Autoantibody fine specificity restriction is associated with clinical response in RA treated with abatacept and methotrexate

IF 4.1 3区医学 Q2 IMMUNOLOGY

Clinical immunology Pub Date : 2026-01-01 Epub Date: 2025-10-21 DOI:10.1016/j.clim.2025.110610

Pauline Brevet , André Gillibert , Léna Le Goaréguer , Claire Lattard , Laurent Drouot , Rémi Varin , Marie-Laure Golinski , Sophie Candon , Olivier Boyer , Thierry Lequerré , Olivier Vittecoq , Manuel Fréret

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引用次数: 0

Abstract

Objective

Anti-modified protein antibodies (AMPA) are central in rheumatoid arthritis (RA). We evaluated whether changes in fine specificities (FS) of anti-citrullinated protein antibodies (ACPA) and anti-CarP antibodies relate to clinical prognosis in RA patients treated with abatacept (ABA) plus methotrexate (MTX).

Methods

A multiplex bead immunoassay measured 6 ACPA FS and 1 anti-CarP FS in 59 anti-CCP+ RA patients (IgG, IgA). Disease activity (DAS28-CRP) and FS levels were assessed at baseline (M0) and 6 months (M6).

Results

After 6 months of ABA+MTX, several FS decreased with frequent negative seroconversion (NS). Higher baseline anti-citrullinated α-enolase (ACit-ENO1) IgG levels predicted better outcome (decrease of −0.17 DAS28 score per decile, 95 % CI −0.27 to −0.07, p = 0.03). Among patients with ≥1 positive FS at M0, a higher number of NS across 14 FS (IgG/IgA) correlated with greater improvement (−0.27 DAS28 score per antibody, 95 % CI −0.39 to −0.15, p < 0.0001).

Conclusions

In this cohort of limited size, clinical response at M6 with ABA+MTX treatment was associated with the restriction of the autoantibody repertoire of IgG and IgA classes in RA patients.

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自身抗体细特异性限制与阿巴接受和甲氨蝶呤治疗RA的临床反应相关。

目的：抗修饰蛋白抗体（AMPA）在类风湿关节炎（RA）中起中心作用。我们评估了抗瓜氨酸蛋白抗体（ACPA）和抗鲤鱼抗体的精细特异性（FS）变化是否与阿巴接受（ABA）加甲氨蝶呤（MTX）治疗的RA患者的临床预后有关。方法：采用多头免疫分析法检测59例抗ccp + RA患者（IgG、IgA）的6个ACPA FS和1个anti-CarP FS。在基线（M0）和6 个月（M6）时评估疾病活度（DAS28-CRP）和FS水平。结果：ABA+MTX治疗6 个月后，几个FS下降，血清转化阴性（NS）频繁发生。基线抗瓜氨酸α-烯醇化酶（ACit-ENO1） IgG水平越高，预后越好（DAS28评分每十分位数降低-0.17,95% % CI -0.27至-0.07,p = 0.03）。在M0≥1阳性FS的患者中，14个FS （IgG/IgA）中NS数量越多，改善程度越高（每个抗体DAS28评分-0.27,95% % CI -0.39至-0.15,p ）。结论：在这个规模有限的队列中，ABA+MTX治疗在M6时的临床反应与RA患者IgG和IgA类自身抗体库的限制有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical immunology 医学-免疫学

CiteScore

12.30

自引率

1.20%

发文量

212

审稿时长

34 days

期刊介绍： Clinical Immunology publishes original research delving into the molecular and cellular foundations of immunological diseases. Additionally, the journal includes reviews covering timely subjects in basic immunology, along with case reports and letters to the editor.