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Diagnosis of Rheumatoid Arthritis

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview Antibodies

Overview

Rheumatoid arthritis is generally diagnosed and treated by rheumatologists, in most countries.

Serum calprotectin: a promising biomarker in rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA). This large study supports the association of serum calprotectin levels with disease activity in both RA and axSpA, but not in psoriatic arthritis. PubMed, Arthritis Res Ther, 2020 May 6;22(1):105.

Type 2 Polarized T Cell Phenotype is Associated with Methotrexate (MTX) Non-response in Patients with Rheumatoid Arthritis (RA). MTX-non-responsive RA patients exhibit a bias towards type 2-polarized T cell inflammatory responses. PubMed, Arthritis Rheumatol, 02/10/2020. (Also see Immunosuppressants and B Cells and T Cells)

B cell synovitis and clinical phenotypes in rheumatoid arthritis: relationship to disease stages and drug exposure. We demonstrate an ongoing B cell-rich synovitis in a larger proportion of patients with established RA that does not seem to be captured by standard clinimetric assessment. PubMed, Arthritis Rheumatol, 11/29/2019. (Also see B Cells and T Cells)

T cell receptor β repertoires (TCR) as novel diagnostic markers for systemic lupus erythematosus and rheumatoid arthritis. These characteristics of the TCR repertoire can potentially serve as biomarkers and provide novel insights for disease status and therapeutical targets in autoimmune diseases. PubMed, Ann Rheum Dis, 05/17/2019. (Also see Diagnosis of Lupus)

Effects of Vitamin D on disease activity and serum interleukin-6 in rheumatoid arthritis (RA). This study suggests that vitamin D is not associated with disease activity or serum IL-6 levels but it may have a role in functional disability in RA patients. PubMed, Int J Rheum Dis, 02/06/2019. (Also see Vitamin D)

C5a and C5aR are elevated in joints of rheumatoid and psoriatic arthritis patients, and C5aR blockade attenuates leukocyte migration to synovial fluid. The data support that the C5a-C5aR axis may be driving the infiltration of inflammatory cells into the synovial fluid and synovium in both rheumatoid and psoriatic arthritis, and suggest that C5a or C5aR may be a promising treatment target in both diseases. PubMed, PLoS One, 2017 Dec 8;12(12):e0189017.(Also see Psoriasis and Psoriatic Arthritis)

Circulating osteoprotegerin levels are elevated in rheumatoid arthritis (RA): a systematic review and meta–analysis. Our meta–analysis revealed a significantly higher circulating osteoprotegerin level in RA patients, and it was influenced by race, disease duration, body mass index and disease activity score based on the assessment of 28 joints. PubMed, Clin Rheumatol, 07/11/2017.

Autoimmunity as a trigger for structural bone damage in rheumatoid arthritis. At present, rheumatoid factor and antibodies recognizing citrullinated proteins are considered as potent osteoclast inducers and triggers for bone loss in arthritis. PubMed, Mod Rheumatol, 2017 Jan 9:1-5.

Antibodies of Rheumatoid Arthritis

Differential synovial tissue (ST) biomarkers among psoriatic arthritis and rheumatoid factor/anti–citrulline antibody–negative rheumatoid arthritis. Histological analysis of ST may help to solve the clinical overlap between the two diseases and provides prognostic data about the therapy success. PubMed, Arthritis Res Ther, 2019 May 9;21(1):116. (Also see Psoriasis and Psoriatic Arthritis)

Diagnostic value of anti–citrullinated fibrinogen antibody in rheumatoid arthritis (RA): A meta–analysis. The ACF antibody had a moderate diagnostic accuracy on RA. PubMed, Int J Rheum Dis, 02/06/2019.

Triple Positivity for Anti–Citrullinated Protein Autoantibodies (ACPAs), Rheumatoid Factor (RF), and Anti–Carbamylated Protein Antibodies (anti–carP) Conferring High Specificity for Rheumatoid Arthritis (RA): Implications for Very Early Identification of At–Risk Individuals. An autoantibody profile of triple positivity for ACPAs, RF and anti–CarP provides interesting information that might help identify individuals at risk of developing RA. PubMed, Arthritis Rheumatol, 2018 Nov;70(11):1721-1731.

Association between anti–citrullinated fibrinogen antibodies and coronary artery disease (CAD) in rheumatoid arthritis (RA). Anti–cit–fibrinogen antibodies as a group were associated with CAD outcomes in our RA cohort, with the strongest signal for association arising from a subset of the autoantibodies. PubMed, Arthritis Care Res (Hoboken), 10/08/2017.

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