Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study

Abstract Autoantibodies directed against carbamylated proteins (anti-CarP) have been recently identified as predictors for RA development. The aim of this study was to determine the positivity of anti-CarP antibodies in a real-life cohort of RA patients and their association with radiological damage...

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Main Authors: Milica Markovic, Corrado Campochiaro, Branislava Glisic, Milan Petronijevic, Gorica Ristic, Ivan Stanojevic, Danilo Vojvodic, Naomi Viapiana, Marco Matucci-Cerinic, Lorenzo Dagna
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Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03464-z
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author Milica Markovic
Corrado Campochiaro
Branislava Glisic
Milan Petronijevic
Gorica Ristic
Ivan Stanojevic
Danilo Vojvodic
Naomi Viapiana
Marco Matucci-Cerinic
Lorenzo Dagna
author_facet Milica Markovic
Corrado Campochiaro
Branislava Glisic
Milan Petronijevic
Gorica Ristic
Ivan Stanojevic
Danilo Vojvodic
Naomi Viapiana
Marco Matucci-Cerinic
Lorenzo Dagna
author_sort Milica Markovic
collection DOAJ
description Abstract Autoantibodies directed against carbamylated proteins (anti-CarP) have been recently identified as predictors for RA development. The aim of this study was to determine the positivity of anti-CarP antibodies in a real-life cohort of RA patients and their association with radiological damage, disability and disease activity. In this open-label, observational, cross-sectional study 69 RA patients and 16 healthy controls (HC) were recruited. The study was approved by institutional Ethical Committee. Circulating levels of anti-CarP antibodies were determined by commercial ELISA anti-CarP quantitative sandwich immunoassay. Articular X-rays were evaluated to define the presence of bone erosions. Disease activity (DAS28-CRP) and disability (HAQ-DI) were assessed. Pearson χ2 test, Wilcoxon test or Kruskall–Wallis test was used. Spearman rank-order correlation coefficient was applied for continuous variables. Multivariable logistic regression model was performed. Anti-CarP positivity was found in 35% of RA patients and in no HC. One quarter of seronegative RA patients were anti-CarP positive. A positive correlation between levels of anti-CarP antibodies with DAS28-CRP (p = 0.0003; Spearman r = 0.4829) and HAQ-DI (p = 0.0003; Spearman r = 0.4253) was found. 87% of anti-CarP positive patients had erosions. At multivariable logistic regression analysis, RA disease activity (OR 1.31, 95% CI [1.14, 1.63]) and circulating levels of anti-CarP antibodies (OR 1.66, 95% CI [1.28, 2.37]) were independent predictors of bone erosions. Our study confirms that anti-CarP antibodies are associated with a more aggressive RA course and are independent predictors of bone erosions.
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spelling doaj-art-e7cadb3d3f1e40f9b65bb36b1ead12952025-08-20T02:00:07ZengNature PortfolioScientific Reports2045-23222025-05-011511810.1038/s41598-025-03464-zAssociation of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational studyMilica Markovic0Corrado Campochiaro1Branislava Glisic2Milan Petronijevic3Gorica Ristic4Ivan Stanojevic5Danilo Vojvodic6Naomi Viapiana7Marco Matucci-Cerinic8Lorenzo Dagna9Clinic for Internal Medicine, Rheumatology Division, Clinical Center of MontenegroUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele UniversityDepartment of Rheumatology and Clinical Immunology, Medical Faculty of the Military Medical Academy, University of DefenseDepartment of Rheumatology and Clinical Immunology, Medical Faculty of the Military Medical Academy, University of DefenseDepartment of Rheumatology and Clinical Immunology, Medical Faculty of the Military Medical Academy, University of DefenseMedical Faculty of the Military Medical Academy, Institute for Medical Research of the Military Medical Academy, University of DefenseMedical Faculty of the Military Medical Academy, Institute for Medical Research of the Military Medical Academy, University of DefenseUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele UniversityUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele UniversityUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele UniversityAbstract Autoantibodies directed against carbamylated proteins (anti-CarP) have been recently identified as predictors for RA development. The aim of this study was to determine the positivity of anti-CarP antibodies in a real-life cohort of RA patients and their association with radiological damage, disability and disease activity. In this open-label, observational, cross-sectional study 69 RA patients and 16 healthy controls (HC) were recruited. The study was approved by institutional Ethical Committee. Circulating levels of anti-CarP antibodies were determined by commercial ELISA anti-CarP quantitative sandwich immunoassay. Articular X-rays were evaluated to define the presence of bone erosions. Disease activity (DAS28-CRP) and disability (HAQ-DI) were assessed. Pearson χ2 test, Wilcoxon test or Kruskall–Wallis test was used. Spearman rank-order correlation coefficient was applied for continuous variables. Multivariable logistic regression model was performed. Anti-CarP positivity was found in 35% of RA patients and in no HC. One quarter of seronegative RA patients were anti-CarP positive. A positive correlation between levels of anti-CarP antibodies with DAS28-CRP (p = 0.0003; Spearman r = 0.4829) and HAQ-DI (p = 0.0003; Spearman r = 0.4253) was found. 87% of anti-CarP positive patients had erosions. At multivariable logistic regression analysis, RA disease activity (OR 1.31, 95% CI [1.14, 1.63]) and circulating levels of anti-CarP antibodies (OR 1.66, 95% CI [1.28, 2.37]) were independent predictors of bone erosions. Our study confirms that anti-CarP antibodies are associated with a more aggressive RA course and are independent predictors of bone erosions.https://doi.org/10.1038/s41598-025-03464-zAutoantibodiesBiomarkersAnti-CarP antibodiesRheumatoid arthritis
spellingShingle Milica Markovic
Corrado Campochiaro
Branislava Glisic
Milan Petronijevic
Gorica Ristic
Ivan Stanojevic
Danilo Vojvodic
Naomi Viapiana
Marco Matucci-Cerinic
Lorenzo Dagna
Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
Scientific Reports
Autoantibodies
Biomarkers
Anti-CarP antibodies
Rheumatoid arthritis
title Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
title_full Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
title_fullStr Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
title_full_unstemmed Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
title_short Association of circulating levels of anti-CarP antibodies with disease activity, disability and radiological damage in rheumatoid arthritis patients: an open-label, observational study
title_sort association of circulating levels of anti carp antibodies with disease activity disability and radiological damage in rheumatoid arthritis patients an open label observational study
topic Autoantibodies
Biomarkers
Anti-CarP antibodies
Rheumatoid arthritis
url https://doi.org/10.1038/s41598-025-03464-z
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