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a Rheumatology
Department, Bichat Teaching Hospital, Paris, France, b Immunology Laboratory,
Montpellier, France, c Rheumatology Department, Lapeyronie Teaching
Hospital, Montpellier, France
Correspondence to: Professor O Meyer, Department of Rheumatology, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France.
Accepted for publication 2 February 1999
OBJECTIVES
Stress
proteins (HSPs) are highly conserved immunodominant antigens found in
various species. The purpose of this study was to assess the prevalence
and prognostic significance of antibodies to HSC 70 kDa and HSP 90 kDa
in three groups of patients with longstanding rheumatoid arthritis (RA)
defined based on the severity of articular erosions.
METHODS73 patients
with longstanding (> 6 years) RA whose HLA-DR genotype was known were
divided in three groups according to Larsen's score and compared with
47 recent onset (<1 year) RA patients and with control groups composed
of patients with other inflammatory diseases (n=137) or of normal
controls (n=48). IgGs and IgMs to HSC 70 kDa and HSP 90 kDa were
determined using an ELISA with purified bovine HSC 70kDa or HSP 90 kDa.
RESULTSConcentrations
of IgGs and IgMs to HSC 70 were significantly increased in 41.1% and
42.5% of longstanding RA patients, respectively. Corresponding
figures for IgGs and IgMs to HSP 90 were 39.7% and 56%. IgMs to HSC
70 and HSP 90 were less frequent in recent onset RA (19% and 13%
respectively). Among the groups with other inflammatory diseases, only
the MCTD group exhibited high frequencies of IgGs to HSC 70 (80%) and
HSP 90 (85%). DRB1*0401 positive RA patients (n=23) were not more
likely to have increased concentrations of antibodies to HSC 70 kDa or
HSP 90 kDa than other RA patients (DR4 positive but DRB1*0401 negative,
or DR1 positive, n=31; or negative for both DR4 and DR1, n=14). IgGs to
HSP 90 kDa were significantly more frequent (p<0.05) in longstanding
RA patients whose Larsen's score was 4 or more (57%) than in those
whose Larsen's score was 2 or 3 (39.4%) or less than 2 (16%). No
associations were found between Larsen's score and IgGs or IgMs to HSC
70 kDa or IgMs to HSP 90 kDa. A significant correlation was
demonstrated between IgGs to HSP 90 kDa and two other serological
markers for RA, rheumatoid factor, and anti-Sa antibody; there were no
correlations with antikeratin antibody, antiperinuclear factor, or
anti-RA 33.
CONCLUSIONIgGs to HSP
90 kDa are most common in longstanding RA patients with articular
erosions, suggesting that they may be related to the articular
prognosis in RA
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