Anti-cyclic citrullinated peptide antibodies in primary Sjögren syndrome may be associated with non-erosive synovitis

Fabiola Atzeni, Piercarlo Sarzi-Puttini, Nicola Lama, Eleonora Bonacci, Francesca Bobbio-Pallavicini, Carlomaurizio Montecucco, Roberto Caporali

Research output: Contribution to journalArticle

Abstract

Introduction: The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data. Methods: We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results: Fourteen patients (9.9%) had moderate to high levels of anti-CCP, and 94 (66.7%) were positive for RF. Eighty-one (57.4%) showed extra-glandular involvement, and 44 (31.2%) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P <0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95% confidence interval 1.475 to 74.870; P = 0.010). Conclusion: Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.

Original languageEnglish
Article numberR51
JournalArthritis Research and Therapy
Volume10
Issue number3
DOIs
Publication statusPublished - May 7 2008

Fingerprint

Synovitis
Antibodies
Rheumatoid Factor
Anti-Idiotypic Antibodies
Rheumatoid Arthritis
Nephelometry and Turbidimetry
Immunoglobulin M
cyclic citrullinated peptide
Multivariate Analysis
Joints
Enzyme-Linked Immunosorbent Assay
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Rheumatology
  • Medicine(all)

Cite this

Anti-cyclic citrullinated peptide antibodies in primary Sjögren syndrome may be associated with non-erosive synovitis. / Atzeni, Fabiola; Sarzi-Puttini, Piercarlo; Lama, Nicola; Bonacci, Eleonora; Bobbio-Pallavicini, Francesca; Montecucco, Carlomaurizio; Caporali, Roberto.

In: Arthritis Research and Therapy, Vol. 10, No. 3, R51, 07.05.2008.

Research output: Contribution to journalArticle

@article{38350f6eeeb948389c9d9e2536ad7959,
title = "Anti-cyclic citrullinated peptide antibodies in primary Sj{\"o}gren syndrome may be associated with non-erosive synovitis",
abstract = "Introduction: The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sj{\"o}gren syndrome (pSS) and its correlation with clinical and laboratory data. Methods: We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results: Fourteen patients (9.9{\%}) had moderate to high levels of anti-CCP, and 94 (66.7{\%}) were positive for RF. Eighty-one (57.4{\%}) showed extra-glandular involvement, and 44 (31.2{\%}) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P <0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95{\%} confidence interval 1.475 to 74.870; P = 0.010). Conclusion: Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.",
author = "Fabiola Atzeni and Piercarlo Sarzi-Puttini and Nicola Lama and Eleonora Bonacci and Francesca Bobbio-Pallavicini and Carlomaurizio Montecucco and Roberto Caporali",
year = "2008",
month = "5",
day = "7",
doi = "10.1186/ar2420",
language = "English",
volume = "10",
journal = "Arthritis Research and Therapy",
issn = "1478-6354",
publisher = "BioMed Central",
number = "3",

}

TY - JOUR

T1 - Anti-cyclic citrullinated peptide antibodies in primary Sjögren syndrome may be associated with non-erosive synovitis

AU - Atzeni, Fabiola

AU - Sarzi-Puttini, Piercarlo

AU - Lama, Nicola

AU - Bonacci, Eleonora

AU - Bobbio-Pallavicini, Francesca

AU - Montecucco, Carlomaurizio

AU - Caporali, Roberto

PY - 2008/5/7

Y1 - 2008/5/7

N2 - Introduction: The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data. Methods: We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results: Fourteen patients (9.9%) had moderate to high levels of anti-CCP, and 94 (66.7%) were positive for RF. Eighty-one (57.4%) showed extra-glandular involvement, and 44 (31.2%) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P <0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95% confidence interval 1.475 to 74.870; P = 0.010). Conclusion: Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.

AB - Introduction: The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data. Methods: We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results: Fourteen patients (9.9%) had moderate to high levels of anti-CCP, and 94 (66.7%) were positive for RF. Eighty-one (57.4%) showed extra-glandular involvement, and 44 (31.2%) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P <0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95% confidence interval 1.475 to 74.870; P = 0.010). Conclusion: Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.

UR - http://www.scopus.com/inward/record.url?scp=44149084455&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44149084455&partnerID=8YFLogxK

U2 - 10.1186/ar2420

DO - 10.1186/ar2420

M3 - Article

C2 - 18462485

AN - SCOPUS:44149084455

VL - 10

JO - Arthritis Research and Therapy

JF - Arthritis Research and Therapy

SN - 1478-6354

IS - 3

M1 - R51

ER -