ABSTRACT
Objective To explore the significance of serum anti-carbamylated protein (anti-CarP) antibody measurement for diagnosing rheumatoid arthritis (RA). Methods In this study, 135 patients with newly diagnosed RA (RA group) and 85 healthy subjects (healthy group) were enrolled. ELISA was performed to measure anti-CarP and anti-cyclic citrullinated peptide (anti-CCP) antibodies. The numbers of swollen and tender joints, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level were recorded. Results Anti-CCP antibody was positive in 106 cases (78.5％) and anti-CarP antibody was positive in 67 cases (49.6％) in the RA group. The sensitivity of combined measurement of anti-CCP and anti-CarP antibodies can improve the specificity of diagnosis, up to 97.6％. Among cases of anti-CarP antibody positivity, the number of swollen and tender joints and DAS-28 score were positively correlated with anti-Car P antibody level (r = 0.61, P = 0.001;r = 0.67, P = 0.001;r = 0.62, P = 0.001, respectively) and weakly correlated with CRP level and ESR (r = 0.28, P =0.015;r = 0.35, P = 0.018, respectively), but not correlated with disease duration (r = 0.09, P = 0.43). A total of 98 cases (72.6％) had radiological changes. At different levels of joint damage severity observed on radiographs, the differences between serum anti-CarP and anti-CCP antibody levels were statistically significant (P ＜ 0.05). Conclusion Combined detection of anti-CarP and anti-CCP antibodies increases diagnostic specificity for RA. Anti-CarP antibody level is also correlated with severity of joint damage, implicating its involvement in the development and progression of RA. It may become an important marker for RA diagnosis, severity evaluation, and prognosis prediction.
ABSTRACT
Rheumatoid arthritis ( RA ) is a common chronic autoimmune disease .A variety of autoantibodies appears in RA patients and the detection of autoantibodies could be used for the diagnosis and treatment for RA.Anti-citrullinated protein antibodies and rheumatoid factor has been currently used in clinical diagnosis of RA. Recently, a new widely concerned autoantibody , anti-carbamylated protein antibody , is expected to become one of the markers for early diagnosis and evaluation of disease activity and bone destruction.
ABSTRACT
Objective To evaluate the value of anti-carbamylated protein (CarP) antibody in the diagnosis of rheumatoid arthritis (RA).Methods The clinical data and serum of 247 in-patients with joint pain of Department of Rheumatology,General Hospital of Ningxia Medical University admitted during September 1,2015 to June 1,2016 were collected and divided into two groups according to the final diagnosis:RA group (case group) which included 126 patients and the non-RA group which included 121 patients (control group).The concentration of anti-CarP antibody in serum was measured by enzyme linked immunosorbent assay (ELISA).The serum rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibodies were detected at the same time.Mann-Whitney U nonparametric test for statistical analysis,receiver operating characteristic curve (ROC) was drawn to determine the cut-off value of anti-CarP antibody to RA diagnosis and to analyze its diagnostic efficacy.Results The ROC curve showed that the anti-CarP antibody had a cutoff value of 63.77 U/ml,with the sensitivity of 74.60％,and specificity of 71.07％.Compared with RF and anti-CCP antibody,the area under the ROC curve (A) were:Aanti-cyclic citrullinted peptide(anti-CCP)antibody (0.88)＞ARF (0.85)＞Anti-CarP antibody (0.78).There was no significant difference between the Aanti-CCP antibodies and ARF as well as ARF and Aanti-CarP antibodies (Z=1.29,P=0.20;Z=1.30,P=0.20),but there was significant difference between Aanti-CCP antibody and A anti Carp antibody (Z=2.28,P=0.02).Conclusion Anti-CarP antibody has certain value in the diagnosis of RA,and can be used as the serological index for RA diagnosis.
ABSTRACT
Rheumatoid arthritis ( RA) was a common autoimmune disease characterized with main clinical manifestations of chronic inflammation in joints.Anti-carbamylated proteins(anti-CarP)antibody, as a promising bio-marker, played a crucial role in the diagnosis of RA patients and the screening of pre-RA patients .In this article , recent progress on the study of anti-CarP antibody and RA related diseases has been reviewed , which was expected to provide new references for the diagnosis and treatment of related clinical diseases .
ABSTRACT
OBJECTIVES: This study evaluated the diagnostic performance of anti-carbamylated protein (anti-CarP) and anti-citrullinated fibrinogen (ACF) antibodies in rheumatoid arthritis (RA). METHODS: We searched the Pubmed, Embase, and Cochrane library databases, and performed two meta-analyses on the diagnostic accuracy of anti-CarP and ACF antibodies in patients with RA. RESULTS: The meta-analysis included data from 12 studies. Of these, seven studies, which included 1,749 patients and 1,044 controls, examined anti-CarP antibody, and five studies, which included 733 patients and 1,178 controls, examined ACF antibody. The pooled sensitivities and specificities of anti-CarP antibody were 43.9% (95% confidence interval [CI], 41.6~46.3) and 94.5% (95% CI, 93.0~95.8), respectively, and those of ACF antibody were 68.3% (95% CI, 64.9~71.6) and 95.8% (95% CI, 94.5~96.9), respectively. The positive likelihood ratio (PLR) of anti-CarP antibody were 9.901 (95% CI, 5.005~19.58), negative likelihood ratio (NLR) was 0.597 (95% CI, 0.541~0.658), and diagnostic odds ratio (DOR) was 14.64 (95% CI, 8.004~34.45). For ACF antibody, PLR was 16.14 (95% CI, 10.23~25.42), NLR was 0.292 (95% CI, 0.192~0.444), and DOR was 58.61 (95% CI, 26.61~129.1). There were no significant difference in sensitivity, specificity, PLR, NLR, AUC, or Q* index between ACF and anti-cyclic citrullinated peptide (anti-CCP) in the diagnosis of RA. CONCLUSION: Our meta-analysis demonstrates that both anti-CarP and ACF antibodies are highly specific for diagnosing RA. However, while ACF and anti-CCP showed comparably high diagnostic accuracy, anti-CarP antibody showed low sensitivity in diagnosing RA.