Rheumatoid Factor Is Associated With the Distribution of Hand Joint Destruction in Rheumatoid Arthritis

Abstract

Objective Rheumatoid arthritis (RA) is a chronic disease leading to joint destruction. Although many studies have addressed factors potentially correlated with the speed of joint destruction, less attention has been paid to the distribution of joint destruction in patients with RA. In this study, destruction of the hand bones in patients with RA was classified into 2 anatomic subgroups, the fingers and the non‐fingers, with the aim of analyzing which factors are associated with destruction of the finger joints. Methods A total of 1,215 Japanese patients with RA were recruited from 2 different populations. The degree of joint destruction was assessed using the total modified Sharp/van der Heijde score (SHS) of radiographic joint damage. The SHS score of joint damage in the finger joints was used as the dependent variable, and the SHS score in the non‐finger joints was used as a covariate. Age, sex, disease duration, smoking, C‐reactive protein level, treatment for RA, and positivity for and levels of anti–citrullinated protein antibodies and rheumatoid factor (RF) were evaluated as candidate correlates. Overall effect sizes were assessed in a meta‐analysis. In addition, associations observed in the Japanese patients were compared to those in a cohort of 157 Dutch RA patients in the BeSt study (a randomized, controlled trial involving 4 different strictly specified treatment strategies for early RA). Results Not surprisingly, disease duration in Japanese patients with RA was associated with the finger SHS score (P ≤ 0.00037). Both positivity for and levels of RF showed significant associations with the finger SHS score after adjustment for covariates (P = 0.0022 and P = 8.1 × 10−7, respectively). These associations were also true in relation to the time‐averaged finger SHS score. An association between RF positivity and the finger SHS score was also observed in Dutch patients with RA in the BeSt study (P = 0.049). Conclusion Positivity for and levels of RF are associated with finger joint destruction independent of non‐finger joint destruction and other covariates. Our findings suggest that there are different mechanisms of joint destruction operating in the finger joints of patients with RA.

Hypoxia-Sensitive COMMD1 Integrates Signaling and Cellular Metabolism in Human Macrophages and Suppresses Osteoclastogenesis

“…To perform functional analysis, we selected rs11125908 in an intron of COMMD1 which was 75bp from and in strong LD with rs10205855 (r 2 =0.98, Figure S3A). In Japanese RA patients (Terao et al, 2015), the minor allele G at rs11125908, showing significant cis eQTL association with increased COMMD1 expression (Figure 3B), was concurrently associated with lower bone erosions of hand joints (Figure 3C). Furthermore, rs11125908 G alleles demonstrated a strong suppressive association with finger joint destruction, independently of rheumatoid factor (RF) positivity (Figure S3B).…”

“…We analyzed 340 patients with RA from the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort at Kyoto University, as previously described (Terao et al, 2015). DNA was available from 176 RA patients among the 340 patients in the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort.…”

“…This study was approved by the local ethics committee at each institution, and written informed consent was obtained from all participants. Details of the cohort were described before (Terao et al, 2015). Genotyping for rs11125908 was performed using Taqman SNP genotyping assay (Thermo Fisher Scientific).…”

Long non‐coding RNAs in rheumatoid arthritis

“…[1][2][3][4] RA could cause joint swelling, pain, loss of function and stiffness and tremendously impact on health and quality of life of patients. [5][6][7][8] The prevalence of RA is about 3 times higher in females than males. [9][10][11] The pathogenesis of RA is complex and involves an intricate interplay between host factors (eg genetic susceptibilities, aberrant immune response, abnormal metabolic enzymes and sex hormones) and environmental triggers (eg bacterial or viral infection).…”

Plasma sLOX-1 is a potent biomarker of clinical remission and disease activity in patients with seropositive RA

“…Interestingly, patients positive for both RF and ACPAs seem to exhibit more severe erosive bone damage compared with those who are positive for only one of the autoantibodies [30], suggesting that the combination of these autoantibodies is strongly linked to a worse clinical disease course of RA [31]. Moreover, we recently reported that RF and ACPAs positivity contribute to joint destruction of particular joints in patients with RA [32,33]. In this study, we found that the sLOX-1 level was markedly higher in patients with the combined presence of RF and ACPAs in the non-remission group compared with those in the remission group ( Figure 1C).…”