MHC class II molecule. J. Immunol. 2003; 171: 538-541.
  47. Xiaofegng Zeng, Maixing Ai, Xiping Tian et al. Diagnostic value of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis. J. Rheumatol. 2003; 30: 1451-1455.
  48. Lee D., Schur P. Clinical utility of the anti-CCP assay in patients with rheumatic diseases. Ann. Rheum. Dis. 2003; 62: 870-874.
  49. Каратеев Д. Е., Александрова Е. Н., Демидова Н. В. и др. Антицитруллиновые антитела и данные магнито-резонансной томографии суставов кисти у больных ранним артритом. Тер. арх. 2008; 80 (10): 72-77.
  50. Riedemann J. P., Munoz S., Ravanaugh A. The use of second generation anti-CCP antibody testing in rheumatoid arthritis- a systematic review. Clin. Exp. Rheumatol. 2005; 2: S69-S76.
  51. Berlgin E., Padyukov L., Sundin U. et al. A combination of autoantibodies to cyclic citrullinated peptide (CCP) and HEA-DRB1 locus antigens is strongly associated with future onset of rheumatoid arthritis. Arthritis. Res. Ther. 2004; 6 (4): 303- 308.
  52. Avouac J., Gossec L., Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann. Rheum. Dis. 2006; 65: 845-851.
  53. Suzuki A., Yamada R., Chang X. et al. Functional haplotipes of PADI4, encoding citrullinating enzyme peptidylarginine deiminase 4, are associated with rheumatoid arthritis. Nat. Genet. 2003; 34: 395-402.
  54. Forslind K., Ahlmen M., Eberhardt K et al. Prediction of radiological outcome in early RA in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann. Rheum. Dis. 2004; 63: 1090-1095.
  55. Mayer O., Labbare C., Moore D. et al. Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann. Rheum. Dis. 2003; 62: 120-126.
  56. Kastbom A., Strandberg G., Lindroos A., Skogh T. Anti-CCP antibody test predicts the disease course during 3 years in early rheumatoid arthritis (the Swedish TIRA project). Ann. Rheum. Dis. 2004; 63: 1085-1089.
  57. Klareskog L., van Vollenhoven R. et al. Disease activity and greater radiological progression status is a stable phenotype that predicts worse follow-up in early rheumatoid arthritis: anti-CCP protein/peptide antibodies during 5 year longitudinal analyses of anti-citrullinated. Ann. Rheum. Dis. 2005; 66 (4): 1136-1139.
  58. Lindqvist E., Eberhardt K., Bendtzen K. et al. Prognostic laboratory markers of joint damage in rheumatoid arthritis. Ann. Rheum. Dis. 2005; 64: 196-201.
  59. Bukhari M., Lunt M., Harrison B. J. et al. Rheumatoid factor is the major predictor of increasing severity of radiographic erosions in rheumatoid arthritis: results from the Norfolk Arthritis Register Study, a large inception cohort. Arthr. and Rheum. 2002; 46: 906-912.
  60. Quinn M. A., Gough A. K., Green M. J. et al. Anti-CCP antibodies measured at disease onset help identify seronegative rheumatoid arthritis and predict radiological and functional outcome. Rheumatology 2006; 45: 478-480.
  61. Gorman J. D., Lum R. F., Chen J. J et al. Impact of shared epitope genotype and ethnicity on. erosive disease: a meta-analysis of 3 240 rheumatoid arthritis patients. Arthr. and Rheum. 2004; 50: 400-412.
  62. Van der Helm-van Mil A. H., Verpoort K. N., Breedveld F. C. et al. Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis. Arthr. Res. Ther. 2005; 7: 949-958.
  63. Van Gaalen F. A., van Aken J., Huizinga T. W et al. Association between HLA class II genes and autoantibodies to cyclic citrullinated peptides (CCPs) influences the severity of rheumatoid arthritis. Arthr. and Rheum. 2004; 50: 2113-2121.
  64. Sanmarti R., Gomez-Cenceno A., Ercilla G. et al. Prognostic factors of radiographic progression in early rheumatoid arthritis: a two year prospective study after a structured therapeutic strategy using DMARDs and very low doses of glucocorticoids. Clin. Rheumatol. 2007; 26 (7): 1111-1118.

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