Long-term follow-up of patients with anti-cyclic citrullinated peptide antibody-positive connective tissue disease: a re
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RESEARCH ARTICLE
Open Access
Long-term follow-up of patients with anticyclic citrullinated peptide antibodypositive connective tissue disease: a retrospective observational study including information on the HLA-DRB1 allele and citrullination dependency Takeshi Iwasaki1†, Shuichiro Nakabo1†, Chikashi Terao2,3,4, Kosaku Murakami1, Ran Nakashima1, Motomu Hashimoto5, Yoshitaka Imura6, Naoichiro Yukawa7, Hajime Yoshifuji1, Yasuo Miura8, Kimiko Yurugi8, Taira Maekawa8, Myrthe A. M. van Delft9, Leendert A. Trouw9,10, Takao Fujii1,11, Tsuneyo Mimori1,12 and Koichiro Ohmura1*
Abstract Background: The anti-cyclic citrullinated peptide (CCP) antibody is a diagnostic biomarker of rheumatoid arthritis (RA). However, some non-RA connective tissue disease (CTD) patients also test positive for the anti-CCP antibody and, thus, may ultimately develop RA. We retrospectively investigated whether anti-CCP-positive non-RA CTD patients developed RA and attempted to identify factors that may differentiate RA-overlapping CTD from pure CTD. Methods: In total, 842 CTD patients with a primary diagnosis that was not RA were selected from our CTD database as of December 2012. Anti-CCP antibody titers were obtained from a retrospective chart review or measured using stored sera. RA was diagnosed according to the 1987 revised American College of Rheumatology classification criteria. Thirty-three anti-CCP-positive non-RA CTD patients were retrospectively followed up for the development of RA. Bone erosions on the hands and feet were assessed by X-ray. Citrullination dependency was evaluated by an in-house ELISA, the HLA-DRB1 allele was typed, and the results obtained were then compared between RA-overlapping and non-RA anti-CCP-positive CTD patients. (Continued on next page)
* Correspondence: [email protected] † Takeshi Iwasaki and Shuichiro Nakabo contributed equally to this work. 1 Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org
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