Enrichment of malondialdehyde-acetaldehyde antibody in the rheumatoid arthritis joint RHEUMATOLOGY Mikuls, T. R., Duryee, M. J., Rahman, R., Anderson, D. R., Sayles, H. R., Hollins, A., Michaud, K., Wolfe, F., Thiele, G. E., Sokolove, J., Robinson, W. H., Lingampalli, N., Nicholas, A. P., Talmon, G. A., Su, K., Zimmerman, M. C., Klassen, L. W., Thiele, G. M. 2017; 56 (10): 1794–1803

Abstract

To characterize the expression of malondialdehdye-acetaldehyde (MAA) adducts and anti-MAA antibody in articular tissues and serum of patients with RA.Paired sera and SF were examined from 29 RA and 13 OA patients. Anti-MAA antibody, RF, ACPA and total immunoglobulin were quantified. SF-serum measures were compared within and between disease groups. The presence and co-localization of MAA, citrulline and select leukocyte antigens in RA and OA synovial tissues were examined using immunohistochemistry.Circulating and SF anti-MAA antibody concentrations were higher in RA vs OA by 1.5- to 5-fold. IgG (P < 0.001), IgM (P = 0.006) and IgA (P = 0.036) anti-MAA antibodies were higher in paired RA SF than serum, differences not observed for total immunoglobulin, RF or ACPA. In RA synovial tissues, co-localization of MAA with citrulline and CD19+ or CD27+ B cells was demonstrated and was much higher in magnitude than MAA or citrulline co-localization with T cells, monocytes, macrophages or dendritic cells (P < 0.01).Anti-MAA antibodies are present in higher concentrations in the RA joint compared with sera, a finding not observed for other disease-related autoantibodies. Co-localization of MAA and citrulline with mature B cells, coupled with the local enrichment of anti-MAA immune responses, implicates MAA-adduct formation in local autoantibody production.

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