Abstract | BACKGROUND: METHODS: The study included patients with IPF from two separate cohorts at National Jewish Health and Brigham Women's Hospital (n = 181), general population control subjects (n = 160), and control subjects with disease (n = 86 [40 with RA- usual interstitial pneumonia and 46 with hypersensitivity pneumonitis]). Serum was tested for RA-associated antibodies (including IgG and IgA) to citrullinated protein antigens (ACPA). Lung tissue in 11 patients with IPF was examined for ectopic lymphoid aggregates. RESULTS: An increased prevalence of ACPA positivity was found in two separate IPF cohorts. In particular, positivity for IgA-ACPA was increased in these two IPF cohorts compared with general population control subjects (21.3% and 24.8% vs 5.6%; P < .01). Patients with IPF were more likely to be IgA-ACPA-positive than IgG-ACPA-positive (23.2% vs 8.3%; P < .01), whereas patients with RA were more likely to be IgG-ACPA-positive than IgA-ACPA-positive (72.5% vs 52.5%; P = .04). There was a strong correlation between IgA-ACPA level and the number of ectopic lymphoid aggregates on lung histologic examination in IPF (r = 0.72; P = .01). CONCLUSIONS: In this study, IgA-ACPA was elevated in patients with IPF and correlated with lymphoid aggregates in the lung, supporting the theory that IgA-ACPA may play a role in lung disease pathogenesis in a subset of individuals with IPF. Future studies are needed to determine whether this subset of ACPA-positive patients with IPF is distinct from patients with IPF but without antibodies.
|
Authors | Joshua J Solomon, Scott Matson, Lindsay B Kelmenson, Jonathan H Chung, Stephen B Hobbs, Ivan O Rosas, Paul F Dellaripa, Tracy J Doyle, Sergio Poli, Anthony J Esposito, Ashley Visser, A Itzam Marin, Isabelle Amigues, Evans R Fernández Pérez, Kevin K Brown, Michael Mahler, David Heinz, Carlyne Cool, Kevin D Deane, Jeffrey J Swigris, M Kristen Demoruelle |
Journal | Chest
(Chest)
Vol. 157
Issue 6
Pg. 1513-1521
(06 2020)
ISSN: 1931-3543 [Electronic] United States |
PMID | 31877269
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Autoantibodies
- Biomarkers
- Immunoglobulin A
|
Topics |
- Aged
- Autoantibodies
(blood, immunology)
- Biomarkers
(blood)
- Female
- Humans
- Idiopathic Pulmonary Fibrosis
(blood, immunology)
- Immunoglobulin A
(blood, immunology)
- Male
- Middle Aged
|