Brief Report: Airways abnormalities and rheumatoid arthritis–related autoantibodies in subjects without arthritis: Early injury or initiating site of autoimmunity?

摘要: Objective To evaluate the presence of pulmonary abnormalities in rheumatoid arthritis (RA)–related autoantibody–positive subjects without inflammatory arthritis. Methods Forty-two who did not have but were positive for anti–cyclic citrullinated peptide antibodies and/or ≥2 factor isotypes (a profile that is 96% specific RA), 15 autoantibody-negative controls, and 12 patients with established seropositive early RA (<1-year duration) underwent spirometry high-resolution computed tomography (HRCT) lung imaging. Results The median age autoantibody-positive was 54 years, 52% female, 38% ever-smokers; these characteristics significantly different from those control subjects. No subject had based on joint examination. HRCT revealed 76% airways including bronchial wall thickening, bronchiectasis, centrilobular opacities, air trapping, compared 33% controls (P = 0.005). The prevalence type among similar to RA. In 2 disease, classifiable as articular developed ∼13 months after evaluation. Conclusion Airways are consistent inflammation common seen These findings suggest may be an site autoimmune-related injury potentially a generation RA-related autoimmunity. Further studies needed define mechanistic role development