Bronchiectasis Contributes to Activity and Seropositivity in Rheumatoid Arthritis Save

UK investigators have shown that rheumatoid arthritis patients with bronchiectasis (BRRA) have a five-fold increased mortality compared to RA without bronchiectasis. It is unclear if serologic differences, activity measures and biomarkers may be different in this cohort. (Citation source: http://buff.ly/1M1m5sV)

RA patients (n = 58) with bronchiectasis (proven by high-resolution chest CT) and without interstitial lung disease (BRRA) and ≥ 2 respiratory infections/year were compared to RA alone (n = 50). BRRA patients had higher DAS28 scores (3.51 vs. 2.59) and more seropositivity (CCP+ 89% vs. 46% and RF+ 79% vs. 52%) (P = 0.003) and more evidence of erosive changes on X-ray (78% vs 43%) when compared to RA alone patients. There were no differences between groups in smoking history or disease-modifying anti-rheumatic drug/biologic therapy use.

Another recent report from Quirke et al compared 122 patients with bronchiectasis (BR) alone, 50 patients with RA+BR, and 50 RA patients without lung disease, as well as 87 asthma and 79 healthy controls and examined their autoantibody reactivities. (Citation source: http://buff.ly/1M0h8u3).

The frequency of ever-smokers wsa the same between groups. The frequency of RF positivity increased in BR patients compared with controls (25% versus 10%), as were the frequencies of antibodies to CCP-2 (5% versus 0%), CEP-1 (7% versus 4%), Cit-vimentin (7% versus 4%), and Cit-fibrinogen (12% versus 4%), although only the differences for RF and Cit-fibrinogen were significant (P 0.05). In BR/RA patients, all ACPA responses were highly citrulline specific.

These studies suggest that bronchiectasis is a potentiating and interesting contributor to RA pathogenesis and severity. Such patients have more activity, damage and seropositivity. Yet the autoantibody responses in BR are not citrulline specific.