ArticleArthritis research & therapy2018
Inflammation functions as a key mediator in the link between ACPA and erosion development: an association study in Clinically Suspect Arthralgia.
Article in Arthritis research & therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Low-input deep learning platform for citrullinated peptide identification, autoantigen discovery and rheumatoid arthritis treatment stratification.Nature biomedical engineering · 2026Article
- Do MRI-detected erosions in the RA-risk phase of arthralgia reflect current or imminent radiographic erosions? A large longitudinal imaging study.Rheumatology (Oxford, England) · 2025Article
- During development of rheumatoid arthritis, intermetatarsal bursitis may occur before clinical joint swelling: a large imaging study in patients with clinically suspect arthralgia.Rheumatology (Oxford, England) · 2022Article
- Identification of poor prognostic joint locations in an early rheumatoid arthritis cohort at risk of rapidly progressing disease: a post-hoc analysis of the Phase III AGREE study.BMC rheumatology · 2022Article
- Calcium-sensing receptor-mediated NLRP3 inflammasome activation in rheumatoid arthritis and autoinflammation.Frontiers in physiology · 2022Review
- Characterization of serum biomarkers and antibody responses againstFrontiers in cellular and infection microbiology · 2022Article
- Association Between Bone Mineral Density and Autoantibodies in Patients With Rheumatoid Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2021Article
- Therapeutic ACPA inhibits NET formation: a potential therapy for neutrophil-mediated inflammatory diseases.Cellular & molecular immunology · 2021Article
- Do magnetic resonance imaging-detected erosions predict progression to rheumatoid arthritis in patients presenting with clinically suspect arthralgia? A longitudinal study.Scandinavian journal of rheumatology · 2020Article
- How Autoantibodies Regulate Osteoclast Induced Bone Loss in Rheumatoid Arthritis.Frontiers in immunology · 2019Review
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAnti-citrullinated protein antibodies (ACPA) are associated with more severe joint erosions in rheumatoid arthritis (RA), but the underlying mechanism is unclear. Recent in vitro and murine studies indicate that ACPAs can directly activate osteoclasts leading to bone erosions and pain. This study sought evidence for this hypothesis in humans and evaluated whether in patients with arthralgia who are at risk of RA, ACPA is associated with erosions (detected by magnetic resonance imaging (MRI)) independent of inflammation, and also independent of the presence of rheumatoid factor (RF).
methodsPatients with Clinically Suspect Arthralgia (n = 507) underwent determination of ACPA and RF and 1.5 T contrast-enhanced MRI of the metacarpophalangeal, wrist and metatarsophalangeal joints at baseline. MRIs were scored for presence of local inflammation and erosions. Comparisons of erosion scores were performed using the Kruskal-Wallis test. To evaluate if inflammation is, in statistical terms, intermediary in the causal path of ACPA and erosions, three-step mediation analysis was performed using linear regression.
resultsACPA-positive patients had higher erosion scores than ACPA-negative patients (p = 0.006). ACPA-positive patients without subclinical inflammation did not have higher erosion scores than ACPA-negative patients (p = 0.68), in contrast to ACPA-positive patients with local inflammation (p < 0.001). Mediation analyses suggested that local inflammation is in the causal path of ACPA leading to higher erosion scores. Compared to ACPA-negative/RF-negative patients, ACPA-positive/RF-negative patients did not differ (p = 0.30), but ACPA-positive/RF-positive patients had higher erosion scores (p = 0.006).
conclusionsThe effect of ACPA on erosions is mediated by inflammation and is not independent of RF.
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