Association of anticytomegalovirus seropositivity with more severe joint destruction and more frequent joint surgery in rheumatoid arthritis
Article first published online: 25 MAY 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 64, Issue 6, pages 1740–1749, June 2012
How to Cite
Pierer, M., Rothe, K., Quandt, D., Schulz, A., Rossol, M., Scholz, R., Baerwald, C. and Wagner, U. (2012), Association of anticytomegalovirus seropositivity with more severe joint destruction and more frequent joint surgery in rheumatoid arthritis. Arthritis & Rheumatism, 64: 1740–1749. doi: 10.1002/art.34346
- Issue published online: 25 MAY 2012
- Article first published online: 25 MAY 2012
- Accepted manuscript online: 19 DEC 2011 10:57AM EST
- Manuscript Accepted: 13 DEC 2011
- Manuscript Received: 9 JAN 2011
- DFG. Grant Number: WA 2765/3-1
Expansion of autoreactive CD4+CD28null T cells is associated with extraarticular disease manifestations, including rheumatoid vasculitis, and it has recently been demonstrated that expansion of these T cells is associated with anticytomegalovirus (anti-CMV) seropositivity. This study was undertaken to investigate a possible link between latent CMV infection and rheumatoid arthritis (RA).
In a retrospective analysis, anti-CMV antibodies and clinical, serologic, and radiologic parameters of joint destruction were examined in 202 RA patients and 272 healthy controls. In addition, frequencies of CD4+CD28null T cells; concentrations of the cytokines monocyte chemotactic protein 1 (MCP-1), interferon-α (IFNα), and IFN-inducible protein 10; and anti-CMV–specific T cell responses were analyzed in RA patients.
Overall, no significant difference in the frequency of anti-CMV seropositivity between RA patients and healthy controls was observed. Among individuals older than age 55 years, however, anti-CMV IgG antibodies were significantly more frequent in RA patients than controls (65.3% and 54.7%, respectively; P = 0.05). Anti-CMV seropositivity in RA patients was associated with an increased frequency of CD4+CD28null T cells and increased serum concentrations of MCP-1. The frequency of anti-CMV–specific CD4+ T cells producing IFNγ was increased in RA patients compared to controls. Most importantly, anti-CMV–seropositive RA patients showed radiographic evidence of more advanced joint destruction and had increased frequencies of joint-related surgical procedures, indicating more severe joint disease.
Our findings indicate that latent CMV infection aggravates the clinical course of RA and is associated with increased frequencies of CD4+CD28null T cells and of CMV-specific IFNγ-secreting CD4+ T cells.