Background: The application of more sensitive imaging techniques, such as ultrasonography (US), changed the concept of non-erosive arthritis in systemic lupus erythematosus (SLE), underlining the need for biomarkers to identify patients developing the erosive phenotype. Anti-citrullinated peptide antibodies (ACPA), associated with erosions in inflammatory arthritis, have been identified in about 50% of patients with SLE with erosive arthritis. More recently, anti-carbamylated proteins antibodies (anti-CarP) have been associated with erosive damage in rheumatoid arthritis. We aimed to assess the association between anti-CarP and erosive damage in a large SLE cohort with joint involvement. Methods: We evaluated 152 patients (male/female patients 11/141; median age 46years, IQR 16; median disease duration 108months, IQR 168). All patients underwent blood draw to detect rheumatoid factor (RF) and ACPA (commercial enzyme-linked immunosorbent assay (ELISA) kit), and anti-CarP ("home-made" ELISA, cutoff 340aU/mL). The bone surfaces of the metacarpophalangeal and proximal interphalangeal joints were assessed by US: the presence of erosions was registered as a dichotomous value (0/1), obtaining a total score (0-20). Results: The prevalence of anti-CarP was 28.3%, similar to RF (27.6%) and significantly higher than ACPA (11.2%, p=0.003). Erosive arthritis was identified in 25.6% of patients: this phenotype was significantly associated with anti-CarP (p=0.004). Significant correlation between anti-CarP titer and US erosive score was observed (r=0.2, p=0.01). Conclusions: Significant association was identified between anti-CarP and erosive damage in SLE-related arthritis, in terms of frequency and severity, suggesting that these antibodies can represent a biomarker of severity in patients with SLE with joint involvement.

Anti-carbamylated protein antibodies as a new biomarker of erosive joint damage in systemic lupus erythematosus / Ceccarelli, Fulvia; Perricone, Carlo; Colasanti, Tania; Massaro, Laura; Cipriano, Enrica; Pendolino, Monica; Natalucci, Francesco; Mancini, Riccardo; Spinelli, Francesca Romana; Valesini, Guido; Conti, Fabrizio; Alessandri, Cristiano. - In: ARTHRITIS RESEARCH & THERAPY. - ISSN 1478-6354. - STAMPA. - 20:1(2018), pp. 126-133. [10.1186/s13075-018-1622-z]

Anti-carbamylated protein antibodies as a new biomarker of erosive joint damage in systemic lupus erythematosus

Ceccarelli, Fulvia;Perricone, Carlo;Colasanti, Tania;Massaro, Laura;Cipriano, Enrica;Pendolino, Monica;Natalucci, Francesco;Spinelli, Francesca Romana;Valesini, Guido;Conti, Fabrizio;Alessandri, Cristiano
2018

Abstract

Background: The application of more sensitive imaging techniques, such as ultrasonography (US), changed the concept of non-erosive arthritis in systemic lupus erythematosus (SLE), underlining the need for biomarkers to identify patients developing the erosive phenotype. Anti-citrullinated peptide antibodies (ACPA), associated with erosions in inflammatory arthritis, have been identified in about 50% of patients with SLE with erosive arthritis. More recently, anti-carbamylated proteins antibodies (anti-CarP) have been associated with erosive damage in rheumatoid arthritis. We aimed to assess the association between anti-CarP and erosive damage in a large SLE cohort with joint involvement. Methods: We evaluated 152 patients (male/female patients 11/141; median age 46years, IQR 16; median disease duration 108months, IQR 168). All patients underwent blood draw to detect rheumatoid factor (RF) and ACPA (commercial enzyme-linked immunosorbent assay (ELISA) kit), and anti-CarP ("home-made" ELISA, cutoff 340aU/mL). The bone surfaces of the metacarpophalangeal and proximal interphalangeal joints were assessed by US: the presence of erosions was registered as a dichotomous value (0/1), obtaining a total score (0-20). Results: The prevalence of anti-CarP was 28.3%, similar to RF (27.6%) and significantly higher than ACPA (11.2%, p=0.003). Erosive arthritis was identified in 25.6% of patients: this phenotype was significantly associated with anti-CarP (p=0.004). Significant correlation between anti-CarP titer and US erosive score was observed (r=0.2, p=0.01). Conclusions: Significant association was identified between anti-CarP and erosive damage in SLE-related arthritis, in terms of frequency and severity, suggesting that these antibodies can represent a biomarker of severity in patients with SLE with joint involvement.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1122900
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