RESEARCH - Associations of erosive arthritis with anti-CCP antibodies and MHC class II alleles in SLE

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Journal of Rheumatology

January 2008

Associations of Erosive Arthritis with Anti-Cyclic Citrullinated Peptide

Antibodies and MHC Class II Alleles in Systemic Lupus Erythematosus

MADELYNN T. CHAN, PATRICIA OWEN, JULIET DUNPHY, BEVERLEY COX, CHARLOTTE

CARMICHAEL, ELEANOR KORENDOWYCH, and NEIL J. McHUGH

ABSTRACT.

Objective. To determine the associations of erosive arthritis (EA) with

anti-cyclic citrullinated peptide (anti-CCP) antibodies and major

histocompatibility class (MHC) II alleles in systemic lupus erythematosus

(SLE).

Methods. One hundred four patients with SLE were evaluated for arthritis and

classified as EA, nonerosive arthritis, or no arthritis. EA was further

classified as major or minor erosions. Sera from patients and 130 serum

controls were tested for anti-CCP2 and rheumatoid factor (RF). Patients and

117 genetic controls were genotyped for HLA-DRB1 and HLA-DQB1. Statistical

associations were tested using chi-square tests and odds ratios (OR) with

95% confidence intervals (CI).

Results. Eight patients (8%) were anti-CCP+ and they accounted for 11%

(8/71) of patients with synovitis. Twelve patients (11%) had EA. Among

patients with synovitis, EA was associated with anti-CCP (OR 28.5, 95% CI

4.7-173.8, p = 0.001), with a weaker association for RF (p = 0.3). Six

patients with EA had major erosions and also met criteria for rheumatoid

arthritis (RA). Four of these patients (67%) were anti-CCP+. HLA-DQB1*0302

was associated with EA (p = 0.01), with similar trends for HLA-DRB1*0401 and

2 copies of the shared epitope (SE). There were trends for associations of

HLA-DQB1*0302 and 2 SE copies with anti-CCP production.

Conclusion. The frequency of EA in SLE is likely to be higher than

previously reported. Anti-CCP+ patients with SLE are more likely to have EA.

Anti-CCP may be a useful serological marker for EA for patients presenting

with synovitis. Anti-citrulline antibodies may have a pathogenic role in the

development of major erosions, resulting in clinical features that overlap

SLE with RA (rhupus). (First Release Dec 15 2007; J Rheumatol 2008;35:77-83)

http://www.jrheum.com/abstracts/abstracts08/77.html

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