Arthritis and Bone Loss: A Hen and Egg Story
Anticitrullinated protein antibodies are associated with a more severe course in patients with RA and are considered as prognosticators for joint damage. ACPA-positive RA patients have higher risk of acquiring bone erosions leading to functional impairment of the joints. Longitudinal observations revealed that patients with recent-onset RA developed more bone erosions and more severe osteopenia when ACPAs were present as compared with RA patients without ACPAs. Furthermore, Güler-Yüksel et al. showed that ACPA, independently of rheumatoid factor, is a prognostic marker for progressive joint damage. Apart from local bone destruction, RA patients likewise suffer from trabecular bone loss. Again, the presence of ACPA has shown to be independently related to more pronounced trabecular bone loss in RA patients, in particular, leading to resorption of trabecular bone of the hand skeleton and the distal radius. These data strongly support the role of autoimmunity in bone destruction of RA. They also suggest that autoimmunity actively contributed to the disease process of RA, particularly to trigger structural damage.
Presence of Anticitrullinated Protein Antibodies Is Associated With Bone Damage in Rheumatoid Arthritis
Anticitrullinated protein antibodies are associated with a more severe course in patients with RA and are considered as prognosticators for joint damage. ACPA-positive RA patients have higher risk of acquiring bone erosions leading to functional impairment of the joints. Longitudinal observations revealed that patients with recent-onset RA developed more bone erosions and more severe osteopenia when ACPAs were present as compared with RA patients without ACPAs. Furthermore, Güler-Yüksel et al. showed that ACPA, independently of rheumatoid factor, is a prognostic marker for progressive joint damage. Apart from local bone destruction, RA patients likewise suffer from trabecular bone loss. Again, the presence of ACPA has shown to be independently related to more pronounced trabecular bone loss in RA patients, in particular, leading to resorption of trabecular bone of the hand skeleton and the distal radius. These data strongly support the role of autoimmunity in bone destruction of RA. They also suggest that autoimmunity actively contributed to the disease process of RA, particularly to trigger structural damage.