Anti-type II collagen antibodies,anti-CCP,IgA RF and IgM RF are associated with joint damage,assessed eight years after onset of juvenile idiopathic arthritis (JIA)

Background: early appearance of antibodies specific for native human type ii collagen (anti-cii) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (ra). the objective of this study was to investigate the occurrence of anti-cii,igm rf,iga rf and anti-ccp in serum samples obtained early after diagnosis,and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (jia).methods: the nordic jia database prospectively included jia patients followed for eight years with data on remission and joint damage. from this database,serum samples collected from 192 patients,at a median of four months after disease onset,were analysed for igg anti-cii,igm rf,iga rf and igg anti-ccp. joint damage was assessed based on juvenile arthritis damage index for articular damage (jadi-a),a validated clinical instrument for joint damage.results: elevated serum levels of anti-cii occurred in 3.1%,igm rf in 3.6%,iga rf in 3.1% and anti-ccp in 2.6% of the patients. occurrence of rf and anti-ccp did to some extent overlap,but rarely with anti-cii. the polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. anti-cii occurred in younger children,usually without overlap with the other autoantibodies and was associated with high levels of c-reactive protein (crp) early in the disease course. all four autoantibodies were significantly associated with joint damage,but not with active disease at the eight-year follow up.conclusions: anti-cii,anti-ccp,iga rf and igm rf detected early in the disease course predicted joint damage when assessed after eight years of disease. the role of anti-cii in jia should be further studied. © 2014 berntson et al.; licensee biomed central ltd.