Vol.21 No.1

Original Article

Antineutrophil cytoplasmic antibodies against myeloperoxidase, proteinase 3, elastase, cathepsin G and lactoferrin in Japanese patients with rheumatoid arthritis

Authors

Issei Kida1 , Shigeto Kobayashi1 , Ken Takeuchi2 , Hiroshi Tsuda3 , Hiroshi Hashimoto4 , Yoshinari Takasaki5

  • Department of Internal Medicine, Juntendo Koshigaya Hospital
  • Takeuchi Clinic
  • Department of Geriatric General Medicine, Juntendo Tokyo Geriatric Medical Center
  • Juntendo University School of Medicine
  • Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine
Received:

19 February 2010

Accepted:

9 August 2010

Published online:

28 September 2010

Full Text

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Abstract

Antineutrophil cytoplasmic antibodies (ANCAs) against myeloperoxidase (MPO), proteinase 3 (PR-3), lactoferrin (LF), cathepsin G (CG) and elastase (EL) were determined to investigate whether the presence of ANCAs is closely related to extra-articular manifestations in Japanese patients with rheumatoid arthritis (RA). Antibodies against MPO, PR-3, LF, CG and EL were determined in sera from 125 patients with RA and 83 sera from patients with other rheumatic diseases by enzyme-linked immunosorbent assay. Clinical manifestations and laboratory parameters of the patients were studied from medical records. Thirty of the 125 (24.0%) RA patients were positive for ANCAs for at least one of these 5 ANCA antigens. Among the 5 ANCAs, anti-LF antibody (anti-LF) (16.8%) was most commonly observed in patients with RA. A higher joint score (JS) and an elevated ESR were demonstrated in ANCA-positive RA patients compared to those of ANCA-negative patients (40.8 ± 43.3, 24.3 ± 26.2, p < 0.05, 44.4 ± 22.4, 28.9 ± 23.6, p < 0.05, respectively). No statistical differences in the presence of interstitial pneumonia, cutaneous vasculitis, rheumatoid nodules and mononeuropathy multiplex were observed between ANCA-positive and ANCA-negative patients. The presence of anti-LF is expected to be of pathological relevance, as the action of anti-LF towards LF results in the inhibition of the anti-inflammatory activity of LF.

Key words

ANCA - Lactoferrin rheumatoid arthritis - Vasculitis