Bone loss before the clinical onset of rheumatoid arthritis in subjects with anticitrullinated protein antibodies

Kleyer A, Finzel S, Rech J, Manger B, Krieter M, Faustini F, Araujo E, Hueber A, Harre U, Engelke K, Schett G (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Annals of the Rheumatic Diseases BMJ Publishing Group

Book Volume: 73

Pages Range: 854-60

Journal Issue: 5

DOI: 10.1136/annrheumdis-2012-202958

Abstract

Anticitrullinated protein antibodies (ACPA) are a major risk factor for bone loss in rheumatoid arthritis (RA). We have recently shown that ACPA directly induce bone loss by stimulating osteoclast differentiation. As ACPA precede the clinical onset of RA by years, we hypothesised that ACPA positive healthy individuals may already show skeletal changes.We performed a comparative micro-CT analysis of the bone microstructure in the metacarpophalangeal joints of ACPA positive and ACPA negative healthy individuals without clinical signs of arthritis.ACPA positive (n=15) and negative (n=15) healthy individuals were not different in age (48.2±4.1 vs 51.4±3.8 years, p=0.57) or gender (eight women and two men in both groups). Bone mineral density was significantly reduced in ACPA positive individuals (mean±SEM 280±11 mg/cm(3)) compared with controls (327±6). Bone loss was based on cortical bone changes, with significant (p=0.044) reduction in cortical thickness in the ACPA positive group (mean±SEM 0.22±0.03 mm) compared with controls (0.32±0.03 mm). Areas of cortical porosity were significantly (p=0.0005) more widespread in ACPA positive (mean±SEM 7.4±1.4%) than in ACPA negative individuals (1.0±0.3%).Structural bone damage starts before the clinical onset of arthritis in subjects with ACPA. These findings revise the concept that bone damage is an exclusive consequence of synovitis in patients with RA.

Authors with CRIS profile

Arnd Kleyer Department of Medicine 3 – Rheumatology and Immunology Stephanie Finzel Lehrstuhl für Innere Medizin III Hans Jürgen Rech Department of Medicine 3 – Rheumatology and Immunology Bernhard Manger Professur für Rheumatologie und Klinische Immunologie Manuel Krieter Lehrstuhl für Innere Medizin III Axel Hueber Department of Medicine 3 – Rheumatology and Immunology Ulrike Steffen Department of Medicine 3 – Rheumatology and Immunology Klaus Engelke Lehrstuhl für Medizinische Physik und Mikrogewebetechnik Georg Schett Lehrstuhl für Innere Medizin III

How to cite

APA:

Kleyer, A., Finzel, S., Rech, J., Manger, B., Krieter, M., Faustini, F.,... Schett, G. (2014). Bone loss before the clinical onset of rheumatoid arthritis in subjects with anticitrullinated protein antibodies. Annals of the Rheumatic Diseases, 73(5), 854-60. https://doi.org/10.1136/annrheumdis-2012-202958

MLA:

Kleyer, Arnd, et al. "Bone loss before the clinical onset of rheumatoid arthritis in subjects with anticitrullinated protein antibodies." Annals of the Rheumatic Diseases 73.5 (2014): 854-60.

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