RESEARCH - Anti-CCP antibodies and RF in Sjogren's syndrome

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Acta Reumatol Port. 2009 Oct-Dec;34(4):608-12.

Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in

Sjögren's syndrome.

Barcelos F, Abreu I, Patto JV, Trindade H, Teixeira A.

Portuguese Institute of Rheumatology, Lisbon, Portugal.

Abstract

OBJECTIVES: The purpose of this study was to evaluate the prevalence

and clinical significance of anti-cyclic citrullinated peptide

antibodies (anti-CCP-Abs), IgM and IgA rheumatoid factors (RFs) in

primary Sjögren's Syndrome (pSS).

MATERIALS AND METHODS: We compared clinical and serological

characteristics of 31 pSS and 31 Rheumatoid Arthritis (RA) patients.

Both, anti-CCP-Abs and RFs (IgM, IgA) directed against Fc determinants

of IgG from humans and rabbit were detected by enzyme-linked

immunosorbent assay (ELISA). We included 31 blood donors as control

group for the evaluation of RFs and anti-CCP-Abs. Nine (29%) pSS

patients presented arthritis, and 10 (32,3%) RA patients also had

secondary Sjögren's syndrome (sSS)

RESULTS: IgM and IgA RFs prevalence was similar in pSS and RA,

whichever the antigene (Human or Rabbit IgG) used. However, RA

patients with sSS showed a tendency to present more often RF

positivity, longer disease duration and higher ESR and CRP when

compared with pSS patients with arthritis. Anti-CCP-Abs were detected

in 64,5% of RA patients and in only 6,9% of pSS patients (p<0,0005).

Anti-CCP-Abs were more often positive in RA patients with sSS (RA/sSS)

(8 patients, 80%) than in RA patients without sSS (18 patients,

58,1%), and were absent in pSS patients with arthritis. RF-positive

pSS patients presented more often pulmonary involvement and higher

inflammatory parameters, and less often neuropathy compared to

RF-negative patients. In controls, anti-CCP-Abs were absent and RFs

were negligible.

CONCLUSIONS: Anti-CCP-Abs were detected in only a few pSS patients,

none of whom presented arthritis, which contrasts with the high

frequency of these antibodies in RA/sSS. These results suggest that

anti-CCP-Abs could be useful in the distinction between pSS and RA

with sSS. Although not useful for the differential diagnosis between

RA and pSS, RFs may have a prognostic role in pSS.

PMID: 20087267

http://www.ncbi.nlm.nih.gov/pubmed/20087267

Read the full article here:

http://www.spreumatologia.pt/download_fich.php?path=pdfs & filename=ARP_2009_4_608\

_09__AO_-_Sjogren_ARP2009_51AO.pdf

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