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Publication Detail
Antibodies to citrullinated peptides in patients with juvenile idiopathic arthritis and rheumatoid arthritis: Shared expression of the inherently autoreactive 9G4 idiotype.
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Peckham H, Cambridge G, Bourke L, Sen D, Radziszewska A, Leandro M, Ioannou Y
  • Publication date:
  • Journal:
    Arthritis & rheumatology (Hoboken, N.J.)
  • Medium:
  • Print ISSN:
  • Language:
  • Addresses:
    Arthritis Research UK Centre for Adolescent Rheumatology, Division of Medicine, University College London.
Objective Antibodies to cyclic citrullinated peptides (CCP) in rheumatoid arthritis (RA) can express the inherently autoreactive gene, VH4-34, as detected using the rat monoclonal antibody, 9G4. Patients with the polyarticular sub-type of juvenile idiopathic arthritis (pJIA) share some but not all features of RA in adults. The aim of this study was to profile rheumatoid factor (RF), anti-CCP and 9G4-CCP serology of a large JIA cohort and compare to a cohort of adult RA patients. Methods Serum from 88 pJIA, 29 enthesitis-related arthritis (ERA), 38 extended oligoarthritis (EOA), 31 adolescent controls, 35 RA and 30 adult controls were tested for RF, IgG, IgA and IgM anti-CCP and 9G4+CCP by ELISA. Serum total 9G4+IgM was also measured. Results Of 65/88 pJIA(RF-ve) patients, 4 (4.6%) were IgG anti-CCP positive. In sera from pJIA(RF+ve) 20/23 (87.0%), RA 30/35 (85.7%) and one EOA patient contained IgG anti-CCP. IgA- and IgM anti-CCP levels were lower in the adolescent group (p<0.01). 9G4-CCP were higher in pJIA RF+ve vs RF-ve (p<0.0001). Median levels of 9G4-CCP in pJIA(RF+ve) and RA did not differ. 9G4 on serum total IgM was greater in pJIA(RF+ve) patients compared with adolescent groups (p<0.01), but similar to adult RA(RF+ve). Conclusion In healthy individuals, 9G4+B cells comprise 5-10% of peripheral blood pool but serum immunoglobulins utilising VH4-34 are disproportionately low. The idiotope recognised by 9G4 was detected on anti-CCP antibodies in >80% pJIA(RF+ve) patients. VH4-34 usage by anti-CCP in both JIA and RA patients suggest elicitation of these autoantibodies through shared pathogenic B cell selection processes. This article is protected by copyright. All rights reserved.
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