Rheumatoid factor, but not anti-citrullinated protein antibodies, is modulated by infliximab treatment in Rheumatoid Arthritis

Leen De Rycke ^1*, Xavier Verhelst ¹, Elli Kruithof ¹, Filip Van den Bosch ¹, Ilse EA Hoffman ¹, Eric M Veys ¹ and Filip De Keyser ¹

¹ Department of Rheumatology - Ghent University Hospital, Belguim

^* To whom correspondence should be addressed. E-mail: leenderycke{at}hotmail.com.

Accepted 16 May 2004

Abstract

Background: Infliximab is effective in the treatment of rheumatoid arthritis (RA). The effect of anti-TNFa therapy on RA-associated auto-antibodies is not extensively evaluated.

Objectives: To analyse 1) the effect of infliximab on IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibodies, and 2) whether baseline autoantibody titres (IgM-RF and anti-CCP antibodies) are associated with changes in acute phase reactants.

Patients and methods: 62 patients with refractory RA were treated with infliximab (3 mg/kg IV at week 0, 2, 6 and every 8 weeks thereafter) combined with methotrexate. At baseline and week 30, sera were tested for IgM-RF by two agglutination assays, and for anti-CCP antibodies by ELISA. The percentage change in C- reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) was calculated.

Results: For both IgM-RF assays, there was a significant reduction in RF titres during infliximab treatment (p<0.001 and p=0.038, respectively), whereas anti-CCP antibodies were not modulated (p=0.240). Baseline IgM-RF titres, but not anti-CCP antibodies, were inversely correlated with changes in CRP and ESR during infliximab treatment. Furthermore, we observed lower IgM-RF titres in patients with a marked decrease in acute phase reactants (= at least 20% decrease in CRP and ESR) compared to those with a less pronounced decrease in CRP and ESR. Again, no statistically significant differences were found for anti-CCP antibodies.

Conclusion: Both the differential effect of infliximab therapy on IgM-RF and anti-CCP antibodies, and the different predictive value on changes in acute phase reactants during infliximab treatment support the existing evidence that RF and anti-citrullinated protein antibodies are two different, independent auto-antibody systems in RA.

Keywords: anti-citrullinated protein antibodies, infliximab, rheumatoid factor

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Cantaert, T., van Baarsen, L. G., Wijbrandts, C. A., Thurlings, R. M., van de Sande, M. G., Bos, C., van der Pouw, T. K., Verweij, C. L., Tak, P. P., Baeten, D. L. (2009). Type I interferons have no major influence on humoral autoimmunity in rheumatoid arthritis. Rheumatology (Oxford) 0: kep345v1-kep345 [Abstract] [Full Text]  
• Song, Y.W., Kang, E.H. (2009). Autoantibodies in rheumatoid arthritis: rheumatoid factors and anticitrullinated protein antibodies. QJM 0: hcp165v1-hcp165 [Abstract] [Full Text]  
• van Tuyl, L H D, Lems, W F, Kerstens, P J S M, Voskuyl, A E, Dijkmans, B A C, Boers, M (2009). IgM-rheumatoid factor and anti-cyclic citrullinated peptide decrease by 50% during intensive treatment in early rheumatoid arthritis. Ann Rheum Dis 68: 1652-1653 [Full Text]  
• Bos, W H, Bartelds, G M, Vis, M, van der Horst, A R, Wolbink, G J, van de Stadt, R J, van Schaardenburg, D, Dijkmans, B A C, Lems, W F, Nurmohamed, M T, Aarden, L, Hamann, D (2009). Preferential decrease in IgG4 anti-citrullinated protein antibodies during treatment with tumour necrosis factor blocking agents in patients with rheumatoid arthritis. Ann Rheum Dis 68: 558-563 [Abstract] [Full Text]  
• Rintisch, C., Ameri, J., Olofsson, P., Luthman, H., Holmdahl, R. (2008). Positional cloning of the Igl genes controlling rheumatoid factor production and allergic bronchitis in rats. Proc. Natl. Acad. Sci. USA 105: 14005-14010 [Abstract] [Full Text]  
• Cantaert, T., Kolln, J., Timmer, T., van der Pouw Kraan, T. C., Vandooren, B., Thurlings, R. M., Canete, J. D., Catrina, A. I., Out, T., Verweij, C. L., Zhang, Y., Tak, P. P., Baeten, D. (2008). B Lymphocyte Autoimmunity in Rheumatoid Synovitis Is Independent of Ectopic Lymphoid Neogenesis. J. Immunol. 181: 785-794 [Abstract] [Full Text]  
• Brown, K. K. (2007). Roger S. Mitchell Lecture. Rheumatoid Lung Disease. Proc Am Thorac Soc 4: 443-448 [Abstract] [Full Text]  
• Jacobsson, L. T H, Turesson, C., Nilsson, J.-A., Petersson, I. F, Lindqvist, E., Saxne, T., Geborek, P. (2007). Treatment with TNF blockers and mortality risk in patients with rheumatoid arthritis. Ann Rheum Dis 66: 670-675 [Abstract] [Full Text]  
• Bobbio-Pallavicini, F., Caporali, R., Alpini, C., Avalle, S., Epis, O. M, Klersy, C., Montecucco, C. (2007). High IgA rheumatoid factor levels are associated with poor clinical response to tumour necrosis factor {alpha} inhibitors in rheumatoid arthritis. Ann Rheum Dis 66: 302-307 [Abstract] [Full Text]  
• Lequerre, T., Jouen, F., Brazier, M., Clayssens, S., Klemmer, N., Menard, J.-F., Mejjad, O., Daragon, A., Tron, F., Le Loet, X., Vittecoq, O. (2007). Autoantibodies, metalloproteinases and bone markers in rheumatoid arthritis patients are unable to predict their responses to infliximab. Rheumatology (Oxford) 46: 446-453 [Abstract] [Full Text]  
• Turesson, C, Jacobsson, L T H, Sturfelt, G, Matteson, E L, Mathsson, L, Ronnelid, J (2007). Rheumatoid factor and antibodies to cyclic citrullinated peptides are associated with severe extra-articular manifestations in rheumatoid arthritis. Ann Rheum Dis 66: 59-64 [Abstract] [Full Text]  
• Chen, H A, Lin, K C, Chen, C H, Liao, H T, Wang, H P, Chang, H N, Tsai, C Y, Chou, C T (2006). The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis. Ann Rheum Dis 65: 35-39 [Abstract] [Full Text]  
• Russell, A S, Maksymowych, W P, de Silva, M (2005). Anti-cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis treated with anti-tumour necrosis factor agents. Ann Rheum Dis 64: 1807-1807 [Full Text]