Malin C Erlandsson1, Minna Turkkila1, Filip Siljehult2, Rille Pullerits3, Catharina Eriksson4, Solbritt Rantapää-Dahlqvist2, Maria I Bokarewa5. 1. Department of Rheumatology and Inflammation Research, Sahlgrenska University Hospital, University of Gothenburg, Box 480, SE 405 30 Gothenburg, Sweden. 2. Department of Public Health and Clinical Medicine, Rheumatology Unit, University of Umeå, Umeå, Sweden. 3. Department of Rheumatology and Inflammation Research, Sahlgrenska University Hospital, University of Gothenburg, Box 480, SE 405 30 Gothenburg, Sweden; Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 4. Department of Public Health and Clinical Medicine, Rheumatology Unit, University of Umeå, Umeå, Sweden; Laboratory of Clinical Immunology University Hospital of Umeå, Umeå, Sweden. 5. Department of Rheumatology and Inflammation Research, Sahlgrenska University Hospital, University of Gothenburg, Box 480, SE 405 30 Gothenburg, Sweden. Electronic address: maria.bokarewa@rheuma.gu.se.
Abstract
OBJECTIVES: The aim of this study was to validate the use of survivin for preclinical recognition of rheumatoid arthritis (RA) among patients with unexplained arthralgia. METHODS: Serum levels of survivin and the arthritis-specific autoantibodies RF and ACPA were measured in total of 5046 patients with musculoskeletal complains during 12 consecutive months in Gothenburg and in Umeå. Among them, 303 arthralgia patients were identified and prospectively followed. RESULTS: After 48 months, 12.2% of the arthralgia patients developed RA. Most of RA cases had high serum survivin, which increased the relative risk for RA (RR = 5.90, p = 3 × 10-7). Combination of survivin with autoantibodies was present in only 4.6% of the arthralgia patients and increased further the risk of RA and shortened time to RA development. Presence of any single autoantibody in the survivin-negative patients was associated with a minor risk for RA and had RA-free survival similar to the reference group. CONCLUSION: This study shows that measurement of survivin in serum improves estimation of RA risk and prospectively predicts RA development in patients with arthralgia. Survivin may indicate a phase preceding autoantibody production.
OBJECTIVES: The aim of this study was to validate the use of survivin for preclinical recognition of rheumatoid arthritis (RA) among patients with unexplained arthralgia. METHODS: Serum levels of survivin and the arthritis-specific autoantibodies RF and ACPA were measured in total of 5046 patients with musculoskeletal complains during 12 consecutive months in Gothenburg and in Umeå. Among them, 303 arthralgiapatients were identified and prospectively followed. RESULTS: After 48 months, 12.2% of the arthralgiapatients developed RA. Most of RA cases had high serum survivin, which increased the relative risk for RA (RR = 5.90, p = 3 × 10-7). Combination of survivin with autoantibodies was present in only 4.6% of the arthralgiapatients and increased further the risk of RA and shortened time to RA development. Presence of any single autoantibody in the survivin-negative patients was associated with a minor risk for RA and had RA-free survival similar to the reference group. CONCLUSION: This study shows that measurement of survivin in serum improves estimation of RA risk and prospectively predicts RA development in patients with arthralgia. Survivin may indicate a phase preceding autoantibody production.