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Published in: Rheumatology International 12/2009

01-10-2009 | Original Article

Serum levels of anti-cyclic citrullinated peptide antibodies are associated with a beneficial response to traditional herbal medicine (Kampo) in rheumatoid arthritis

Authors: Toshiaki Kogure, Hiroko Sato, Daijiro Kishi, Tomoyuki Ito, Takeshi Tatsumi

Published in: Rheumatology International | Issue 12/2009

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Abstract

This study investigated the usefulness of biomarkers indicating beneficial response to traditional herbal medicine (THM) among patients with rheumatoid arthritis (RA). We assessed 34 RA patients who received keishinieppiittokaryojutsubu (KER), one of the representative THM. The observational term was 12 months, and we calculated the disease activity score of 28 joints every 3 months and evaluated the response to KER using European League Against Rheumatism (EULAR) response criteria. Additionally, serum levels of anti-cyclic citrullinated peptide antibody (ACPA) were measured by enzyme-linked immunosorbent assay at the baseline and after 6 and 12 months of the treatment with KER. As a result, 14 (41.2%) of the 34 patients were defined as responders, 13 as non-responders and 7 as out of assessment after 6 months, respectively. Pretreatment levels of serum ACPA were lower in KER responders than in non-responders (P = 0.042), although other univariate analysis did not show any significant differences in baseline clinical measures between the two groups. Furthermore, responders to KER showed a significant decrease in the serum levels of ACPA. These findings suggest that pretreatment serum levels of ACPA are a useful predictor of a good response to treatment with KER. Furthermore, a decrease in serum levels of ACPA may be an adjunctive indicator in predicting the efficacy of this kind of treatment.
Literature
1.
go back to reference American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines (2002) Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum 46:328–346. doi:10.1002/art.10148 CrossRef American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines (2002) Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum 46:328–346. doi:10.​1002/​art.​10148 CrossRef
2.
go back to reference Kogure T, Hoshino A, Ito K, Sato H, Tatsumi T, Ohyama Y, Kawata E, Fujita K, Tamura J (2005) Beneficial effect of complementary alternative medicine on lymphedema with rheumatoid arthritis. Mod Rheumatol 15:445–449. doi:10.1007/s10165-005-0438-2 PubMedCrossRef Kogure T, Hoshino A, Ito K, Sato H, Tatsumi T, Ohyama Y, Kawata E, Fujita K, Tamura J (2005) Beneficial effect of complementary alternative medicine on lymphedema with rheumatoid arthritis. Mod Rheumatol 15:445–449. doi:10.​1007/​s10165-005-0438-2 PubMedCrossRef
3.
go back to reference Niizawa A, Kogure T, Hai LX, Fujinaga H, Takahashi K, Shimada Y, Terasawa K (2003) Clinical and immunomodulatory effects of fun-boi, an herbal medicine, on collagen-induced arthritis in vivo. Clin Exp Rheumatol 21:57–62PubMed Niizawa A, Kogure T, Hai LX, Fujinaga H, Takahashi K, Shimada Y, Terasawa K (2003) Clinical and immunomodulatory effects of fun-boi, an herbal medicine, on collagen-induced arthritis in vivo. Clin Exp Rheumatol 21:57–62PubMed
5.
go back to reference Wessels JAM, van der Kooij SM, le Cessie S, Kievit W, Barerra P, Allaart CF, Huizinga TWJ, Guchelaar H-J (2007) A clinical pharmacogenetic model to predict the efficacy of methotrexate monotherapy in recent onset rheumatoid arthritis. Arthritis Rheum 56:1765–1775. doi:10.1002/art.22640 PubMedCrossRef Wessels JAM, van der Kooij SM, le Cessie S, Kievit W, Barerra P, Allaart CF, Huizinga TWJ, Guchelaar H-J (2007) A clinical pharmacogenetic model to predict the efficacy of methotrexate monotherapy in recent onset rheumatoid arthritis. Arthritis Rheum 56:1765–1775. doi:10.​1002/​art.​22640 PubMedCrossRef
6.
go back to reference Kogure T, Tatsumi T, Fujinaga H, Niizawa A, Terasawa K (2007) Insights to clinical use of serial determination in titers of cyclic citrullinated peptide autoantibodies. Mediators Inflamm 2007:12367 [Epub 2007 Mar 7] Kogure T, Tatsumi T, Fujinaga H, Niizawa A, Terasawa K (2007) Insights to clinical use of serial determination in titers of cyclic citrullinated peptide autoantibodies. Mediators Inflamm 2007:12367 [Epub 2007 Mar 7]
7.
go back to reference Hoekstra M, van Ede AE, Haagsma CJ, van de Laar MAFJ, Huizinga TWJ, Kruijsen MWM, Laan RFJM (2003) Factors associated with toxicity, final dose, and efficacy of methotrexate in patients with rheumatoid arthritis. Ann Rheum Dis 62:423–426. doi:10.1136/ard.62.5.423 PubMedCrossRef Hoekstra M, van Ede AE, Haagsma CJ, van de Laar MAFJ, Huizinga TWJ, Kruijsen MWM, Laan RFJM (2003) Factors associated with toxicity, final dose, and efficacy of methotrexate in patients with rheumatoid arthritis. Ann Rheum Dis 62:423–426. doi:10.​1136/​ard.​62.​5.​423 PubMedCrossRef
8.
go back to reference Kaltenhäuser S, Pierer M, Arnold S, Kamprad M, Baerwald C, Häntzschel H, Wagner U (2007) Antibodies against cyclic citrullinated peptide are associated with the DRB1 shared epitope and predict joint erosion in rheumatoid arthritis. Rheumatology (Oxford) 46:100–104. doi:10.1093/rheumatology/kel052 CrossRef Kaltenhäuser S, Pierer M, Arnold S, Kamprad M, Baerwald C, Häntzschel H, Wagner U (2007) Antibodies against cyclic citrullinated peptide are associated with the DRB1 shared epitope and predict joint erosion in rheumatoid arthritis. Rheumatology (Oxford) 46:100–104. doi:10.​1093/​rheumatology/​kel052 CrossRef
9.
go back to reference Sghiri R, Bouagina E, Zaglaoui H, Mestiri H, Harzallah L, Harrabi I, Ghannouchi M, Mokhtar F, Ghedira I (2007) Diagnostic performances of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis. Rheumatol Int 27:1125–1130. doi:10.1007/s00296-007-0351-4 PubMedCrossRef Sghiri R, Bouagina E, Zaglaoui H, Mestiri H, Harzallah L, Harrabi I, Ghannouchi M, Mokhtar F, Ghedira I (2007) Diagnostic performances of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis. Rheumatol Int 27:1125–1130. doi:10.​1007/​s00296-007-0351-4 PubMedCrossRef
10.
go back to reference Arnett FC, Edworthy SM, Bloch DA, Mcshane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger TA Jr, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324. doi:10.1002/art.1780310302 PubMedCrossRef Arnett FC, Edworthy SM, Bloch DA, Mcshane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger TA Jr, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324. doi:10.​1002/​art.​1780310302 PubMedCrossRef
11.
go back to reference Terasawa K (1993) Introduction. In: Terasawa K (ed) KAMPO Japanese-oriental medicine; insights from clinical cases. K.K. Standard McIntyre, Tokyo, pp 1–13 Terasawa K (1993) Introduction. In: Terasawa K (ed) KAMPO Japanese-oriental medicine; insights from clinical cases. K.K. Standard McIntyre, Tokyo, pp 1–13
12.
go back to reference Yamanaka H, Tanaka Y, Sekiguchi N, Inoue E, Saito K, Kameda H, Iikuni N, Nawata M, Amano K, Shinozaki M, Takeuchi T (2007) Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan. Mod Rheumatol 17:28–32. doi:10.1007/s10165-006-0532-0 PubMedCrossRef Yamanaka H, Tanaka Y, Sekiguchi N, Inoue E, Saito K, Kameda H, Iikuni N, Nawata M, Amano K, Shinozaki M, Takeuchi T (2007) Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan. Mod Rheumatol 17:28–32. doi:10.​1007/​s10165-006-0532-0 PubMedCrossRef
13.
go back to reference Pincus T, Larsen A, Brooks RH, Kaye J, Nance EP, Callahan LF (1997) Comparison of 3 quantitative measures of hand radiographs in patients with rheumatoid arthritis: Steinbrocker stage, Kaye modified Sharp score, and Larsen score. J Rheumatol 24:2106–2112PubMed Pincus T, Larsen A, Brooks RH, Kaye J, Nance EP, Callahan LF (1997) Comparison of 3 quantitative measures of hand radiographs in patients with rheumatoid arthritis: Steinbrocker stage, Kaye modified Sharp score, and Larsen score. J Rheumatol 24:2106–2112PubMed
14.
go back to reference Komatireddy GR, Leitch RW, Cella K, Browning G, Minor M (1997) Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III. J Rheumatol 24:1531–1539PubMed Komatireddy GR, Leitch RW, Cella K, Browning G, Minor M (1997) Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III. J Rheumatol 24:1531–1539PubMed
15.
go back to reference Papadopoulos NG, Tsiaousis GZ, Pavlitou-Tsiontsi A, Giannakou A, Galanopoulou VK (2008) Does the presence of anti-CCP autoantibodies and their serum levels influence the severity and activity in rheumatoid arthritis patients? Clin Rev Allergy Immunol 34:11–15. doi:10.1007/s12016-007-8018-1 PubMedCrossRef Papadopoulos NG, Tsiaousis GZ, Pavlitou-Tsiontsi A, Giannakou A, Galanopoulou VK (2008) Does the presence of anti-CCP autoantibodies and their serum levels influence the severity and activity in rheumatoid arthritis patients? Clin Rev Allergy Immunol 34:11–15. doi:10.​1007/​s12016-007-8018-1 PubMedCrossRef
16.
go back to reference Ogawa K, Kojima T, Matsumoto C, Kamegai S, Oyama T, Shibagaki Y, Muramoto H, Kawasaki T, Fujinaga H, Takahashi K, Hikiami H, Goto H, Kiga C, Koizumi K, Sakurai H, Shimada Y, Yamamoto M, Terasawa K, Takeda S, Saiki I (2007) Identification of a predictive biomarker for the beneficial effect of a Kampo (Japanese traditional) medicine keishibukuryogan in rheumatoid arthritis patients. Clin Biochem 40:1113–1121. doi:10.1016/j.clinbiochem.2007.06.005 PubMedCrossRef Ogawa K, Kojima T, Matsumoto C, Kamegai S, Oyama T, Shibagaki Y, Muramoto H, Kawasaki T, Fujinaga H, Takahashi K, Hikiami H, Goto H, Kiga C, Koizumi K, Sakurai H, Shimada Y, Yamamoto M, Terasawa K, Takeda S, Saiki I (2007) Identification of a predictive biomarker for the beneficial effect of a Kampo (Japanese traditional) medicine keishibukuryogan in rheumatoid arthritis patients. Clin Biochem 40:1113–1121. doi:10.​1016/​j.​clinbiochem.​2007.​06.​005 PubMedCrossRef
17.
go back to reference Visser K, Verpoort KN, van Dongen H, van der Kooij SM, Allaart CF, Toes RE, Huizinga TW, n Mil AH (2008) Pretreatment serum levels of anti-cyclic citrullinated peptide antibodies are associated with the response to methotrexate in recent-onset arthritis. Ann Rheum Dis 67:1194–1195. doi:10.1136/ard.2008.088070 PubMedCrossRef Visser K, Verpoort KN, van Dongen H, van der Kooij SM, Allaart CF, Toes RE, Huizinga TW, n Mil AH (2008) Pretreatment serum levels of anti-cyclic citrullinated peptide antibodies are associated with the response to methotrexate in recent-onset arthritis. Ann Rheum Dis 67:1194–1195. doi:10.​1136/​ard.​2008.​088070 PubMedCrossRef
19.
go back to reference De Rycke L, Verhelst X, Kruithof E, Van den Bosch F, Hoffman IE, Veys EM, De Keyser F (2005) Rheumatoid factor, but not anti-cyclic citrullinated peptide antibodies, is modulated by infliximab treatment in rheumatoid arthritis. Ann Rheum Dis 64:299–302. doi:10.1136/ard.2004.023523 PubMedCrossRef De Rycke L, Verhelst X, Kruithof E, Van den Bosch F, Hoffman IE, Veys EM, De Keyser F (2005) Rheumatoid factor, but not anti-cyclic citrullinated peptide antibodies, is modulated by infliximab treatment in rheumatoid arthritis. Ann Rheum Dis 64:299–302. doi:10.​1136/​ard.​2004.​023523 PubMedCrossRef
20.
go back to reference Caramaschi P, Biasi D, Tonolli E, Pieropan S, Martinelli N, Carletto A, Volpe A, Bambara LM (2005) Antibodies against cyclic citrullinated peptides in patients affected by rheumatoid arthritis before and after infliximab treatment. Rheumatol Int 26:58–62. doi:10.1007/s00296-004-0571-9 PubMedCrossRef Caramaschi P, Biasi D, Tonolli E, Pieropan S, Martinelli N, Carletto A, Volpe A, Bambara LM (2005) Antibodies against cyclic citrullinated peptides in patients affected by rheumatoid arthritis before and after infliximab treatment. Rheumatol Int 26:58–62. doi:10.​1007/​s00296-004-0571-9 PubMedCrossRef
21.
go back to reference Alessandri C, Bombardieri M, Papa N, Cinquini M, Magrini L, Tincani A, Valesini G (2004) Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNF-alpha therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement. Ann Rheum Dis 63:1218–1221. doi:10.1136/ard.2003.014647 PubMedCrossRef Alessandri C, Bombardieri M, Papa N, Cinquini M, Magrini L, Tincani A, Valesini G (2004) Decrease of anti-cyclic citrullinated peptide antibodies and rheumatoid factor following anti-TNF-alpha therapy (infliximab) in rheumatoid arthritis is associated with clinical improvement. Ann Rheum Dis 63:1218–1221. doi:10.​1136/​ard.​2003.​014647 PubMedCrossRef
22.
go back to reference Ahmed MM, Mubashir E, Wolf RE, Hayat S, Hall V, Shi R, Berney SM (2006) Impact of treatment with infliximab on anticyclic citrullinated peptide antibody and rheumatoid factor in patients with rheumatoid arthritis. South Med J 99:1209–1215PubMed Ahmed MM, Mubashir E, Wolf RE, Hayat S, Hall V, Shi R, Berney SM (2006) Impact of treatment with infliximab on anticyclic citrullinated peptide antibody and rheumatoid factor in patients with rheumatoid arthritis. South Med J 99:1209–1215PubMed
23.
go back to reference Meyer O, Nicaise-Roland P, Santos MD, Labarre C, Dougados M, Goupille P, Cantagrel A, Sibilia J, Combe B (2006) Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis. Arthritis Res Ther 8:R40 [Epub]. doi:10.1186/ar1896 Meyer O, Nicaise-Roland P, Santos MD, Labarre C, Dougados M, Goupille P, Cantagrel A, Sibilia J, Combe B (2006) Serial determination of cyclic citrullinated peptide autoantibodies predicted five-year radiological outcomes in a prospective cohort of patients with early rheumatoid arthritis. Arthritis Res Ther 8:R40 [Epub]. doi:10.​1186/​ar1896
Metadata
Title
Serum levels of anti-cyclic citrullinated peptide antibodies are associated with a beneficial response to traditional herbal medicine (Kampo) in rheumatoid arthritis
Authors
Toshiaki Kogure
Hiroko Sato
Daijiro Kishi
Tomoyuki Ito
Takeshi Tatsumi
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 12/2009
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-009-0877-8

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