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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Related Experiment Video

Updated: Oct 29, 2025

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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In Rheumatoid Arthritis Patients, HLA-DRB1*04:01 and Rheumatoid Nodules Are Associated With ACPA to a Particular

Guillaume Larid1, Mikael Pancarte2, Géraldine Offer2

  • 1Rhumatologie, Institut du Mouvement et de l'appareil Locomoteur (IML), Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France.

Frontiers in Immunology
|July 12, 2021
PubMed
Summary

Rheumatoid arthritis patients with HLA-DRB1*04:01 may develop rheumatoid nodules due to specific antibodies against citrullinated fibrinogen. Targeting these epitope-specific antibodies could offer new therapeutic options for rheumatoid nodules.

Keywords:
ACPAAhFibAHLA-DRB1citrullinated peptides 2rheumatoid arthritis

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Area of Science:

  • Immunology
  • Genetics
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) is linked to HLA-DRB1 genes and anti-citrullinated protein antibodies (ACPAs).
  • ACPAs target citrullinated epitopes, including those from human fibrin(ogen) (hFib).
  • Five specific citrullinated hFib peptides (α36-50cit, α171-185cit, α501-515cit, α621-635cit, β60-74cit) represent key ACPA epitopes.

Purpose of the Study:

  • To investigate associations between RA clinical phenotypes and specific antibody reactivity to five citrullinated hFib epitopes.
  • To determine if RA clinical characteristics and HLA-DRB1 genotypes correlate with specific epitope recognition.

Main Methods:

  • Studied 184 ACPA-positive RA patients meeting 2010 ACR/EULAR criteria.
  • Collected patient data including HLA-DRB1 genotype.
  • Analyzed anti-CCP2, anti-hFib-derived peptide antibodies (AhFibA) using ELISA.

Main Results:

  • Anti-α501-515cit antibodies strongly associated with HLA-DRB1*04:01 (OR=5.52, p=0.0003).
  • High levels of anti-α501-515cit antibodies linked to rheumatoid nodules (OR=2.71, p=0.044).

Conclusions:

  • Immune complexes involving anti-α501-515cit antibodies and rheumatoid factors may contribute to rheumatoid nodules in HLA-DRB1*04:01 positive RA patients.
  • Apheresis targeting these epitope-specific antibodies presents a potential novel therapy for rheumatoid nodules.