Markovic Milica, Campochiaro Corrado, Glisic Branislava, Petronijevic Milan, Ristic Gorica, Stanojevic Ivan, Vojvodic Danilo, Viapiana Naomi, Matucci-Cerinic Marco, Dagna Lorenzo
Clinic for Internal Medicine, Rheumatology Division, Clinical Center of Montenegro, Podgorica, Montenegro.
Department of Rheumatology and Clinical Immunology, Medical Faculty of the Military Medical Academy, University of Defense, Belgrade, Serbia.
Sci Rep. 2025 May 26;15(1):18325. doi: 10.1038/s41598-025-03464-z.
Autoantibodies directed against carbamylated proteins (anti-CarP) have been recently identified as predictors for RA development. The aim of this study was to determine the positivity of anti-CarP antibodies in a real-life cohort of RA patients and their association with radiological damage, disability and disease activity. In this open-label, observational, cross-sectional study 69 RA patients and 16 healthy controls (HC) were recruited. The study was approved by institutional Ethical Committee. Circulating levels of anti-CarP antibodies were determined by commercial ELISA anti-CarP quantitative sandwich immunoassay. Articular X-rays were evaluated to define the presence of bone erosions. Disease activity (DAS28-CRP) and disability (HAQ-DI) were assessed. Pearson χ test, Wilcoxon test or Kruskall-Wallis test was used. Spearman rank-order correlation coefficient was applied for continuous variables. Multivariable logistic regression model was performed. Anti-CarP positivity was found in 35% of RA patients and in no HC. One quarter of seronegative RA patients were anti-CarP positive. A positive correlation between levels of anti-CarP antibodies with DAS28-CRP (p = 0.0003; Spearman r = 0.4829) and HAQ-DI (p = 0.0003; Spearman r = 0.4253) was found. 87% of anti-CarP positive patients had erosions. At multivariable logistic regression analysis, RA disease activity (OR 1.31, 95% CI [1.14, 1.63]) and circulating levels of anti-CarP antibodies (OR 1.66, 95% CI [1.28, 2.37]) were independent predictors of bone erosions. Our study confirms that anti-CarP antibodies are associated with a more aggressive RA course and are independent predictors of bone erosions.
近期研究发现，针对氨甲酰化蛋白的自身抗体（抗CarP）可作为类风湿关节炎（RA）发病的预测指标。本研究旨在确定RA患者真实队列中抗CarP抗体的阳性率及其与放射学损伤、残疾和疾病活动度的相关性。本研究为开放标签、观察性横断面研究，共纳入69例RA患者和16例健康对照（HC）。本研究经机构伦理委员会批准。采用商业化ELISA抗CarP定量夹心免疫分析法测定循环抗CarP抗体水平。通过关节X线评估确定是否存在骨侵蚀。评估疾病活动度（DAS28-CRP）和残疾程度（HAQ-DI）。采用Pearson χ检验、Wilcoxon检验或Kruskall-Wallis检验。连续变量采用Spearman等级相关系数分析。进行多变量逻辑回归模型分析。结果发现，35%的RA患者抗CarP呈阳性，而健康对照均为阴性。四分之一的血清阴性RA患者抗CarP呈阳性。抗CarP抗体水平与DAS28-CRP（p = 0.0003；Spearman r = 0.4829）和HAQ-DI（p = 0.0003；Spearman r = 0.4253）呈正相关。87%的抗CarP阳性患者存在骨侵蚀。多变量逻辑回归分析显示，RA疾病活动度（OR 1.31，95%CI [1.14, 1.63]）和循环抗CarP抗体水平（OR 1.66，95%CI [1.28, 2.37]）是骨侵蚀的独立预测因素。我们的研究证实，抗CarP抗体与更具侵袭性的RA病程相关，且是骨侵蚀的独立预测因素。
