Elevated free secretory component in early rheumatoid arthritis and prior to arthritis development in patients at increased risk. / Martinsson, Klara; Roos Ljungberg, Karin; Ziegelasch, Michael; Cedergren, Jan; Eriksson, Per; Klimovich, Vladimir; Reckner, Åsa; Griazeva, Irina; Sjöwall, Christopher; Samoylovich, Marina; Skogh, Thomas; Wetterö, Jonas; Kastbom, Alf.
In: Rheumatology, Vol. 59, No. 5, 01.05.2020, p. 979-987.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Elevated free secretory component in early rheumatoid arthritis and prior to arthritis development in patients at increased risk
AU - Martinsson, Klara
AU - Roos Ljungberg, Karin
AU - Ziegelasch, Michael
AU - Cedergren, Jan
AU - Eriksson, Per
AU - Klimovich, Vladimir
AU - Reckner, Åsa
AU - Griazeva, Irina
AU - Sjöwall, Christopher
AU - Samoylovich, Marina
AU - Skogh, Thomas
AU - Wetterö, Jonas
AU - Kastbom, Alf
N1 - Publisher Copyright: © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Objectives: Considering growing evidence of mucosal involvement in RA induction, this study investigated circulating free secretory component (SC) in patients with either recent-onset RA or with ACPA and musculoskeletal pain. Methods: Two prospective cohorts were studied: TIRA-2 comprising 452 recent-onset RA patients with 3 years of clinical and radiological follow-up, and TIRx patients (n = 104) with ACPA IgG and musculoskeletal pain followed for 290 weeks (median). Blood donors and three different chronic inflammatory diseases served as controls. Free SC was analysed by sandwich ELISA. Results: Serum levels of free SC were significantly higher in TIRA-2 patients compared with TIRx and all control groups (P < 0.01). Among TIRx patients who subsequently developed arthritis, free SC levels were higher compared with all control groups (P < 0.05) except ankylosing spondylitis (P = 0.74). In TIRA-2, patients with ACPA had higher baseline levels of free SC compared with ACPA negative patients (P < 0.001). Free SC status at baseline did not predict radiographic joint damage or disease activity over time. In TIRx, elevated free SC at baseline trendwise associated with arthritis development during follow-up (P = 0.066) but this disappeared when adjusting for confounders (P = 0.72). Cigarette smoking was associated with higher levels of free SC in both cohorts. Conclusion: Serum free SC levels are increased in recent-onset RA compared with other inflammatory diseases, and associate with ACPA and smoking. Free SC is elevated before arthritis development among ACPA positive patients with musculoskeletal pain, but does not predict arthritis development. These findings support mucosal engagement in RA development.
AB - Objectives: Considering growing evidence of mucosal involvement in RA induction, this study investigated circulating free secretory component (SC) in patients with either recent-onset RA or with ACPA and musculoskeletal pain. Methods: Two prospective cohorts were studied: TIRA-2 comprising 452 recent-onset RA patients with 3 years of clinical and radiological follow-up, and TIRx patients (n = 104) with ACPA IgG and musculoskeletal pain followed for 290 weeks (median). Blood donors and three different chronic inflammatory diseases served as controls. Free SC was analysed by sandwich ELISA. Results: Serum levels of free SC were significantly higher in TIRA-2 patients compared with TIRx and all control groups (P < 0.01). Among TIRx patients who subsequently developed arthritis, free SC levels were higher compared with all control groups (P < 0.05) except ankylosing spondylitis (P = 0.74). In TIRA-2, patients with ACPA had higher baseline levels of free SC compared with ACPA negative patients (P < 0.001). Free SC status at baseline did not predict radiographic joint damage or disease activity over time. In TIRx, elevated free SC at baseline trendwise associated with arthritis development during follow-up (P = 0.066) but this disappeared when adjusting for confounders (P = 0.72). Cigarette smoking was associated with higher levels of free SC in both cohorts. Conclusion: Serum free SC levels are increased in recent-onset RA compared with other inflammatory diseases, and associate with ACPA and smoking. Free SC is elevated before arthritis development among ACPA positive patients with musculoskeletal pain, but does not predict arthritis development. These findings support mucosal engagement in RA development.
KW - clinical progress
KW - cyclic citrullinated peptide antibodies (ACPA)
KW - free secretory component
KW - musculoskeletal pain
KW - rheumatoid arthritis (RA)
UR - http://www.scopus.com/inward/record.url?scp=85084167837&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kez348
DO - 10.1093/rheumatology/kez348
M3 - Article
C2 - 31504979
AN - SCOPUS:85084167837
VL - 59
SP - 979
EP - 987
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 5
ER -
ID: 89787689