Prospective evaluation of the frequency and clinical significance of antineutrophil cytoplasmic and anticardiolipin antibodies in community cases of patients with rheumatoid arthritis

• Published in: Rheumatology (Oxford, England) Vol. 39; no. 5; pp. 481 - 489
• Main Authors: Vittecoq, O., Jouen‐Beades, F., Krzanowska, K., Bichon‐Tauvel, I., Menard, J. F., Daragon, A., Gilbert, D., Tron, F., Le Loët, X.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2000
• Subjects: Adult; Aged; ANCA; Antibodies, Anticardiolipin - analysis; Antibodies, Antineutrophil Cytoplasmic - analysis; Antibody Specificity; Anticardiolipin antibodies; Antilactoferrin antibodies; Anti‐β2‐glycoprotein 1 antibodies; Arthritis, Rheumatoid - immunology; beta 2-Glycoprotein I; Demography; Enzyme-Linked Immunosorbent Assay; Evaluation Studies as Topic; Fluorescent Antibody Technique, Indirect; Glycoproteins - immunology; Humans; Middle Aged; Prospective Studies; Rheumatoid arthritis
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/39.5.481

Objectives. To evaluate the frequencies of antineutrophil cytoplasmic (ANCA), anticardiolipin (aCLA) and anti‐β2‐glycoprotein 1 antibodies (aβ2‐GP1A) in rheumatoid arthritis (RA) of limited duration in patients recruited primarily from private practitioners (80%), and to attempt to correlate the presence of these antibodies with certain clinical and/or biological criteria. Patients and methods. Patients (n = 102) with RA evolving for <5 yr (mean 2.2 yr) were recruited. A home evaluation collected clinical data [Ritchie articular index, Health Assessment Questionnaire (HAQ) index, extra‐articular manifestations] and blood for biological analyses [C‐reactive protein (CRP), rheumatoid factor, ANCA, aCLA, aβ2‐GP1A]. ANCA were detected by indirect immunofluorescence on neutrophils and their specificity was determined by enzyme‐linked immunosorbent assay (ELISA) and confirmed by immunoblotting; aCLA and aβ2‐GP1A were detected by ELISA. Results. Patients had mild RA (Ritchie = 11/78 ± 9.6; HAQ = 0.79/3 ± 0.7), probably due to the recruitment procedure. ANCA, aCLA and aβ2‐GP1A frequencies were 18.5, 7 and 0%, respectively. Titres of ANCA and aCLA were low. A perinuclear ANCA staining pattern was exclusively observed and lactoferrin was shown to be the major antigen recognized. No relationship was found between ANCA and aCLA and/or rheumatoid factor, or any clinical manifestations. ANCA were more common in RA of longer duration (cut‐off: 4 yr; P = 0.05) and aCLA were correlated with the CRP level (P = 0.05). Conclusions. In RA of recent onset, ANCA and aCLA were detected at low titres and frequencies, and were not associated with any clinical manifestations. A longitudinal study is needed to determine whether their early appearance is predictive of subsequent disease severity.