Dr. Ron’s Research Review – June 24, 2010

This week’s research review focuses on a new test for rheumatoid arthritis - anti-CCP autoantibodies. (Lee, Beck et al. 2008)

Of particular interest is a recent study that shows HRT may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP. (Salliot, Bombardier et al. 2009)

You may be interested in this month’s Natural Medicine Journal: Use of Serum Magnesium Measurements to Exclude Magnesium Deficiency is Cause for Concern, Commentary by: Carolyn Dean, MD, ND Link

Most magnesium researchers find that the RDA is inadequate to prevent magnesium deficiency

Ismail et al found that serum magnesium is a very limited test because magnesium can be normal despite negative body stores.

Dr. Ron


Articles

Rheumatoid factor and anti-CCP autoantibodies in rheumatoid arthritis: a review

            (Lee, Beck et al. 2008) Download

For many years, laboratory diagnosis of rheumatoid arthritis has relied on the detection of rheumatoid factor. A new assay that detects antibodies to citrullinated peptides, called the anti-CCP assay, has demonstrated a comparable sensitivity but a much higher specificity than the RF test. This paper reviews RF and anti-CCP in rheumatoid arthritis and examines the usefulness of each autoantibody in RA testing.

Hormonal replacement therapy may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP: results from the ESPOIR cohort

            (Salliot, Bombardier et al. 2009) Download

OBJECTIVE: /st> To assess the effect of reproductive factors, especially hormone replacement therapy (HRT) and its interaction with HLA-DRB1 *01 and/or *04 alleles on the diagnosis of rheumatoid arthritis (RA) and the presence of anti-cyclic citrullinated peptide (CCP) antibodies in women included in the ESPOIR cohort (early arthritis cohort). METHODS: /st> 568 patients were included in the analyses, which were performed using logistic regression. RESULTS: /st> HRT reduced the risk of RA due to the HLA-DRB1 *01 and/or *04 alleles from OR 1.88 (95% CI 1.32 to 2.68, p<0.000) for HLA-DRB1 *01 and/or *04 alleles alone to OR 1.07 (95% CI 0.51 to 2.26, p=0.85) in women with HLA-DRB1 *01 and/or *04 alleles who received HRT. One explanation might be the protective effect of HRT on the presence of anti-CCP antibodies (OR 0.43, 95% CI 0.24 to 0.77, p<0.006). Other reproductive factors such as the number of pregnancies, menopause and age at menopause, age at menarche and a history of pregnancy with poor outcome were not associated with the diagnosis of RA and the presence of anti-CCP antibodies. CONCLUSION: /st> HRT may reduce the risk of RA due to HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP antibodies.


References

Lee, A. N., C. E. Beck, et al. (2008). "Rheumatoid factor and anti-CCP autoantibodies in rheumatoid arthritis: a review." Clin Lab Sci 21(1): 15-8.

Salliot, C., C. Bombardier, et al. (2009). "Hormonal replacement therapy may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP: results from the ESPOIR cohort." Ann Rheum Dis.