This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by De Rycke, L Articles by De Keyser, F Search for Related Content PubMed PubMed Citation Articles by De Rycke, L Articles by De Keyser, F Social Bookmarking                   What's this?

The effect of TNFalpha blockade on the antinuclear antibody profile in patients with chronic arthritis: biological and clinical implications

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

D Baeten

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

E Kruithof

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

F Van den Bosch

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

E M Veys

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

F De Keyser

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, filip.dekeyser{at}ugent.be

Since the first proof of efficacy of TNFalpha blockade, both the number of patients treated worldwide and the number of indications for treatment with TNFalpha blockers have grown steadily. Surprisingly, the profound immunomodulation induced by anti-TNFalpha therapy is associated with a relatively low incidence of immune-related complications such as lupus-like syndromes and demyelinating disease. This contrasts sharply with the prominent induction of autoantibodies such as antinuclear antibodies (ANA) and anti-dsDNA antibodies during TNFalpha blockade. Although this phenomenon has been recognized for several years, the clinical and biological implications are not yet fully understood. In this review, recent studies analysing the effect of TNFalpha blockade (infliximab and etanercept) on the ANA profile in autoimmune arthritis will be discussed. Taken together, these reports indicate that the prominent ANA and anti-dsDNA autoantibody response is 1) not a pure class effect of TNFalpha blockers, 2) independent of the disease background, 3) largely restricted to the induction of short-term IgM anti-dsDNA antibodies, and 4) not associated with other serological or clinically relevant signs of lupus. Nevertheless, a careful follow-up of patients treated with TNFalpha blockers remains mandatory, including monitoring for lupus-like characteristics.

Key Words: anti-dsDNA antibodies • antinuclear antibodies • etanercept • infliximab • lupus-like symptoms

Lupus, Vol. 14, No. 12, 931-937 (2005)
DOI: 10.1191/0961203305lu2240rr


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E. L. Williams, S. Gadola, and C. J. Edwards Anti-TNF-induced lupus Rheumatology, July 1, 2009; 48(7): 716 - 720. [Abstract] [Full Text] [PDF]

				K. Van den Bergh, H. Hooijkaas, D. Blockmans, R. Westhovens, K. Op De Beeck, P. Verschueren, D. Dufour, J. P. van de Merwe, M. Fijak, J. Klug, et al. Heterogeneous Nuclear Ribonucleoprotein H1, a Novel Nuclear Autoantigen Clin. Chem., May 1, 2009; 55(5): 946 - 954. [Abstract] [Full Text] [PDF]

				M Aringer and J. Smolen TNF inhibition in SLE: where do we stand? Lupus, January 1, 2009; 18(1): 5 - 8. [PDF]

				D. McGonagle, A. L. Tan, J. Madden, L. Taylor, and P. Emery Rituximab use in everyday clinical practice as a first-line biologic therapy for the treatment of DMARD-resistant rheumatoid arthritis Rheumatology, June 1, 2008; 47(6): 865 - 867. [Abstract] [Full Text] [PDF]

				D E Furst, F C Breedveld, J R Kalden, J S Smolen, G R Burmester, P Emery, E C Keystone, M H Schiff, P L C M van Riel, M E Weinblatt, et al. Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2006 Ann Rheum Dis, November 1, 2006; 65(suppl_3): iii2 - iii15. [Full Text] [PDF]