Immunological and clinical correlation in patients with rheumatoid arthritis associated with autoimmune thyroiditis



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Rheumatoid arthritis is a systemic autoimmune inflammatory disease of unknown etiology characterized by chronic inflammation of the synovial joints and progressive destruction of cartilage and bone. Serum and synovial fluid of RA patients revealed a wide range of autoantibodies. The highest value in the laboratory diagnosis of the disease serological tests is related to the determination of rheumatoid factor and antibodies to cyclic citrullinated peptide. In rheumatoid arthritis it is often combined with other autoimmune disorders, in particular - with autoimmune thyroiditis. Modern literature suggests that autoimmune thyroiditis and rheumatoid arthritis share common mechanisms of pathogenesis. The aim of the work was to determine the clinical and laboratory features of rheumatoid arthritis in association with autoimmune thyroiditis. We examined 146 patients with this pathology and different immunological profile. The study was conducted in three phases. In the first phase only the effect of the antibodies was determined by cyclic citrullinated peptide on the clinical and laboratory features of rheumatoid arthritis in combination with autoimmune thyroiditis. The second phase determined the effect of rheumatoid factor and antibodies to cyclic citrullinated peptide. In the third phase assessed the role of antibodies to cyclic citrullinated peptide and antibodies to citrullinated vimentin modified. The first phase showed a significant link between the immunological activity of the disease and disease activity indices, the second phase detected reliable correlation between rheumatoid factor presence in blood and age, on the third phase we found a link between immunological activity and joint destruction. Based on these data we can conclude that in patients with different immunological profile suffering from rheumatoid arthritis in combination with autoimmune thyroiditis, there were various pathogenic mechanisms of the disease.

Full Text

Restricted Access

About the authors

A. E Dvorovkin

S.M. Kirov Military Medical Academy

Saint Petersburg, Russia

V. I Odin

S.M. Kirov Military Medical Academy

Saint Petersburg, Russia

O. V Inamova

Rheumatic Clinical Hospital № 25

Saint Petersburg, Russia

V. V Tyrenko

S.M. Kirov Military Medical Academy

Saint Petersburg, Russia

M. M Toporkov

S.M. Kirov Military Medical Academy

Saint Petersburg, Russia

E. N Tzygan

S.M. Kirov Military Medical Academy

Saint Petersburg, Russia

References

  1. Насонов Е.Л. Ревматоидный артрит. В: Насонов Е.Л., Кара-теев Д.Е., Балабанова Р.М. Ревматология. Национальное руководство. М.: ГЭОТАР-Медиа; 2008. с. 290-331.
  2. World Health Organization. The global burden of disease, 2004 Update. http://www.who.int/healthinfo/global_burden_disease/2004_ report_update/en/.
  3. Балабанова Р.М., Эрдес Ш.Ф. Динамика распространенности ревматических заболеваний, входящих в XIII класс МКБ-10, в популяции взрослого населения Российской Федерации за 20002010 гг. Научно-практическая ревматология 2012; 52(3): 10-2.
  4. Da Silva E., Doran M.F., Crowson C.S. et al. Declining use of orthopedic surgery in patients with RA? Results of a longterm, population-based assessment. Arthr. Rheum. 2003; 49(2): 216-20.
  5. Bizzaro N., Tozzoli R., Shoenfeld Y. Are we at a stage to predict autoimmune rheumatic diseases? Arthr. Rheum. 2007; 56(3): 1736-44.
  6. Vallerskog T., Gunnarsson I., Widhe M. et. al. Treatment with rituximab affects both the cellular and the humoral arm of the immune system in patients with SLE. Clin. Immun. 2007; 122: 62-74.
  7. Bang Н., Egerer K., Gauliard A. et al. Mutation and citrullination modifies vimentin to a novel autoantigen for rheumatoid arthritis. Arthr. Rheum. 2007; 56: 2503-11.
  8. Conrad K., Roggenbuck D., Reinhold D. et al. Profiling of rheumatoid arthritis associated autoantibodies. Autoimmun. Rev. 2010; 9: 431-35.
  9. Kinloch A., Tatzer V., Wait R. et al. Identification of citrullinated alpha-enolase as a candidate autoantigen in rheumatoid arthritis. Arthritis Res. Ther. 2005; 7: 1421-9.
  10. Song Y.W., Kang E.H. Autoantibodies in rheumatoid arthritis: rheumatoid factors and anticitrullinated protein antibodies. QJM 2010; 103: 139-46.
  11. Aletaha D., Neogi T., Silman A. et al. 2010 rheumatoid arthritis classification criteria. Arthr. Rheum. 2010; 62(9): 2569-81. 1 2. Shmerling R.H., Delbanco T.L. The rheumatoid factor: an analysis of clinical utility. Am. J. Med. 1991; 91: 528-34.
  12. Shmerling R.H., Delbanco T.L. How useful is the rheumatoid factor? An analysis of sensitivity, specificity, and predictive value. Arch. Intern. Med. 1992; 152: 2417.
  13. van Leeuwen M.A., Westra J., van Riel P.L. et al. IgM, IgA, and IgG rheumatoid factors in early rheumatoid arthritis predictive of radiological progression? Scand. J. Rheumatol. 1 995; 24: 146-53. 1 5. van Boekel M.A., Vossenaar E.R., Hoogen F.H. et al. Autoantibody systems in rheumatoid arthritis: specificity, sensitivity and diagnostic value. Arthritis Res. 2002; 4: 87-93.
  14. Houssien D.A., Jonsson T., Davies E. et al. Clinical significanse of IgA rheumatoid factor subclasses in rheumatoid arthritis. J. Rheumatol. 1997; 24: 2119-22.
  15. Новиков А.А., Александрова Е.Н., Черкасова М.В. и др. Современные методы лабораторной диагностики ревматоидного артрита. Научно-практическая ревматология 2010; 1: 31-45.
  16. Block D.R., Jenkins S.M., Dalenberg D.A. et al. Analytical and clinical comparison of anti-CCP assays with rheumatoid factor for the diagnosis of rheumatoid arthritis. Clin. Chim. Act. 2012; 413(11): 1015-7. 1 9. Koivula M.K., Heliovaara M., Rissanen H. et al. Antibodies binding to citrullinated telopeptides of type I and type II collagens and to mutated citrullinated vimentin synergistically predict the development of seropositive rheumatoid arthritis. Ann. Rheum. Dis. 2012; 14: 23-7.
  17. Aggarwal A., Nair R. Anti-citrullinated peptide antibody assays and their role in the diagnosis of rheumatoid arthritis. Arthr. Rheum. 2009; 61: 1472-83.
  18. van Beers J.J., van Venrooij W.J., Pruijn G.J. Two major classes of rheumatoid arthritis: CCP distinguishes between ACPA-positive and ACPA-negative RA. In: Conrad K., Chan E.K., Fritzler M.J. et al., editors. From pathogenesis to therapy of autoimmune diseases: autoantigens, autoantibodies, autoimmunity. Proceedings of the 9th Dresden Symposium on Autoantibodies; 2009 Sep 2-5; Dresden; 2009. p. 265-78.
  19. Bang H., Luthke K., Gauliard A. et al. Mutadetcitrullinated vimentin (MCV) as a candidate autoantigen for diagnosis and monitoring of disease activity in rheumatoid arthritis. Ann. Rheum. Dis. 2006; 65 Suppl 11: 144.
  20. Dejaco C., Klotz V., Larcher H. et al. Diagnostic value of antibodies against a modified citrullinated vimentin in rheumatoid arthritis. Arthritis Res. Ther. 2006; 8(4): 119-125.
  21. Mathsson L., Mullazehi M., Wick M.C. et al. Antibodies against citrullinated vimentin in rheumatoid arthritis. Arthritis & Rheumatism 2008; 58: 36-45.
  22. Luime J.J., Colin E.M., Hazes J.M. et al. Does anti-mutated citrullinated vimentin have additional value as a serological marker in the diagnostic and prognostic investigation of patients with rheumatoid arthritis? A systematic review. Ann. Rheum. Dis. 2010; 69: 337-44.
  23. Combe B., Landewe R., Lukas C. et al. EULAR recommendations for themanagement of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann. Rheum. Dis. 2007; 66(1): 34-45.
  24. Braverman L. Disease of the thyroid. Totowa, New Jersey, USA: Human Press; 2003.
  25. Dayan C.M., Daniels G.H. Chronic autoimmune thyroiditis. N. Eng. J. Med. 1996; 335(2): 99-107.
  26. Andonopoulos A.P., Siambi V., Makri M. et al. Thyroid function and immune profile in rheumatoid arthritis. A controlled study. Clin. Rheum. 1996; 15(6): 599-603.
  27. Hijmans W., Doniach D., Roitt I.M. et al. Serological overlap between lupus erythematosus, rheumatoid arthritisand thyroid auto-immune disease. British Medical Journal 1961; 5257(2): 909-14.
  28. Becker K., Ferguson R., McConahey W. The connective-tissue diseases and symptoms associated with Hashimoto's thyroiditis. N. Eng. J. Med. 1963; 268: 277-80.
  29. Punzi L., Betterle C. Chronic autoimmune thyroiditis and rheumatic manifestations. Joint Bone Spine 2004; 71(4): 275-83.
  30. Chistiakov D.A., Turakulov R.I. CTLA-4 and its role in autoimmune thyroid disease. J. Mol. Endocrinol. 2003; 31(1): 21-36.
  31. Один В.И., Дворовкин А.Э., Колюбаева С.Н. и др. Цитогенетические нарушения у больных ревматоидным артритом, ассоциированным с аутоиммунным тиреоидитом. Биомедицинский журнал 2015; 16: 826-33.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: 

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies