1. Microstructural Bone Changes Are Associated With <scp>Broad‐Spectrum</scp> Autoimmunity and Predict the Onset of Rheumatoid Arthritis
- Author
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Juergen Rech, Andreas Ramming, David Simon, Cong Duy Bui, Holger Bang, Axel J. Hueber, Georg Schett, and Arnd Kleyer
- Subjects
Male ,medicine.medical_specialty ,Hand Joints ,Immunology ,Enolase ,Autoimmunity ,Vimentin ,AMPA receptor ,Fibrinogen ,medicine.disease_cause ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Bone Density ,Internal medicine ,Cortical Bone ,medicine ,Humans ,Immunology and Allergy ,Longitudinal Studies ,030212 general & internal medicine ,030203 arthritis & rheumatology ,biology ,business.industry ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,medicine.anatomical_structure ,Endocrinology ,Rheumatoid arthritis ,Cancellous Bone ,biology.protein ,Female ,Cortical bone ,Antibody ,Tomography, X-Ray Computed ,business ,medicine.drug - Abstract
To assess if microstructural bone lesions in individuals at risk of developing rheumatoid arthritis (RA) are related to the spectrum of anti-modified protein antibodies (AMPAs) and affect the risk of developing RA.Cortical microchannels as well as cortical and trabecular bone mineral density (BMD) volumes (expressed as mg hydroxyapatite/cmSubjects at risk of developing RA (n = 75) who had broad-spectrum AMPAs (6-8 reactivities) had significantly more severe microstructural changes, including a higher mean ± SD number of cortical microchannels per joint (95 ± 3) and lower total volumetric BMD (vBMD; 265 ± 45), trabecular vBMD (176 ± 42), and cortical vBMD (585 ± 138), than those with moderate AMPA reactivity (3-5 reactivities) (number of cortical microchannels, 79 ± 30; total vBMD, 293 ± 33; trabecular vBMD, 195 ± 32; and cortical vBMD, 627 ± 91) and those with narrow AMPA reactivity (1-2 reactivities) (number of cortical microchannels, 47 ± 20; total vBMD, 311 ± 34; trabecular vBMD, 211 ± 30; and cortical vBMD, 674 ± 56). Progressors to RA had significantly higher numbers of cortical microchannels (103 ± 30 versus 71 ± 35) and lower bone volume (258 ± 37 versus 295 ± 34) compared to nonprogressors. Furthermore, rate of progression to RA was high in subjects with broad AMPA reactivity (48%) versus those with medium AMPA reactivity (26%) or narrow AMPA reactivity (0%), as well as in those with a high number of cortical microchannels (44%) versus those with a low number of cortical microchannels (10%).Microstructural changes in individuals at risk of RA are associated with broad-spectrum autoimmunity and predict the onset of RA. These data support the concept of structural priming of joints by autoimmunity before the onset of the inflammatory phase of the disease.
- Published
- 2022