gms | German Medical Science

Background: To investigate the influence of an infectious disease on Rheumatoid Arthritis (RA), patients from the ADAPTHERA study cohort were screened for antibodies to Borrelia antigens.

Methods: 204 sera from early RA patients with disease duration < 6 months were screened using the following ELISAs (AESKU.DIAGNOSTICS): AESKULISA® Rf-AGM, AESKULISA® CCP-IgG and -IgM, AESKULISA® Borrelia-IgG and –IgM, AESKUBLOT® Borrelia-IgG and -IgM and AESKULISA® DF MMP-3. Statistical analysis was performed using MedCalc V.15.6.1

Results: 10.8% of the patients tested at their 1st visit were positive for Borrelia-specific antibodies. 18/204 patients were positive for IgG or IgM, or both, and 4/204 patients had equivocal results.

5/22 Borrelia positive patients were CCP positive but negative for Rf-AGM. Interestingly, 10/13 patients that were negative for RA parameters had high MMP-3 levels, while only 1/9 of CCP positive patients showed elevated MMP-3 titres.

Measurements were continued in 3 serologically RA negative up to visit 4, only one patient showed CCP positivity. IgM antibody titres for Borrelia antigens remained highly positive and correlated with coexisting high MMP-3 levels. 2/3 patients remained positive in Borrelia Western blot for IgG and negative in RA parameters. 1/3 patients remained positive in CCP and showed negative Western blot results in Borrelia.

Interestingly, classical RA parameters remained negative in most patients which showed high MMP-3 and positive Borrelia outcomes throughout the investigated time period.

Conclusion: Co-measurement of MMP-3 and correlation with further serological markers may assist in improved differential diagnosis and helps to eliminate unnecessary patient therapies, thus saving time, money and improving overall patient care.