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Rheumatoid arthritis-associated rheumatoid factors post-COVID-19.

Adam H Titi1, Braedon T Krisko1, S Janna Bashar1

  • 1Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States.

Frontiers in Immunology
|February 28, 2025
PubMed
Summary
This summary is machine-generated.

Rheumatoid factors (RFs) associated with rheumatoid arthritis were found in some individuals after COVID-19 infection, particularly IgA RFs targeting homocitrulline. This suggests a potential link between infections and rheumatoid arthritis development.

Keywords:
COVID-19autoantibodyautoimmunityrheumatoid arthritisrheumatoid factor

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Area of Science:

  • Immunology
  • Rheumatology
  • Infectious Diseases

Background:

  • Rheumatoid factors (RFs) are key markers of rheumatoid arthritis (RA) and can also appear after infections like COVID-19.
  • Infections, including COVID-19, are linked to RA development, suggesting RFs may bridge these conditions.
  • Recent findings show specific IgG RFs in RA and IgM RFs post-COVID-19, hinting at varied RF reactivity.

Purpose of the Study:

  • To investigate if RA-associated RFs emerge after COVID-19.
  • To gain insights into how infections might lead to a loss of immune tolerance.
  • To explore potential biomarkers for preclinical RA.

Main Methods:

  • Enzyme-linked immunosorbent assay (ELISA) was used to test sera from COVID-19 convalescents, RA patients, and controls.
  • Antibody (IgG, IgM, IgA) binding to native and modified IgG1 peptides (citrulline/homocitrulline) was assessed.
  • Statistical analysis included Kruskal-Wallis and Fisher's exact tests.

Main Results:

  • Rheumatoid arthritis sera showed increased IgG binding to citrulline/homocitrulline peptides.
  • Post-COVID-19 sera exhibited increased IgA binding to homocitrulline peptides, unlike controls.
  • Some individuals post-COVID-19 developed RA-associated RFs, particularly IgA isotype and homocitrulline-reactive.

Conclusions:

  • RA-associated RFs are largely specific to RA, but some individuals post-COVID-19 develop them.
  • These findings offer new perspectives on post-infectious immune tolerance loss.
  • The study highlights potential new biomarkers for identifying preclinical RA.