Anti-type II collagen antibodies, anti-CCP, IgA RF and IgM RF are associated with joint damage, assessed eight years after onset of juvenile idiopathic arthritis (JIA).

Abstract

BACKGROUND:

Early appearance of antibodies specific for native human type II collagen (anti-CII) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (RA). The objective of this study was to investigate the occurrence of anti-CII, IgM RF, IgA RF and anti-CCP in serum samples obtained early after diagnosis, and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (JIA).

METHODS:

The Nordic JIA database prospectively included JIA patients followed for eight years with data on remission and joint damage. From this database, serum samples collected from 192 patients, at a median of four months after disease onset, were analysed for IgG anti-CII, IgM RF, IgA RF and IgG anti-CCP. Joint damage was assessed based on Juvenile Arthritis Damage Index for Articular damage (JADI-A), a validated clinical instrument for joint damage.

RESULTS:

Elevated serum levels of anti-CII occurred in 3.1%, IgM RF in 3.6%, IgA RF in 3.1% and anti-CCP in 2.6% of the patients. Occurrence of RF and anti-CCP did to some extent overlap, but rarely with anti-CII. The polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. Anti-CII occurred in younger children, usually without overlap with the other autoantibodies and was associated with high levels of C-reactive protein (CRP) early in the disease course. All four autoantibodies were significantly associated with joint damage, but not with active disease at the eight-year follow up.

CONCLUSIONS:

Anti-CII, anti-CCP, IgA RF and IgM RF detected early in the disease course predicted joint damage when assessed after eight years of disease. The role of anti-CII in JIA should be further studied.

• Authors: Lillemor Berntson, Ellen Nordal, Anders Fasth, Kristiina Aalto, Troels Herlin, Susan Nielsen, Marite Rygg, Marek Zak, Johan Rönnelid, Nordic Study Group of Pediatric Rheumatology (NoSPeR)
• Journal: Pediatric rheumatology online journal (Pediatr Rheumatol Online J) Vol. 12 Pg. 22 ( 2014) ISSN: 1546-0096 [Print] England
• PMID: 24944545 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Biomarkers
• Collagen Type II
• Immunoglobulin A
• Immunoglobulin M
• Rheumatoid Factor

Topics

• Adult
• Age of Onset
• Arthritis, Juvenile (diagnosis, epidemiology, immunology)
• Arthritis, Rheumatoid (diagnosis, epidemiology, immunology)
• Autoantibodies (blood)
• Biomarkers (blood)
• Child
• Collagen Type II (immunology)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Immunoglobulin A (blood)
• Immunoglobulin M (blood)
• Male
• Prognosis
• Rheumatoid Factor (blood)
• Scandinavian and Nordic Countries (epidemiology)