bromochloroacetic-acid and Arthritis--Juvenile

Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been found in sera of 76% of patients with rheumatoid arthritis (RA), mainly in rheumatoid factor (RF) positive patients, with a specificity of 96%. We evaluated the presence of anti-CCP antibodies in patients with juvenile idiopathic arthritis (JIA) and assessed the possibility of synthetic citrullinated peptides as antigenic determinants in JIA.. The presence of anti-CCP antibodies was determined using 3 synthetic citrullinated peptide variants and 2 commercial kits (Inova Diagnostics and Axis-Shield Diagnostics) optimized for detecting JIA-specific antibodies in serum by an ELISA based assay. We evaluated 66 patients with JIA (16 RF positive polyarthritis, 18 RF negative polyarthritis, 19 oligoarthritis, and 13 systemic arthritis). We also tested 9 adult RA patients, 34 patients with systemic lupus erythematosus (SLE), and 25 healthy persons as controls.. Significant concentrations of anti-CCP antibodies were detected in the majority of RF positive JIA patients with polyarthritis. Using the 2 synthetic linear peptides, 12/16 (75%) were positive; 9/12 (75%) were positive with the Inova kit and 9/10 (90%) were positive with the Axis-Shield kit. However, utilizing the synthetic linear peptides, significant concentrations of anti-CCP antibodies were detected in 51/66 (77%) JIA patients, including 15/18 (83%) RF negative polyarthritis, 16/19 (84%) oligoarthritis, and 8/13 (62%) systemic arthritis patients. No healthy control showed elevated antibody levels. In contrast, 4/9 (44%) patients with adult RA and 2/6 (33%) with SLE had elevated anti-CCP levels. The synthetic cyclic variant cfc-1-cyc yielded significant anti-CCP levels for 13/14 (93%) patients with RF negative polyarthritis, 6/10 (60%) with oligoarthritis, and 3/7 (43%) with systemic arthritis, and 8/9 (88%) RF positive patients. No healthy control had increased anti-CCP levels. However, 4/9 (44%) adult RA and 9/34 (26%) SLE patients were found to have elevated anti-CCP levels. Using the Inova and Axis-Shield kits, much smaller percentages were found in the RF negative patients, with only 4/16 (25%) in the oligoarthritis and RF negative polyarthritis patients with the Inova kits and 0/25 (0%) by the Axis-Shield kits. The Inova kit revealed elevated anti-CCP antibodies in 5/9 (56%) adult RA patients and in 8/34 (24%) SLE patients. No healthy control had elevated anti-CCP antibodies. However, the Axis-Shield kits did not detect anti-CCP antibodies in adult RA (0/9) or SLE (0/34) patients. Moreover, 0/25 (0%) healthy individuals exhibited anti-CCP levels. The presence of anti-CCP antibodies correlated more frequently with the presence of RF.. This study confirms the presence of anti-CCP antibodies in patients with JIA, especially those with RF positive polyarthritis, by all ELISA based methods. Use of synthetic peptides also revealed anti-CCP antibodies in a percentage of RF negative patients with polyarthritis, oligoarthritis, and systemic arthritis; there was a loss in specificity, but an increase in sensitivity. These results suggest that antibodies to these antigenic peptides may be markers for JIA, and indicate a possible role of citrulline-containing epitopes in the pathogenesis of JIA.

Topics: Adolescent; Adult; Antibodies, Antinuclear; Arthritis, Juvenile; Autoantibodies; Child; Enzyme-Linked Immunosorbent Assay; Epitopes; Humans; Keratins; Peptides, Cyclic

We analyzed the frequency and clinical correlates of antiperinuclear factor (APF) and antibodies to the stratum corneum of rat esophagus in 86 children with juvenile idiopathic arthritis (JIA), 32 children with juvenile systemic lupus erythematosus, and 52 healthy children. Forty-two patients with JIA (49%) were positive for APF. No association was observed between APF and current age, sex, JIA subtype, age at disease onset, or disease duration. APF was found in one patient with juvenile systemic lupus erythematosus and in no healthy child. Antibodies to the stratum corneum of rat esophagus were detected in 3 patients with polyarticular JIA. APF may be a valuable tool in the differential diagnosis of JIA.

Topics: Animals; Antibodies; Antibodies, Antinuclear; Arthritis, Juvenile; Child, Preschool; Female; Fluorescent Antibody Technique, Indirect; Humans; Keratins; Lupus Erythematosus, Systemic; Male; Rats; Reference Values; Rheumatoid Factor

Antiperinuclear factor (APF), antikeratin antibodies (AKA), and anti-RA 33 antibodies are currently considered to be good markers for the diagnosis of adult rheumatoid arthritis with or without rheumatoid factor (RF). The prevalence of these markers was retrospectively reviewed in children with juvenile chronic arthritis (JCA) to determine whether they were associated with specific features.. One hundred and twenty-four patients with JCA participated in this study. Controls included 28 patients with juvenile systemic lupus erythematosus and 21 healthy children. Antiperinuclear factor and AKA were determined by indirect immunofluorescence on buccal mucosal cells and oesophagus sections respectively. Anti-RA 33 antibodies were detected using a Western blot technique on HeLa cell nuclear extract.. Antiperinuclear factor was virtually absent in all the tested subgroups and anti-RA 33 antibodies were detected only in a subset of patients with RF positive polyarticular onset. Antikeratin antibodies were found in 27% of all children with JCA and in 42% of those with RF negative polyarticular onset. These results were statistically significant compared with healthy controls, but the presence of AKA was not specific to any patient subgroup. Moreover, in contrast with previous studies in adult RA, no relation was found between the presence of AKA and disease severity or activity.. These data suggest that APF, AKA, and anti-RA 33 antibodies are not useful for the diagnosis or classification of JCA.

Topics: Antibodies, Antinuclear; Arthritis, Juvenile; Autoantibodies; Biomarkers; Child; Child, Preschool; Female; Humans; Immunoglobulin G; Keratins; Male; Nuclear Proteins; Prognosis; Retrospective Studies