{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:30:55Z","timestamp":1780471855642,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"publisher","award":["20164"],"award-info":[{"award-number":["20164"]}],"id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Antibodies to cyclic citrullinated peptides (anti\u2010CCP) in rheumatoid arthritis (RA) can express the inherently autoreactive gene V<jats:sub>H<\/jats:sub>4\u201334, detected using the rat monoclonal antibody 9G4. Patients with the polyarticular subtype of juvenile idiopathic arthritis (JIA) share some but not all of the features of adult patients with RA. This study was undertaken to compare serologic findings for rheumatoid factor (RF), anti\u2010CCP, and 9G4\u2010expressing anti\u2010CCP in a large JIA cohort with a cohort of adult RA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum from 88 patients with polyarticular JIA, 29 patients with enthesitis\u2010related arthritis, 38 patients with extended oligoarthritis, 31 adolescent controls, 35 patients with RA, and 30 adult controls were tested for RF, for IgG, IgA, and IgM anti\u2010CCP, and for 9G4\u2010expressing anti\u2010CCP by enzyme\u2010linked immunosorbent assay. Total serum 9G4\u2010positive IgM was also measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 65 patients with RF\u2010negative polyarticular JIA, 4 (6.2%) were IgG anti\u2010CCP positive. Sera from 20 of 23 patients with RF\u2010positive polyarticular JIA (87.0%), 24 of 35 patients with RA (68.6%), and 1 patient with extended oligoarthritis contained IgG anti\u2010CCP. IgA and IgM anti\u2010CCP levels were lower in the adolescent group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Levels of 9G4\u2010expressing anti\u2010CCP were higher in patients with RF\u2010positive polyarticular JIA than in those with RF\u2010negative polyarticular JIA (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Median levels of 9G4\u2010expressing anti\u2010CCP in patients with RF\u2010positive polyarticular JIA and those with RA did not differ. Expression of 9G4 on serum total IgM was greater in patients with RF\u2010positive polyarticular JIA than other adolescent groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), but similar to adult RF\u2010positive RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In healthy individuals, 9G4\u2010positive B cells comprise 5\u201310% of the peripheral blood pool but serum immunoglobulins utilizing V<jats:sub>H<\/jats:sub>4\u201334 are disproportionately low. The idiotope recognized by 9G4 was detected on anti\u2010CCP antibodies in &gt;80% of patients with RF\u2010positive polyarticular JIA. V<jats:sub>H<\/jats:sub>4\u201334 usage by anti\u2010CCP in both JIA and RA patients suggest elicitation of these autoantibodies through shared pathogenic B cell selection processes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40117","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T18:32:19Z","timestamp":1491417139000},"page":"1387-1395","source":"Crossref","is-referenced-by-count":14,"title":["Antibodies to Cyclic Citrullinated Peptides in Patients With Juvenile Idiopathic Arthritis and Patients With Rheumatoid Arthritis: Shared Expression of the Inherently Autoreactive 9G4 Idiotype"],"prefix":"10.1002","volume":"69","author":[{"given":"Hannah","family":"Peckham","sequence":"first","affiliation":[{"name":"Arthritis Research UK Centre for Adolescent Rheumatology, University College London London 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