The lung in ACPA-positive rheumatoid arthritis: an initiating site of injury?

Elizabeth Perry; Clive Kelly; Paul Eggleton; Anthony De Soyza; David Hutchinson

doi:10.1093/rheumatology/keu195

The lung in ACPA-positive rheumatoid arthritis: an initiating site of injury?

Rheumatology (Oxford). 2014 Nov;53(11):1940-50. doi: 10.1093/rheumatology/keu195. Epub 2014 May 15.

Authors

Elizabeth Perry¹, Clive Kelly², Paul Eggleton³, Anthony De Soyza³, David Hutchinson²

Affiliations

¹ Department of Rheumatology, Queen Elizabeth Hospital, Gateshead, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK, Department of Biochemistry, University of Alberta, Edmonton, Canada, Lung Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, Sir William Leech Centre, Freeman Hospital, Newcastle and Department of Rheumatology, Royal Cornwall Hospital, Truro, UK. Department of Rheumatology, Queen Elizabeth Hospital, Gateshead, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK, Department of Biochemistry, University of Alberta, Edmonton, Canada, Lung Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, Sir William Leech Centre, Freeman Hospital, Newcastle and Department of Rheumatology, Royal Cornwall Hospital, Truro, UK. e.perry@nhs.net.
² Department of Rheumatology, Queen Elizabeth Hospital, Gateshead, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK, Department of Biochemistry, University of Alberta, Edmonton, Canada, Lung Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, Sir William Leech Centre, Freeman Hospital, Newcastle and Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.
³ Department of Rheumatology, Queen Elizabeth Hospital, Gateshead, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK, Department of Biochemistry, University of Alberta, Edmonton, Canada, Lung Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, Sir William Leech Centre, Freeman Hospital, Newcastle and Department of Rheumatology, Royal Cornwall Hospital, Truro, UK. Department of Rheumatology, Queen Elizabeth Hospital, Gateshead, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK, Department of Biochemistry, University of Alberta, Edmonton, Canada, Lung Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, Sir William Leech Centre, Freeman Hospital, Newcastle and Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.

PMID: 24831057
DOI: 10.1093/rheumatology/keu195

Abstract

Recent findings have highlighted the potential initiation of ACPA in sites away from the joint. Periodontitis is an example of this concept. This process in the gums appears to be independent of smoking, the main environmental risk factor for ACPA-positive RA. There is extensive literature regarding the potential role of smoking in the pathogenesis of ACPA-positive RA. As a consequence of this strong association, the lung has become the focus of research to determine whether processes within the lung are linked to the generation of ACPA. Here we outline the current body of evidence and explore the hypothesis that the lung as an organ of immune defence has a role in the pathogenesis of the autoimmune disease ACPA-positive RA.

Keywords: anti-citrullinated protein/peptide antibodies; autoimmunity; bronchiectasis; cigarette smoking; infection; interstitial lung disease; pathogenesis; rheumatoid arthritis; rheumatoid factor.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Arthritis, Rheumatoid* / complications
Arthritis, Rheumatoid* / immunology
Arthritis, Rheumatoid* / metabolism
Autoantibodies / immunology*
Autoimmunity*
Humans
Lung Diseases, Interstitial* / etiology
Lung Diseases, Interstitial* / immunology
Lung Diseases, Interstitial* / metabolism
Peptides, Cyclic / immunology*
Peptides, Cyclic / metabolism

Substances

Autoantibodies
Peptides, Cyclic
cyclic citrullinated peptide

Abstract

Publication types

MeSH terms

Substances

Grants and funding