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myocardial citrullination in rheumatoid arthritis a correlative histopathologic study心肌citrullination风湿性关节炎相关病理研究
Giles et al. Arthritis Research Therapy 2012, 14:R39
/content/14/1/R39
RESEARCH ARTICLE Open Access
Myocardial citrullination in rheumatoid arthritis: a
correlative histopathologic study
1* 2 3 3 3 4
Jon T Giles , Justyna Fert-Bober , Jin Kyun Park , Clifton O Bingham III , Felipe Andrade , Karen Fox-Talbot ,
1 3 2 1 4
Dimitrios Pappas , Antony Rosen , Jennifer van Eyk , Joan M Bathon and Marc K Halushka
Abstract
Introduction: The aim of this study was to explore the presence and localization of myocardial citrullination in
samples from rheumatoid arthritis (RA) patients compared to rheumatic and non-rheumatic disease control groups.
Methods: Archived myocardial samples obtained during autopsy from 1995 to 2009 were assembled into four
groups: RA; scleroderma; fatal myocarditis; and non-rheumatic disease controls. Samples were examined by
immunohistochemistry (IHC) for the presence and localization of citrullination and peptidyl arginine deiminase
enzymes (PADs) by a single cardiovascular pathologist blinded to disease group and clinical characteristics.
Results: Myocardial samples from seventeen RA patients were compared with those from fourteen controls, five
fatal myocarditis patients, and ten scleroderma patients. Strong citrullination staining was detected exclusively in
the myocardial interstitium in each of the groups. However, average and peak anti-citrulline staining was 59% and
44% higher, respectively, for the RA group compared to the combined non-RA groups (P 0.05 for both
comparisons). Myocardial fibrosis did not differ between the groups. In contrast to
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