TY - JOUR T1 - Distinct ACPA fine specificities, formed under the influence of HLA shared epitope alleles, have no effect on radiographic joint damage in rheumatoid arthritis JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1461 LP - 1464 DO - 10.1136/ard.2010.146506 VL - 70 IS - 8 AU - Hans Ulrich Scherer AU - Diane van der Woude AU - Annemiek Willemze AU - Leendert A Trouw AU - Rachel Knevel AU - Silje W Syversen AU - Michael PM van der Linden AU - Benedicte Lie AU - Tom WJ Huizinga AU - Désirée MFM van der Heijde AU - Annette HM van der Helm-van Mil AU - Tore K Kvien AU - René EM Toes Y1 - 2011/08/01 UR - http://ard.bmj.com/content/70/8/1461.abstract N2 - Objectives Human leucocyte antigen shared epitope (SE) alleles are associated with joint destruction, the presence of anticitrullinated protein antibodies (ACPA) and the ACPA fine specificity repertoire in rheumatoid arthritis (RA). A large variation in joint destruction is seen within the ACPA-positive patient population, and it is conceivable that certain ACPA reactivities contribute to radiological damage. The authors investigated whether ACPA fine specificities, which are formed under the influence of SE alleles, associate with the extent of radiographic joint damage. Methods Antibodies recognising six citrullinated epitopes were determined in sera of 330 ACPA-positive RA patients genotyped for SE alleles. The association between SE alleles, ACPA fine specificity and radiographic joint damage was assessed using radiographic follow-up data. A second cohort of 154 RA patients with 5 and 10-year radiographic follow-up was used for replication. Results SE alleles predisposed to the recognition of certain citrullinated epitopes. However, none of the ACPA fine specificities studied influenced radiographic joint damage. Importantly, although SE alleles associated with radiographic damage in the total RA population, this association was no longer detectable after stratification for the presence of ACPA. Conclusions SE alleles are instrumental in shaping the ACPA repertoire. However, ACPA fine specificities formed under the influence of SE alleles do not seem to affect joint destruction. ER -