Autoantibodies

About

Unmet Need:  Rheumatoid Arthritis is a complex and clinically heterogeneous disease which presents a recognized challenge for diagnosis and prediction of future severity. Peptidylarginine deiminase (PAD) enzyme family members are known to be central players in the pathology of Rheumatoid Arthritis (RA). There is a need for precise biomarkers to identify clinically unique disease subgroups in order to help direct treatment plans.  In a subset of patients with RA, autoantibodies that activate some of these PAD enzymes have been identified. These antibodies are associated with severe joint and lung disease, highlighting the potential importance of functional autoantibodies in disease pathogenesis. JHU scientists have discovered that patients with auto-antibodies to another PAD family member have less severe joint damage and interstitial lung disease. Technical Details: JHU scientists found that clinical characteristics of anti-PAD positive patients were distinct from those previously observed for anti-PAD4 antibodies. Those patients with RA which had circulating anti-PAD antibodies had a reduced swollen joint count, had less interstitial lung disease and appear to be protected against radiographic progression. Anti-PAD antibodies represent a novel biomarker in RA that is not associated with the traditional risk factors linked to disease severity.  The antibodies represent a novel prognostic biomarker in RA that identifies a demographically unique subset of patients with less severe disease and suggests an unappreciated mechanistic role of one of the PADs in RA pathogenesis. This novel biomarker has potential implications for disease monitoring and highlights an unappreciated role of a PAD family member in RA pathogenesis.   Stage of development/data:  Pre-clinical. JHU is looking for partners to develop and clinically validate this assay.