Serum anti-cyclic citrullinated peptide [anti_CCP] antibody level in rheumatoid arthritic patients with and without nodal osteoarthritis

Rheumatoid Arthritis [RA] is chronic systemic inflammatory disease affects synovial joints, articular structures and extra articular, the prevalence rate occurs aprox in about 1% of population Anti citrullinated peptide/protein antibody [Anti-CCP] antibody are autoantibodies [antibodies directed against one or. more of the individuals own proteins] frequently detected in RA patients during inflammation. citrulline is incorporated enzymalically into proteins. The current study is a trail to ensure that Anti-CCP marker is more specific and sensitive for diagnosis of RA patients and to detect the effect of the presence of other disease like NOA on Anti- CCP value. Evaluation of Anti-CCP Ab level in RA patients with and without NOA. The serum level of Accp_Ab is estimated using ELISA technique in patients with RA and NOA. The studied group includes 30 RA patients [24 females and 6 males], who fulfilled four or more of the 1987 ACR criteria compared with 30 RA+NOA patients [23 females and 7 males] also fulfilled four or more of the 1987 ACR criteria for the classification of Rheumatoid arthritis and nodal osteoarthritis group. Blood samples were taken from three groups to analyze and measure the serum levels of Anti-CCP. Result of investigations were compared with that for the 30 apparently healthy control individuals who matched the patient's group in age and sex. The result of the study showed that majority of patients is females [80%] for RA patients and [76.6%] for RA+NOA patients [with females: males 4:1 and 3.28:1 for RA and RA+NOA respectively]. Moreover, the mean age for RA, RA+NOA and control groups are:48.03 +/- 12.95y, 51.3 +/- 11.8y and 37.43 +/- 12.57 years respectively. It was observed from the result that there is a higher positivity of Anti-CCP in the patients sera[76.7% for RA+NOA cases and 70% for RA cases] in comparison with healthy control group [0.0%] so there is highly significant difference [p<0.001]. While the quantitative estimation of Anti-CCP antibodies showed that its level was higher among sera of RA+NOA patients in addition to RA patients [53.59 +/- 33.29 RU/ml and 52.28 +/- 48.99 RU/ml respectively] in comparison with healthy control group 2.88 +/- 2.50 RU/ml. We found that Anti-CCP is a good and specific marker for diagnosis of RA and RA can be differentiated from other disease by measuring this marker. Moreover, Anti-CCP Ab level in RA patients does not significantly affected by the presence of NOA

Levels of magnesium, zinc, calcium and copper in serum of patients with fibromyalgia syndrome

Fibromyalgia syndrome [FMS] is a chronic musculoskeletal syndrome; almost invariably, symptoms persist at 5- and 10-year follow-ups. Several studies reported the importance of trace elements on the immune system. It plays an important role in physiological processes that are crucial for normal functioning of the immune system. Fibromyalgia could be the result of an over-active immune system, the immune system works to protect the body by attacking bacteria, viruses, and other foreign cells. When over-active, the immune system can cause severe inflammation and pain. The main objective of this study is the association between the levels of Magnesium, Zinc, Calcium and Copper in patients with FMS. This study was performed during the period from April 2009 to February 2010, and included 60 patients with FMS according to the ACR 1990 criteria, these criteria, a history of widespread pain has been present for at least three months affecting all four quadrants of the body, i.e., both sides, and above and below the waist, and there are 18 designated possible tender or trigger points. During diagnosis, four kilograms-force [39 newtons] of force is exerted at each of the 18 points; the patient must feel pain at 11 or more of these points for fibromyalgia to be considered. Four kilograms of force is about the amount of pressure required to blanch the thumbnail when applying pressure. Their age range was from 20-60 with the mean age of 39.95 +/- 1.10 years. These patients were matched by age and sex to 30 healthy control subjects with the mean age 42.81 +/- 2.16 years. Blood samples were taken from each individual and separated for the estimation of Mg, Zn, Ca and Cu levels using atomic absorption technique. The laboratory tests were done in Teaching Laboratories of the Medical City and the Department of Physiological Chemistry / College of Medicine University of Baghdad. The level of Mg, Zn and Ca in serum of patients with FMS was significantly lower than in serum of healthy control while the level of Cu in serum of FMS patients was significantly higher than healthy control. Levels of Mg, Zn, Ca concentrations in serum of patients with FMS were significantly lower than healthy control subjects, while Cu concentration in patients with FMS was significantly higher than healthy control subjects and levels of Mg, Zn, Ca and Cu may be a good indicator to evaluate this disease

Lipid peroxidation and oxidative stress in patients with fibromyalgia syndrome

Fibromyalgia [FMS] is a common, chronic widespread pain syndrome usually associated with other somatic and psychologic symptoms including fatigue, sleep disturbances, cognitive difficulties Oxidative stress means an alteration in the delicate balance between free radicals and the scavenging capacity of antioxidant enzymes in favor of free radical in the body system. To evaluate and compare the antioxidants and lipid peroxidation in patients with fibromyalgia and healthy control. The study has included sixty patients with FMS [40 females and 20 males] and thirty healthy subjects. The subjects were selected from people attending the out patients clinic in Medical City-Baghdad Teaching Hospital-Rheumatology and Rehabilitation Consultation Unit. Laboratory parameters included: uric acid, albumin, caeruloplasmin, total thaiol, malondiaaldehyde [MDA] and peroxinitrate[ONOO[-]]. MBA and uric acid levels in serum of patients with fibromyalgia were significantly higher than in the control group. While the levels of ONOO[-] GSH,CP, albumin in serum of patients with fibromyalgia were significantly lower than in healthy control. oxidative stress may have a role in the pathophysiology of fibromyalgia syndrome

Determination of anti-cyclic citrullinated peptide [ACCP] and C-reactive protein [C-RP] concentrations in serum of patients with fibromyalgia syndrome [FMS]

Fibromyalgia syndrome [FMS] is a chronic musculoskeletal syndrome; almost invariably, symptoms persist at 5-and 10-year follow-ups. The degree of functional impairment is similar to that seen in patients with moderate to severe rheumatoid arthritis. Anti-cyclic citrullinated peptide [anti-CCP] antibody testing is particularly useful in the diagnosis of rheumatoid arthritis, with high specificity, in the early disease process, with the ability to identify patients who are likely to have severe disease and irreversible damage. CRP is a member of the class of acute-phase reactants that its levels rise dramatically during inflammatory processes occurring in the body. The main objective of this study is to determine the frequency of anti CCP-in patients with FM and the association of anti-CCP level with C-RP. This study included 60 patients with FMS according to the ACR 1990 criteria. Their age range was 20-60 years. These patients were then matched by age and sex to 30 healthy control persons with mean age 42.81 +/- 2.16 years. The mean values of ACCP antibodies concentration in serum of patients with FMS were no significant difference as compared to the level in serum of healthy controls [p>0.05], while the mean values of C-RP concentration in serum of patients with FMS were significantly increased than the level in serum of healthy control [p< 0.05]. It is clear from this study that there is no relationship between the levels of ACCP concentration and FMS while C-RP concentration in patients with FMS may be a good indicator to evaluate this disease