Anti-cyclic citrullinated Peptide antibody is associated with interstitial lung disease in patients with rheumatoid arthritis.

Yufeng Yin,Fengchun Zhang,Di Liang,Yang Li,Wei Liu,Fulin Tang,Yan Ren,Yongzhe Li,Xiaofeng Zeng,Lidan Zhao,Xuan Zhang,Guangliang Shan

doi:10.1371/journal.pone.0092449

Yufeng Yin, Fengchun Zhang + Show 10 more

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https://doi.org/10.1371/journal.pone.0092449

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ObjectivePatients with rheumatoid arthritis (RA) are at risk to develop RA-associated interstitial lung disease (RA-ILD). This retrospective study aimed to investigate the potential association of the positivity of serum anti-cyclic citrullinated peptide antibody (anti-CCP2) and rheumatoid factor (RF) with RA-ILD in RA patients.MethodsA total of 285 RA patients were recruited at the inpatient service of Peking Union Medical College Hospital in China between 2004 and 2013. Individual patients were evaluated for the evidence of ILD. The concentrations of serum anti-CCP2 and RF in individual patients were measured. The potential risk factors for ILD in RA patients were assessed by univariate and multivariate models.ResultsThere were 71 RA patients with RA-ILD, accounting for 24.9% in this population. The positive rates of anti-CCP2 and RF in the patients with RA-ILD were significantly higher than that in the patients with RA-only (88.7% vs. 67.3%, p<0.001; 84.5% vs. 70.6%, p = 0.02, respectively). Univariate and multivariate logistic regression analysis revealed that RA patients with positive serum anti-CCP2, but not RF, were associated with an increased risk of ILD (crude odds ratio [cOR] 3.83, 95% confidence interval [CI] 1.74–8.43, p<0.001; adjusted odds ratio [aOR] 3.50, 95% CI 1.52–8.04, p<0.001).ConclusionOur findings suggest that positive serum anti-CCP2, but not RF, may be associated with RA-ILD in RA patients.

Highlights

Patients with rheumatoid arthritis (RA) display high levels of autoantibodies as well as extra-articular manifestations, such as interstitial lung disease (ILD) [1,2,3]
Patients and clinical characteristics To determine the potential risk factors associated with ILD, a total of 285 patients with RA were recruited
There was no significant difference in the distribution of gender and in the percentages of smokers between the RA-only and related interstitial lung disease (RA-ILD) groups of patients

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Introduction

Patients with rheumatoid arthritis (RA) display high levels of autoantibodies as well as extra-articular manifestations, such as interstitial lung disease (ILD) [1,2,3]. Autoantibodies are valuable biomarkers for the diagnosis of RA and extra-articular manifestations. Anti-CCP2 antibodies have been shown to be highly specific or independently associated with the development of extra-articular manifestations, including ischemic heart disease [10], type 1 diabetes mellitus [11], serositis [12], and subclinical atherosclerosis in patients with RA [13]. RF is another autoantibody most commonly detected in RA [1,14] Detection of both anti-CCP2 and RF has additional values for the early diagnosis of RA, for those with RA at early stage of the disease process [15]

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