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Anti-cyclic citrullinated peptide antibody titers decrease in rheumatoid arthritis patients treated with tocilizumab : A pilot study

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Title: Anti-cyclic citrullinated peptide antibody titers decrease in rheumatoid arthritis patients treated with tocilizumab : A pilot study
Authors: Noguchi, Atsushi Browse this author
Yasuda, Shinsuke Browse this author →KAKEN DB
Hisada, Ryo Browse this author
Kato, Masaru Browse this author →KAKEN DB
Oku, Kenji Browse this author →KAKEN DB
Bohgaki, Toshiyuki Browse this author →KAKEN DB
Suzuki, Miho Browse this author
Matsumoto, Yoshihiro Browse this author
Atsumi, Tatsuya Browse this author →KAKEN DB
Keywords: Anti-cyclic citrullinated peptide antibody
B-cell subpopulation
rheumatoid arthritis
Issue Date: 3-Mar-2020
Publisher: Taylor & Francis
Journal Title: Modern rheumatology
Volume: 30
Issue: 2
Start Page: 276
End Page: 281
Publisher DOI: 10.1080/14397595.2019.1583784
Abstract: Objectives: To analyze the effects of tocilizumab on peripheral B-cell subpopulation and its ability to produce anti-cyclic citrullinated peptide (CCP) antibody in patients with rheumatoid arthritis (RA). Methods: Thirteen consecutive RA patients initiated with tocilizumab were enrolled in our prospective study. Anti-CCP antibody titers and clinical parameters were evaluated during treatment. Peripheral blood B-cell subsets were analyzed using flow cytometry according to the Human Immunology Project. Results: Disease activity was significantly improved and anti-CCP antibody titers significantly decreased at week 24 compared to baseline. The percentages of post-switch memory B cells in CD19+ cells transiently increased at week 12, but there was no significant difference in any of the investigated B-cell subpopulations at week 24 compared to baseline. The ratios of post-switch memory to naive B cells (post-switch/naive) correlated negatively with anti-CCP antibody titers regardless of the time-points. Conclusion: Our study indicated that tocilizumab has a potential to reduce anti-CCP antibody production presumably by affecting post-switch/naive ratio, and that anti-CCP antibody titers reflect B-cell distribution/subpopulation. As anti-CCP antibodies are produced in lymph nodes or ectopic lymphoid structures in synovial tissues, not in circulation, transient increment of post-switch memory B cells after tocilizumab treatment may reflect the altered balance of B-cell distribution between circulation and arthritic joints, resulting in suppressed production of anti-CCP antibody in situ.
Rights: This is an Accepted Manuscript of an article published by Taylor & Francis in Modern rheumatology on 3 Mar 2020, available online:
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 渥美 達也

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