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JCDR. 2021; 12(3): 1056-1063

Anticitrullinated HSP90a In Rheumatoid Arthritis With Interstitial Lung Diseases

Esraa F.Abdallah, Mona H. Nasr, Moustafa A. Abdel-Wahab, Nezar R.Tawfike, Amany A. Bekhit, Ayman F. Darwish.


Rheumatoid arthritis (RA) is a chronic inflammatory disease that mostly affects the synovial joints. The arthritis is usually symmetrical, and it causes joint deterioration by eroding cartilage and bone. RA can also cause a variety of extra-articular symptoms (Esposito A, et al., 2019). While cardiac complications account for the majority of RA-related deaths, pulmonary involvement also plays a significant role in morbidity and mortality, accounting for about 10%–20% of all deaths (Esposito A, et al., 2019).

The parenchyma, pleura, airways, or vasculature can all be involved in pulmonary presentation, but parenchymal involvement from ILD is the most prevalent. Pulmonary involvement may occur before the development of articular symptoms in up to 20% of individuals (Esposito A, et al., 2019).

Autoantibodies in the blood have been linked to the development of RA-ILD. Smoking raises the risk through causing the development of antibodies as well as raising the citrullination of lung proteins, which increases their affinity for antibodies. (Shaw M, et al., 2015).

Anticyclic citrullinated protein antibodies (90 IU/ml) and high titers of rheumatoid factor (100 IU/ml) are indicators linked to an increased risk of developing RA-ILD (Zhu J, et al., 2014). Hsp90, a kind of antiicitrullinated protein antibody, shows a specificity of more than 95% for RA-ILD (Harlow L, et al., 2013).

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