Biomarkers in rheumatoid arthritis management

Abstract

  The purpose of using biomarkers is to help diagnosis, assessing disease activity, predicting prognosis, classifying into disease subset and so on. There are various kinds of biomarkers including autoantibodies, cytokines, cell surface markers, genomic data, gene expression, micro RNA, metabolome etc. Anti-CCP antibody is a specific diagnosis biomarker of rheumatoid arthritis （RA）, but one has to be careful it can be positive in various collagen vascular diseases. Combining anti-CCP antibody with rheumatoid factor（RF）predicts prognosis of joint damage more precisely, especially in anti-CCP（-）subset. MMP-3 is not a good marker for diagnosis of RA, but is useful for predicting erosive disease. Anti-CCP antibody is also a good marker for predicting erosive disease, but there is a report that HLA-DR13 predicts less joint damage in anti-CCP（+）RA. So, we surveyed the charts of anti-CCP（+）RA patients with HLA-DR13 allele, and found that there is a fraction of patients who did not develop bone erosions even after 10 years of RA history. In contrast, most patients with very long RA history develop severe bone erosions even possessing HLA-DR13. HLA-DR13 may become a good biomarker for predicting less erosive disease, but more sophisticated biomarkers are required.