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Anticitrullinated protein antibodies and radiological progression in juvenile idiopathic arthritis
Joanna Lipinska1, Henryka Brózik, Jerzy Stanczyk
1Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland. joanna-lipinska@wp.pl
Insights
Anticitrullinated protein antibodies (ACPA) in children with juvenile idiopathic arthritis (JIA) predict disease severity and joint damage. ACPA testing is superior to IgM-rheumatoid factor for JIA diagnosis and prognosis.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Diagnostic Biomarkers
Background:
- Juvenile idiopathic arthritis (JIA) is a heterogeneous autoimmune disease affecting children.
- Early diagnosis and prognostic markers are crucial for managing JIA and preventing joint destruction.
Purpose of the Study:
- To evaluate the predictive value of anticitrullinated protein antibodies (ACPA) in children with JIA.
- To assess the correlation between ACPA levels and disease severity, activity, and radiological joint damage.
Main Methods:
- Sera from 74 children with JIA were tested for ACPA using ELISA.
- Radiographs of hands were scored for joint destruction at baseline and during follow-up (median 11.5 months).
- Correlations between ACPA levels and clinical/radiological parameters were analyzed.
Main Results:
- 35% of JIA patients were ACPA-positive.
- ACPA levels correlated positively with disease activity and radiological joint destruction at baseline and follow-up.
- ACPA were present in all JIA onset types, including early disease stages.
Conclusions:
- ACPA determination is a valuable diagnostic tool for JIA.
- ACPA levels provide predictive information on disease severity and long-term radiological outcomes in JIA patients.
- ACPA are superior to IgM-rheumatoid factor in diagnosing JIA and predicting its course.
Objective:
The aim of the study was to investigate whether determination of anticitrullinated protein antibodies (ACPA) provides predictive information on severity of disease course and joint destruction in children with juvenile idiopathic arthritis (JIA).
Methods:
Sera from 74 children with JIA were examined for ACPA using the ELISA test. To assess joint destruction, plain radiographs of both hands were scored twice according to the Steinbrocker scale: at the beginning of observation and after 8.9 to 15.2 months (median 11.5 months) of the followup. Correlations between ACPA serum levels and the disease characteristics (type of JIA onset, disease activity, disease duration, radiological status) were investigated.
Results:
Twenty-six out of 74 examined children with JIA (35.0%) were ACPA-positive [> 5 relative units (RU)/ml]. ACPA were present in all types of JIA onset, including 36.6% of children with early stage JIA (disease duration < 6 months). All of the IgM-rheumatoid factor (RF)-positive children with polyarticular type of JIA onset were simultaneously positive for ACPA. ACPA levels correlated positively with disease activity at the beginning of the study (rho = 0.7196; p < 0.0001) and after followup (rho = 0.2485; p = 0.0486). Disease duration did not significantly affect ACPA serum levels. ACPA levels correlated positively with radiological joint destruction in children with JIA, both at the beginning of the study (rho = 0.4599; p = 0.0004) and after the followup period (rho = 0.5523; p < 0.0001).
Conclusion:
ACPA were superior to IgM-RF in diagnosing JIA and provided predictive information on severity of disease course and radiological outcome.
