Article Text

other Versions

High anti-collagen type II antibody levels and induction of pro-inflammatory cytokines by anti-collagen antibody containing immune complexes in vitro characterize a distinct RA phenotype associated with acute inflammation at the time of disease onset
  1. Mohammed Mullazehi (mohammed.mullazehi{at}
  1. Unit of Clinical Immunology, Uppsala University, Uppsala, Sweden
    1. Linda Mathsson (linda.mathsson{at}
    1. Unit of Clinical Immunology, Uppsala University, Uppsala, Sweden
      1. Jon Lampa (jon.lampa{at}
      1. Unit of Rheumatology, Karolinska Institute, Stockholm, Sweden
        1. Johan Rönnelid (johan.ronnelid{at}
        1. Unit of Clinical Immunology, Uppsala University, Uppsala, Sweden


          Objective: We have earlier reported cytokine- inducing properties of surface-bound collagen type II (CII)-containing immune complexes (IC). We have now investigated whether this finding might have clinical impact.

          Methods: Anti-CII serology was analyzed in 274 early RA patients. Patients with elevated levels of anti- CII were followed serially for 1-5 years concerning anti- CII IC-induced levels of TNF-a, IL-1ß and IL-8. Levels of antibodies and IC-induced cytokines were compared to clinical indices over five years of follow-up.

          Results: 5/100 healthy controls and 24/274 (8.8%) RA patients exhibited elevated levels (>29 AU/ml) of anti-native CII antibodies, a non-significant difference. 9/274 (3.3%) RA patients and no controls comprised a discrete group with very high anti-CII levels > 450 AU/ml. These very high anti-CII level sera were associated with induction of pro-inflammatory cytokines by anti-CII-containing IC formed in vitro. 8/9 patients with high baseline anti-CII levels exhibited a parallel decline in antibody levels, IC-induced cytokines, CRP and ESR. Anti-CII positive patients had significantly elevated levels of CRP and ESR at baseline but not later during the follow-up.

          Conclusions: Anti-native CII positive RA patients have a distinct clinical phenotype characterized by an early acute phase response that might be driven by anti- CII containing IC in joint cartilage.

          • antigen-antibody complex
          • collagen type II
          • cytokines
          • hyaline cartilage
          • rheumatoid arthritis

          Statistics from

          Request Permissions

          If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.