Rheumatoid arthritis associated with a cytotoxic cell leukemia is characterized by enhanced reactivity to citrullinated antigens

Abstract T cell large granular lymphocyte leukemia (T-LGLL) is characterized by clonal expansion of cytotoxic cells and neutropenia. Compared to 1% the general population, about 25% T-LGLL patients develop rheumatoid arthritis (RA), an autoimmune disease anti-citrullinated protein antibodies (ACPAs). To investigate response in with both RA (T-LGLL/RA), we analyzed their ACPA positivity specificity using anti-CCP ELISA (n=30 for T-LGLL/RA T-LGLL; n=150 RA) multiplex array (n=26 per group), respectively. We found that was enriched (90%) compared those alone (75%; p=0.09), or (33%; p<0.0001). This supported serological profiling reactivity 51 individual autoantigens, which demonstrated are more responsive citrullinated (cit)-antigens. were overrepresented (61%) a cluster highly reactive individuals (39%) (0%), recognized higher number cit-antigens than either alone: 11.7 vs. 5.8 (p=0.2135) 2.4 (p<0.0001). Among specific antigens, recognition cit-clusterin cit-fibrinogen alpha peptide (p=0.0253 0.0507, respectively). Our results show have robust responses recognize wider diversity autoantigens alone. Investigating immune T-LGLL/ RA, may consist extreme form provide insight into pathogenesis. research funded NIH/NIAMS R01-AR079404.