Certain gene signatures may predict progression to rheumatoid arthritis in patients with arthralgia who are autoantibody positive, a Dutch study suggested.
In at-risk patients who have an increased expression of genes involved in interferon-mediated immunity or cytokine and chemokine activity, the odds ratio for developing arthritis within a year was 21 (95% CI 2.8 to 156.1, P=0.003), according to Lisa G.M. van Baarsen, PhD, of the Academic Medical Center in Amsterdam, and colleagues.
In contrast, expression of genes relating to B-cell immunology was associated with protection against progression (OR 0.38, 95% CI 0.21 to 0.70, P=0.002), the researchers reported in the March issue of Arthritis & Rheumatism.
The availability of treatments that can induce remission and prevent joint damage in rheumatoid arthritis has heightened the importance of early diagnosis.
In fact, diagnosis of rheumatoid arthritis in its preclinical phase could represent a breakthrough in progress towards a cure, the investigators asserted.
Studies have documented that rheumatoid factor and anti-citrullinated protein antibodies can be detected in serum years before symptom onset in rheumatoid arthritis.
However, arthritis does not develop in all individuals who test positive for these autoantibodies.
"Hence, either additional factors are needed to result in a chronic inflammatory response ultimately leading to [rheumatoid arthritis], or some individuals may have a protective immune profile that suppresses disease development despite the presence of autoantibodies," the researchers wrote.
http://www.medpagetoday.com/Rheumatology/Arthritis/19153I like the part about possibly leading to a cure. bump