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Antibodies to Viral Citrullinated Peptide in Rheumatoid Arthritis
CONSUELO ANZILOTTI, GIUSEPPINA MERLINI, FEDERICO PRATESI, CRISTINA TOMMASI, DANIELE CHIMENTI, and PAOLA MIGLIORINI ABSTRACT. Methods. Anti-VCP antibodies were determined in 627 serum samples, 300 from patients with RA and 327 from controls, including connective tissue diseases, chronic arthritides, and healthy donors. Among patients with RA, a possible correlation with systemic involvement, disease severity, and disease activity was investigated; in 94 RA patients antibodies to cyclic citrullinated protein (anti-CCP) were also measured. Results. Anti-VCP antibodies were found in 45% of RA sera versus less than 5% of controls; anti-VCP levels correlated with anti-CCP levels (p < 0.0001), rheumatoid factor (p = 0.02), and erythrocyte sedimentation rate (p = 0.0058). No correlation was found with extraarticular manifestations of the disease or with disease severity. Conclusion. Anti-VCP antibodies are helpful in discriminating RA from other chronic arthritides or connective tissue disorders. The level of positivity is positively correlated with the anti-CCP level, suggesting that VCP can be considered a novel substrate to detect anti-citrullinated peptide/protein antibodies (ACPA). The reactivity of RA-specific antibodies with a viral citrullinated antigen raises questions on the role of EBV in the induction of ACPA. (First Release Mar 1, 2006; J Rheumatol 2006;33:647-51)
Key Indexing Terms: ANTI-CITRULLINATED PEPTIDE/PROTEIN ANTIBODIES
From the Clinical Immunology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy. C. Anzilotti, MD; G. Merlini, MD; Federico Pratesi, BSc; C. Tommasi, MD; D. Chimenti, BSc; P. Migliorini, MD. Address reprint requests to Dr. P. Migliorini, Clinical Immunology Unit, Department of Internal Medicine, Via Roma 67, 56126 Pisa, Italy. E-mail: p.migliorini@med.unipi.it Accepted for publication December 7, 2005.
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