ACPA response in evolution of rheumatoid arthritis

The ACPA response is different from conventional antibody responses. The ACPA response is generally of a much lower avidity than recall responses. Avidity maturation is limited and occurs before disease onset. The presence of low avidity ACPA is associated with higher rate of joint destruction. In vitro, the binding of low avidity ACPA to citrullinated epitopes was weakly inhibited by citrullinated antigens and low avidity ACPA have a higher ability to activate the complement system. In addition, there are certain antigens which continuously drive ACPA (IgM) response in RA.Ramathibodi hospital, Mahidol university, Bangkok, ThailandUBL - phd migration 201

The fine specificity of IgM anti-citrullinated protein antibodies (ACPA) is different from that of IgG ACPA

Pathophysiology and treatment of rheumatic disease

Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis

AbstractObjectivesThe association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were to conduct a systematic review and meta-analysis comparing sleep in persons with and without T1D, and to explore relationships between sleep and glycemic control in T1D.MethodsStudies were identified from Medline and Scopus. Studies reporting measures of sleep in T1D patients and controls, and/or associations between sleep and glycemic control, were selected.ResultsA total of 22 studies were eligible for the meta-analysis. Children with T1D had shorter sleep duration (mean difference [MD] = −26.4 minutes; 95% confidence interval [CI] = −35.4, −17.7) than controls. Adults with T1D reported poorer sleep quality (MD in standardized sleep quality score = 0.51; 95% CI = 0.33, 0.70), with higher scores reflecting worse sleep quality) than controls, but there was no difference in self-reported sleep duration. Adults with TID who reported sleeping >6 hours had lower hemoglobin A1c (HbA1c) levels than those sleeping ≤6 hours (MD = −0.24%; 95% CI = −0.47, −0.02), and participants reporting good sleep quality had lower HbA1c than those with poor sleep quality (MD = −0.19%; 95% CI = −0.30, −0.08). The estimated prevalence of obstructive sleep apnea (OSA) in adults with TID was 51.9% (95% CI = 31.2, 72.6). Patients with moderate-to-severe OSA had a trend toward higher HbA1c (MD = 0.39%, 95% CI = −0.08, 0.87).ConclusionT1D was associated with poorer sleep and high prevalence of OSA. Poor sleep quality, shorter sleep duration, and OSA were associated with suboptimal glycemic control in T1D patients

Expression of the Inherently Autoreactive Idiotope 9G4 on Autoantibodies to Citrullinated Peptides and on Rheumatoid Factors in Patients with Early and Established Rheumatoid Arthritis.

The pre-symptomatic stage of Rheumatoid arthritis (RA) is associated with pro-inflammatory cytokines and autoantibodies. High levels and epitope spread by Rheumatoid factors (RhF) and autoantibodies to citrullinated proteins signify progression towards disease expression. In established RA, the persistence of high autoantibody levels reflects production by both long-lived plasma cells and short-lived plasmablasts. Neither the relative contributions to pathogenesis by autoantibodies from either source, nor the factors responsible for deciding the fate of autoantigen specific 'parent' B-cells, is understood. Phenotypic markers identifying subsets of autoreactive B-cells are therefore of interest in understanding the origin and perpetuation of the autoimmune response in RA. One such phenotypic marker is the rat monoclonal antibody, 9G4, which recognises an idiotope on immunoglobuins derived from the inherently autoreactive VH-gene, VH4-34. We therefore investigated whether the 9G4 idiotope was expressed on autoantibodies in patients with RA

ACPA response in evolution of rheumatoid arthritis

The ACPA response is different from conventional antibody responses. The ACPA response is generally of a much lower avidity than recall responses. Avidity maturation is limited and occurs before disease onset. The presence of low avidity ACPA is associated with higher rate of joint destruction. In vitro, the binding of low avidity ACPA to citrullinated epitopes was weakly inhibited by citrullinated antigens and low avidity ACPA have a higher ability to activate the complement system. In addition, there are certain antigens which continuously drive ACPA (IgM) response in RA

Anti-citrullinated protein antibodies (ACPA) in early rheumatoid arthritis

Pathophysiology and treatment of rheumatic disease