Korean J Intern Med.  2013 Jan;28(1):45-53. 10.3904/kjim.2013.28.1.45.

Greater prevalence of seropositivity for anti-cyclic citrullinated peptide antibody in unaffected first-degree relatives in multicase rheumatoid arthritis-affected families

• Kim SK
• Bae J
• Lee H
• Kim JH
• Park SH
• Choe JY

• KMID: 1793218
• DOI: http://doi.org/10.3904/kjim.2013.28.1.45

Abstract

BACKGROUND/AIMS
This study determined the prevalence and determinants of seropositivity for rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, and anti-mutated citrullinated vimentin (anti-MCV) antibody in unaffected first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients.
METHODS
A total of 337 subjects (135 with RA and 202 FDRs) were enrolled in this case-control study. Serum RF, anti-CCP antibody, and anti-MCV antibody were assayed. Subjects in multicase families (> or = 2 affected FDRs within the same family) were identified. Multivariate logistic regression analysis was used to identify risk factors associated with RA-related autoantibodies.
RESULTS
Seropositivity for RF, anti-CCP antibody, or anti-MCV antibody was detected in 14.4%, 5.0%, or 13.4% of unaffected FDRs, respectively. Anti-CCP antibody seropositivity was more prevalent in FDRs in multicase families (17.8%) than in those not in multicase families (1.3%, p < 0.0001). Significant correlations between RA-associated autoantibodies were detected in the FDR group (between RF and anti-CCP antibody: r = 0.366, p < 0.0001; between RF and anti-MCV antibody: r = 0.343, p < 0.0001; and between anti-CCP antibody and anti-MCV antibody: r = 0.849, p < 0.0001). After adjustment for age and sex, anti-CCP antibody seropositivity in FDRs was significantly associated with being in a multicase family (odds ratio, 49.8; 95% confidence interval, 5.6 to 441.6).
CONCLUSIONS
The association between anti-CCP antibody seropositivity in unaffected FDRs and being in a multicase family suggests that genetic and/or environmental factors may increase the risk for RA development in unaffected FDRs.

Keyword

Rheumatoid arthritis; First-degree relative; Rheumatoid factor; Citrullinated antigen

MeSH Terms

Adolescent
Adult
Arthritis, Rheumatoid/blood/*epidemiology/genetics/*immunology
Autoantibodies/*blood
Biological Markers/blood
Case-Control Studies
Chi-Square Distribution
Cross-Sectional Studies
Female
Gene-Environment Interaction
Genetic Predisposition to Disease
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Pedigree
Peptides, Cyclic/*immunology
Republic of Korea/epidemiology
Risk Factors
Seroepidemiologic Studies
Vimentin/immunology
Young Adult
Autoantibodies
Biological Markers
Peptides, Cyclic
Vimentin