Anti-heat shock protein 70 kDa and 90 kDa antibodies in serum of patients with rheumatoid arthritis

doi:10.1136/ard.58.5.291

Annals of the Rheumatic Diseases 1999;58:291-296; doi:10.1136/ard.58.5.291

Ann Rheum Dis 1999;58:291-296 ( May )

Extended reports

Anti-heat shock protein 70 kDa and 90 kDa antibodies in serum of patients with rheumatoid arthritis G Hayem,^a M De Bandt,^a E Palazzo,^a S Roux,^a B Combe,^c J F Eliaou,^b J Sany,^c M F Kahn,^a O Meyer^a

^a Rheumatology Department, Bichat Teaching Hospital, Paris, France, ^b Immunology Laboratory, Montpellier, France, ^c Rheumatology Department, Lapeyronie Teaching Hospital, Montpellier, France

Correspondence to: Professor O Meyer, Department of Rheumatology, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France.

Accepted for publication 2 February 1999

OBJECTIVES $---$ Stress proteins (HSPs) are highly conserved immunodominant antigens found in various species. The purpose of this study wasto assess the prevalence and prognostic significance of antibodiesto HSC 70 kDa and HSP 90 kDa in three groups of patients withlongstanding rheumatoid arthritis (RA) defined based on the severityof articularerosions.
METHODS $---$ 73 patients with longstanding (> 6 years) RA whose HLA-DR genotype was known were divided in three groups according to Larsen'sscore and compared with 47 recent onset (<1 year) RA patientsand with control groups composed of patients with other inflammatorydiseases (n=137) or of normal controls (n=48). IgGs and IgMs toHSC 70 kDa and HSP 90 kDa were determined using an ELISA withpurified bovine HSC 70kDa or HSP 90kDa.
RESULTS $---$ Concentrations of IgGs and IgMs to HSC 70 were significantly increased in 41.1% and 42.5% of longstanding RA patients, respectively.Corresponding figures for IgGs and IgMs to HSP 90 were 39.7% and56%. IgMs to HSC 70 and HSP 90 were less frequent in recent onsetRA (19% and 13% respectively). Among the groups with other inflammatorydiseases, only the MCTD group exhibited high frequencies of IgGsto HSC 70 (80%) and HSP 90 (85%). DRB1*0401 positive RA patients(n=23) were not more likely to have increased concentrations ofantibodies to HSC 70 kDa or HSP 90 kDa than other RA patients(DR4 positive but DRB1*0401 negative, or DR1 positive, n=31; ornegative for both DR4 and DR1, n=14). IgGs to HSP 90 kDa weresignificantly more frequent (p<0.05) in longstanding RA patientswhose Larsen's score was 4 or more (57%) than in those whose Larsen'sscore was 2 or 3 (39.4%) or less than 2 (16%). No associationswere found between Larsen's score and IgGs or IgMs to HSC 70 kDaor IgMs to HSP 90 kDa. A significant correlation was demonstratedbetween IgGs to HSP 90 kDa and two other serological markers forRA, rheumatoid factor, and anti-Sa antibody; there were no correlationswith antikeratin antibody, antiperinuclear factor, or anti-RA33.
CONCLUSION $---$ IgGs to HSP 90 kDa are most common in longstanding RA patients with articular erosions, suggesting that they may be relatedto the articular prognosis in RA

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