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Objective To observe the intervention effect of typical hot spring bathing in Guizhou province on joint pain, serum anti-keratin antibody(AKA), anti-perinuclear factor antibody(APF)and anti-cyclic citrullinated peptide antibody(CCP). Methods A total of 160 people with joint pain symptoms from five typical hot spring areas in Guizhou province were selected as the subjects. They were treated with hot spring bathing intervention for 4 weeks, once a day, 5 times a week, 40 to 50 minutes each time. According to the evaluation index of physiotherapy natural mineral water in the Code for Geological Exploration and Evaluation of Natural Warm Mineral Water Resources(GB/T 13727-2016)and geological types, the five typical hot springs were divided into three different types, namely water temperature type hot springs(water temperature > 36 ℃), metasilicate type hot springs(metasilicate > 50 mg/L)and warm mineral spring type hot springs(total dissolved solids > 1 000 mg/L). WHO pain grading standard was used to score the degree of joint pain before and after hot spring bathing intervention. Serum APF, AKA and CCP antibodies were detected by ELISA kit before and after hot spring bathing. Results The joint pain score of the subjects was 2.60±0.60, and the joint pain score of the total population decreased after intervention(0.61±0.57, P < 0.05). Before intervention, the joint pain scores of water temperature type, metasilicic acid type and warm mineral spring type were 2.78±0.96, 1.98±1.15 and 3.31±0.57, respectively. After intervention, the scores of joint pain of the three kinds of hot spring bathing patients all decreased(P < 0.05), and were 0.50±0.65, 0.48±0.74 and 0.85±0.90, respectively. Before intervention, AKA(ng/L)and CCP(μg/mL)antibody levels of the observed subjects were 34.89±16.06 and 107.58±10.40, respectively, which significantly decreased after intervention(both P < 0.05), namely 26.06±10.68 and 102.93±6.01, respectively. AKA(ng/L)was 35.04±20.01 before intervention, but decreased significantly after intervention(26.61±7.54, P < 0.05). AKA(ng/L)and CCP(μg/mL)were 31.09±17.26 and 106.51±10.13 before intervention, respectively. After intervention, the above two antibody indexes significantly decreased(all P < 0.05)to 24.53±13.98 and 98.57±5.68, respectively. Before intervention, the AKA(ng/L), APF(ng/mL)and CCP(μg/mL)antibody levels were 38.40±8.66, 349.46±118.43 and 104.96±9.66, respectively. After intervention, the above three antibody indexes significantly decreased(all P < 0.05). The values were 34.00±7.55, 269.38±127.55 and 101.65±3.04, respectively. Conclusion The typical hot spring bathing intervention in Guizhou province can relieve the symptoms of joint pain, and the three types of hot springs can reduce the levels of AKA, APF and CCP antibodies to different degrees, and the warm mineral spring type of hot spring is better than the other types of hot spring.
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OBJECTIVE@#To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients.@*METHODS@#The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1.@*RESULTS@#The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ2=20.355, P < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ2=6.414, P < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ2=23.300, P < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ2=25.743, P < 0.01, 74.9% vs. 59.4%, χ2=11.694, P < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P < 0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) vs. (114.47±18.48) g/L, t=-2.734, P < 0.01; (266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L, t=-2.970, P < 0.01, respectively].@*CONCLUSION@#The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.
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Female , Humans , Antibodies, Antinuclear , Arthritis, Rheumatoid/epidemiology , Autoantibodies , Laboratories , Peptides, Cyclic , Rheumatoid FactorABSTRACT
OBJECTIVE： To study the efficacy enhancing effect of compatibility of Aconitum carmichaeli liposoluble alkaloids and total glucosides of peony in the treatment of wind-cold-dampness type bi-syndrome model rats. METHODS： Totally 100 SD male rats were randomly divided into blank group （water）， model group （water）， rotundine group [positive control， 10.0 mg/（kg·d）]， dexamethasone group [positive control， 0.3 mg/（kg·d）]，A. carmichaeli alkaloids low-dose and high-dose groups [A. carmichaeli liposoluble alkaloid extract 12.5， 25.0 mg/（kg·d）]， total glucosides of peony low-dose and high-dose groups [total glucosides of peony powder 200.0，400.0 mg/（kg·d）]， compatibility low-dose and high-dose groups [A. carmichaeli liposoluble alkaloid+total glucosides of peony powder were 12.5 mg/（kg·d）+400.0 mg/（kg·d）， 25.0 mg/（kg·d）+800.0 mg/（kg·d） respectively]， with 10 rats in each group. Except for blank group， other groups were given complete Freund’s adjuvant 0.1 mL on the right hind paw and wind-cold-dampness stimulation to induce wind-cold-dampness type bi-syndrome model. Nineteen days after modeling， they were given relevant medicine or water intragastrically， once a day， for consecutive 14 d. The joint tenderness threshold （except for dexamethasone group） and joint swelling index （except for rotundine group） were measured at 0 （before medication）， 3rd and 6th day after administration respectively. HE staining was used to observe the pathological changes of synovial membrane of ankle joint in rats （except for rotundine group）. ELISA assay was used to determine anti-cyclic citrullinated peptide （CCP） antibody in serum of rats （except for rotundine group）， and compatibility index （CI） were calculated. RESULTS： Compared with blank group， joint tenderness threshold of rats were decreased significantly in model group at different time points， while joint swelling index was increased significantly （P＜0.01）. Inflammatory lesions in synovial tissue were obvious， and the content of anti-CCP antibody in serum was significantly increased （P＜0.01）. Compared with model group， the joint tenderness threshold， joint swelling index， synovial tissue pathological changes and anti-CCP antibody content in serum of rats in medication groups were improved in varying degrees， most of the indicators had significant difference （P＜0.05 or P＜0.01）， and the improvement effect of the compatibility groups was better than single component treatment groups. CI value calculated based on anti-CCP antibody content was 0.213，suggesting that the compatibility of the two components had synergistic effect. CONCLUSIONS： The compatibility of A. carmichaeli liposoluble alkaloids and total glucosides of peony in the treatment of wind-cold-dampness type bi-syndrome model rats has analgesia，anti-inflammation and synovial tissue protection， with synergistic efficacy-enhancing effect.
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OBJECTIVE: To observe the effect of fire-needle acupuncture of "Zusanli" (ST 36) and "Kunlun" (BL 60) on ankle-joint swelling and serum tumor necrosis factor-α (TNF-α) and anti-cyclic citrullinated peptide antibody (ACPA) contents in collagen-induced arthritis (CIA) rats, so as to study its mechanism underlying improvement of rheumatoid arthritis (RA)．. METHODS: Thirty-two male Wistar rats were randomized into control, model, medication (Methotrexate) and fire-needling groups (n＝8 in each). The RA model was established by injecting type Ⅱ chicken collagen (0.1 mol/L) plus Freund's complete adjuvant (primary immunization) and Freund's incomplete adjuvant (immunization once more) into the subcutaneous tissues of the right foot bottom, back and tail root of rats. Fire-needling was applied to the left and right "Zusanli" (ST 36) and "Kunlun" (BL 60) alternatively for 3 times in each acupoint, once daily for 10 days. For rats of the medication group, Methotrexate sodium chloride solution (0.1 mg/100 g) was administrated by gavage, once every 5 days, twice together. The rats' right hind ankle diameter was measured before and after the treatment. The X-ray film of the right ankle was taken, and the contents of serum TNF-α and ACPA were assayed by ELISA. RESULTS: The ankle diameter and serum concentrations of TNF-α and ACPA were significantly increased in the model group compared to the control group (P0.05). CONCLUSION: Fire-needling stimulation of ST 36 and BL 60, similar to Methotrexate, can relieve the inflammatory reactions of hind-ankle joint in CIA rats, which may be related to its effect in down-regulating ACPA and TNF-α levels.
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Objective To investigate the clinical efficacy of methotrexate combined with leflunomide in the treatment of rheumatoid arthritis. Methods From January 2017 to February 2018,90 patients with rheumatoid arthritis in Shengzhou Hospital of Traditional Chinese Medicine were divided into control group and observation group according to the random number table method,with 45 cases in each group. The control group was treated with metho-trexate,the observation group was treated with methotrexate and leflunomide. The clinical efficacy of the two groups was evaluated. The anti - cyclic citrullinated peptide antibody (ACCP),rheumatoid factor (RF),and C - reactive protein (CRP) levels were measured before and after 4 months of treatment. The adverse reactions were recorded. Results The total effective rate in the observation group was 95. 56％ after 4 months of treatment,which was signifi-cantly higher than 80. 00％ in the control group (χ2 = 8. 196,P = 0. 016). The ACCP,RF and CRP levels in the two groups were significantly decreased after treatment for 4 months. The ACCP,RF and CRP levels in the observation group were (12423. 68 ± 174. 82) U/ L,(6. 24 ± 2. 14) U/ L,and (6. 69 ± 3. 32) mg/ L,respectively,which were significantly lower than those in the control group [(15421. 27 ± 287. 33) U/ L,(16. 58 ± 3. 26) U/ L,(10. 14 ± 5. 22)mg/ L,t = 59. 787,17. 786,3. 741,P = 0. 000,0. 000,0. 000]. The incidence rate of adverse reaction in the observation group was 6. 67％ ,which in the control group was 4. 44％ ,the difference between the two groups was not statistically significant ( χ2 = 0. 211, P = 0. 645). Conclusion Methotrexate combined with leflunomide in the treatment of rheumatoid arthritis can significantly improve the clinical efficacy,reduce the serum ACCP,RF,CRP levels in patients with a certain degree of control of the disease,while not increasing adverse reactions,has certain degree of safety.
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OBJECTIVE: To explore the detection of autoantibodies in serum of patients with coal workers' pneumoconiosis( CWP).METHODS: Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody( ANCA) in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency( MPO) antibody,anti-mitochondrial M2 antibody( AMA-M2) and anti-cyclic citrullinated peptide( CCP) antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor( RF) was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.RESULTS: In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted( 43.6%), cytoplasmic( 20.5%), homogenous( 7.7%) and nucleolus( 5.1%),with a titer of 1:100.The positive rate of anti-nuclear antibody in the > 70.0 years group was higher than that of ≤60.0 and ≤70.0 years group( P < 0.017); the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group( P < 0.01); the positive rate of anti-CCP antibody in the dust exposure length > 30.0 years group was higher than that of ≤30.0 years group( P < 0.017); the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group( P < 0.01).CONCLUSION: The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.
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Objective To investigate the correlations of Eotaxin-1,rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody with the activity of rheumatoid arthritis (RA).Methods A total of 58 patients with early RA,46 patients without RA and 53 healthy controls from our hospital during December 2014 and December 2015 were enrolled in our study.The activity of RA was evaluated by the swollen joint count (SJC),tender joint count (TJC) and DAS28 score.The levels of serum Eotaxin-1 and antiCCP antibody were detected by ELISA and serum RF levels were determined by the immunological turbidimetry.The comparisons of serum Eotaxin-1,anti-CCP antibody and RF levels between different groups were performed with ANOVA and their correlations with SJC,TJC and DAS28 score were analyzed by Spearman rank correlation.Results The levels of Eotaxin-1,anti-CCP antibody and RF in RA patients were (96.02 ± 2 1.07) pg/mL,(183.42 ± 87.45) U/mL and (119.09 ± 62.30) RU/mL,respectively,which were significantly higher than those in the patients without RA and healthy controls (P ＜ 0.01).The levels of serum Eotaxin-1 in RA patients were significantly related to TJC,SJC and DAS28 score (P ＜ 0.01),while the levels of anti-CCP antibody were related to TJC and DAS28 score.The levels of RF were only related to DAS28 score.Conclusion The levels of serum Eotaxin-1 and anti-CCP antibody in RA patients are significantly correlated with the activity of RA,which may be new serum markers to monitor the activity of RA.
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Objective To investigate the changes of anti-cyclic citrullinated peptide antibody ,rheumatoid factor (RF) ,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) levels in the patients with early rheumatoid arthritis (RA) and their applica-tion value in the diagnosis and treatment.Methods A total of 210 cases of early RA in sixth affiliated hospital of Guangzhou Medi-cal University from December 2015 to June 2016 were selected as the RA group ,including 28 males and 182 females ,at the same time 115 cases of other rheumatism were selected as the non-RA group ,male ,including 38 males and 77 females.85 persons under-going the healthy physical examination were taken as the health group ,including 46 males and 39 females.The latex enhanced im-mune turbidimetry was adopted to quantitatively detect anti-cyclic citrullinated peptide antibody.The RF and CRP levels were quan-titatively detected by using the immune turbidimetry.The Westergren method was used to test the ESR ,their content changes in RA ,non-RA arthritis and other autoimmune diseases were detected.Results The sensitivity ,specificity ,positive predictive value , negative predictive value and Youden index of anti-cyclic citrullinated peptide antibody in the RA group were 60.95% ,97.64% , 98.46% ,50.30% and 0.59 respectively ,which of RF test were 52.38% ,95.29% ,96.49% ,44.75% and 0.48 respectively ,which of CRP test were 30.48% ,89.41% ,87.67% ,87.67% ,34.23% and 0.20 respectively ,which of ESR test were 49.52% ,87.06% , 90.43% ,41.11% and 0.37 respectively.Anti-cyclic citrullinated peptide antibody detection in the RA group was obviously higher than that of the RF test ,their test results were obviously higher than those of the non-RA group and healthy group ,the differences were statistically significant (P0.05).Conclusion Anti-cyclic citrullinated peptide antibody level is higher in the patients with RA ,which is signifi-cantly superior to the RF test ,and anti-cyclic citrullinated peptide antibody detection has higher value for early diagnosis of RA.
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Objective To evaluate the clinical application value of anti cyclic citrullinated peptide antibody(CCP) by immune tur‐bidity method for the the diagnosis of rheumatoid arthritis (RA) .Methods The serum of 195 cases of RA patients ,105 cases of os‐teoarthritis ,52 cases of osteoporosis ,42 cases of connective tissue ,40 patients with systemic lupus erythematosus ,305 cases of pa‐tients with other diseases and 90 cases of healthy controls were collected ,the CCP were detected by latex CMIA and ELISA . Results The CCP positive were 141 cases in RA(72 .30% ) ,54 cases(51 .42% ) in arthritis ,15 cases in osteoporosis (28 .84% ) ,15 cases in connective tissue(35 .71% ) ,18 cases (45 .0% ) in systemic lupus erythematosus (SLE) ,11 cases (3 .60% ) in other disea‐ses .There were negative in 90 cases of healthy controls .The variation coefficient was 1 .9% -2 .0% ,and the total coefficient of var‐iation was 2 .0% -2 .1% .The linear range of Latex method was divided into 0 .8-100 U/mL .There were no diffrence in the sensi‐tivity and specificity of detection to CCP by CMIA ,ELISA and Latex .Conclusion The sensitivity and specificity of detection to CCP by Latex was good ,and there was wide linear range .
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Objective To explore the sensitivity and specificity of anti‐cyclic citrullinated peptide antibody (anti‐CCP antibody) and anti‐keratin antibody (anti‐AKA antibody) detection for diagnosing rheumatoid arthritis (RA) and the application value of their combination detection in the diagnosis and treatment of RA .Methods The chemiluminescent microparticle immunoassay and indi‐rect immunofluorescence analysis were adopted to detect anti‐CCP antibody and anti‐AKA antibody in 80 cases of RA ,40 cases of other auto‐immune diseases(AID) and 30 people undergoing the physical examination .Results The positive rates of anti‐CCP anti‐body and anti‐AKA antibody in the RA group were significantly higher than those in the non‐RA group and control group ,the differences were statistically significant (P< 0 .05) .The sensitivity of single anti‐CCP antibody detection in the RA group was 73 .8% ,which was higher than 41 .3% of anti‐AKA antibody ,while the specificity of single anti‐CCP antibody detection was 86 .2% ,which was lower than 95 .7% of anti‐AKA antibody detection .In their combined detection ,the sensitivity and specificity were increased .Conclusion The anti‐CCP antibody detection has higher sensitivity and specificity for diagnosing RA .Its combined detection with anti‐AKA antibody can avoid the missed diagnosis of atypical clinical early stage RA ,which has a higher clinical value in the diagnosis and prognosis of RA .
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Objective To investigate the expression of antinuclear antibodies(ANA) ,anti‐cyclic citrullinated peptide antibody (anti‐CCP) in elderly patients with rheumatoid arthritis(RA) ,and analyze its relation with depression .Methods ANA ,anti‐CCP were detected in 58 elderly RA patients ,50 non‐RA and 50 healthy people .Self‐rating Depression Scale(SDS) was used to assess the incidence of depression .Results The positive rate of anti‐CCP in RA group was significantly higher than that in control group and non‐RA group(P0 .05) .The positive rates of anti‐CCP and ANA in active stage were significantly higher than those in stable stage(P<0 .05) .The positive rates of anti‐CCP and ANA in RA complicated with depression were significantly higher than those in RA without depression(P<0 .05) .Multiple linear regression analysis showed that positive rates of anti‐CCP and ANA were all in‐dependent influence factors of depression in elderly RA patients(P<0 .05) .Conclusion Anti‐CCP and ANA in elderly RA patients over express ,and the positive rates are positively related with disease activity and depression .
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Objective To investigate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody(anti-CCP antibody),rheumatoid factor(RF),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in the diagnosis of rheu-matoid arthritis(RA).Methods The detection results of the four serum indicators of 290 cases of patients with RA(RA group), 286 cases of patients with non-RA autoimmune diseases(non-RA group)and 1 50 cases of healthy individuals(control group),from March 2013 to August 2014 in this hospital,were retrospectively analysed.Results The serum levels of the four indicators have significant differences among the three groups,between the RA group and non-RA group,and between the RA group and control group(P =0.000).Between non-RA group and control group,there was significant difference of serum levels of anti-CCP antibodies (P =0.013),while the other three serum indicators had no significant differences (P >0.05).The sensitivity of combined detection of anti-CCP antibody and RF,combined detection of anti-CCP antibody,RF and CRP,combined detection of anti-CCP antibody,RF and ESR,and combined detection of anti-CCP antibody,RF,CRP and ESR for RA diagnosis have statistically significant differences (P 0.05 ).The area under a receiver operating characteristic (ROC) curve of anti-CCP antibody,RF,CRP and ESR were 0.873,0.893,0.678 and 0.747,respectively. Conclusion Combined detection of anti-CCP antibody and RF has good specificity and sensitivity,which could improve the clinical diagnosis of RA.Combined detection of CRP and ESR could improve the detection rate of RA.
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Objective To evaluate the effectiveness of using anti‐cyclic citrullinated peptide (anti‐CCP) antibody or rheumatoid factor(RF) as the single laboratory parameter for rheumatoid arthritis(RA) diagnosis ,versus to using the two parameters in com‐bination .Methods A total of 56 cases of patients with RA were enrolled into RA group ,other 34 cases of patients with out RA were enrolled into non‐RA group .Levels of anti‐CCP antibody and RF were detected by using electro‐chemiluminescence immunoas‐say(ECLIA)and compared between the two groups .And the diagnostic efficacy of single and combined detection of anti‐CCP anti‐body and RF were evaluated .Results The levels of anti‐CCP antibody and RF in the RA group were higher than those in the non‐RA group ,had statistically significant differences(P<0 .05) .In diagnosis of RA ,the areas under receiver operating characteristic (ROC)curve of anti‐CCP antibody and RF were 0 .925 and 0 .822 respectively .The sensitivity and specificity of anti‐CCP antibody were both higher than those of RF .Compared with single detection of anti‐CCP antibody ,there was no significant increase of sensi‐tivity in using anti‐CCP antibody/RF ,whereas the specificity dropped significantly .Combined detection of anti‐CCP antibody and RF ,compared with single detection of anti‐CCP antibody ,had significantly lower sensitivity ,but no significant changes were found in specificity .Conclusion Single detection of anti‐CCP antibody is more effective than RF for diagnosing RA ,while combined detec‐tion of anti‐CCP antibody and RF could not significantly improve the specificity and sensitivity .It is suggested to only use anti‐CCP antibody for diagnosis of RA .
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Objective To evaluate the diagnostic values of enzyme‐linked immunosorbent assay (ELISA ) and colloidal gold im‐munochromatographic assay in detecting serum anti‐cyclic citrullinated peptide(anti‐CCP) antibody .Methods Colloidal gold immu‐nochromatographic assay and ELISA were used to detect serum anti‐CCP antibody in 110 RA patients and 110 healthy cases . Results The data were analysed with the paired Chi‐Square Test (χ2 = 174 .354 ,P < 0 .01) ,the difference was significant .The K ap pa value was 0 .890(P< 0 .01) ,indicating that the coincidence between the two kinds of methods was good .The sensitivity , speciality of ELISA were 83 .64% and 92 .73% respectively .Conclusion In detecting serum anti‐CCP Antibody ,there was dife‐rence between colloidal gold immunochromatographic assay and ELISA according to statistics analysis .The sensitivity and speciality of ELISA were higher than those of colloidal gold immunochromatographic assay .
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Objective To study the concentration of anti-cyclic citrullinated peptide antibody (CCP),rheumatoid factor (RF),immunoglobulin (Ig) in synovial fluid and serum of patients with rheumatoid arthritis (RA),and the positive rate of anti-keratin antibodies (AKA) and anti-perinuclear factor (APF) were also measured.The aim was to explore the diagnostic value of these antibodies in synovial fluid for RA.Methods Thirty RA patients were collected,synovial fluid were withdrawn from the inflamed joints and peripheral blood were collected at the same time.Anti-CCP antibody,AKA,APF and RF were measured.The cut-off value of CCP in synovial fluid was determined through operating characteristic curve (ROC curves) analysis.The antibody levels in serum and synovial fluid were compared.Statistical analyses were performed using t test,and Pearson's correlation test.Results The cutoff value of CCP in RA synovial was higher,which was 29.00 U/ml,with the sensitivity of 87.00％ and specificity of 94.10％.There were significant differences in the concentration among anti-CCP antibody [(326±313) U/ml,(496±454) U/ml,t=-2.399,P＜0.05],IgG [(57±39) mg/L,(173±86) mg/L,t=-7.4792,P＜0.05),RF [(53±36) U/ml,(149±104) U/ml,t=-2.402,P＜0.05] in synovial and blood serum respectively in RA patients.Conchsion The diagnosis of RA is enhanced if anti-CCP antibodies,RF and IgG in synovial fluid are examined.They are supplementary to RA diagnosis and are helpful for clinical practice,especially for patient with very recent-onset RA.
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Objective To evaluate the clinical value of Sharp-van der Heijde score (SHS)in rheumatoid arthritis (RA).Methods Clinical and X-ray of hands data in 200 patients with RA met the ACR criteria were collected in this study.Clinical DAS28,anti-cyclic citrullinated peptide antibody (aCCP)and imaging SHS were used to evaluate the activity of RA quantitatively before and after treatment.Results A moderate correlation existed between SHS and DAS28 (r s =0.61,P =0.00),but there was no significant cor-relation either between SHS and aCCP (r s = -0.1 5,P =0.03)or between aCCP and DAS28 (r s =0.14,P =0.05 ).Significant differences before and after treatment was existed in SHS (t=24.27,P =0.00)and DAS28 (t=1 5.98,P =0.00)respectively.And there was a moderate correlation between the difference in SHS before and after treatment and aCCP (r s =0.66,P =0.00).Conclu-sion The SHS,DAS28 and the aCCP in RA are closely related.Combination of three methods will help to develop the clinical pro-grams,evaluate the efficacy and prognosis.
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Objective To investigate the detection of anti-cyclic citrullinated peptide(anti-CCP)antibody,alkaline phosphatase (ALP),glucose-6-phosphate isomerase(G6PI)and rheumatoid factor(RF)in the diagnosis of rheumatoid arthritis(RA).Methods Serum RF,anti-CCP body,ALP and G6PI were detected in 206 cases of RA,68 cases of other autoimmune diseases and 48 persons with the healthy physical examination,at the same time the erythrocyte sedimentation rate(ESR)was measured;the sensitivity and specificity of each indicator and the relationship between each index and RA′s diagnosis.Results The serum level of each index in the RA group was significantly higher than that in the other two groups(P <0.05).The sensitivity of RF,anti-CCP antibody and G6PI for diagnosing RA is similar;the specificity of anti-CCP body was highest(94.8%),RF was similar to G6PI;ALP with rela-tively lower sensitivity and specificity also reflected the potential of RA to some extent.Conclusion The simultaneous detection of serum RF,anti-CCP body,G6PI and ALP can improve the accuracy of early diagnosis of RA,reduce the missed diagnosis and guide the clinical treatment.
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Objective To investigate the changes and significance of serum anti-CCP (ACCP)antibody,matrix metalloprotein-ase-3 (MMP-3 ),interleukin-17 (IL-17 ),interleukin-18 (IL-18 )in the patients with rheumatoid arthritis (RA).Methods The ELISA method was adopted to detect the in the peripheral blood serum ACCP antibody,MMP-3,IL-17 and IL-18 in 80 patients with RA,32 patients with osteoarthritis (OA)and 32 cases of healthy controls and the detection results were performed the statis-tical analysis.Results The ACCP antibody,MMP-3,IL-17 and IL-18 levels in the RA group were significantly higher than those in the OA group and the healthy control groups;the ACCP antibody,MMP-3,IL-17 and IL-18 levels in the low,middle and high RA activity groups were higher than those in the stable group,the ACCP antibody,MMP-3,IL-17,IL-18,disease activity score (DAS28),C-reactive protein (CRP)and erythrocyte sedimentation rate(ESR)in the RA group were increased;the MMP-3,IL-17, IL-18 and DAS28 in the ACCP antibody positive group were higher than those in the A CCP antibody negative group;the positive correlation existed among the ACCP antibody,MMP-3,IL-17 and IL-18 in the RA group (P <0.05);the ACCP antibody,MMP-3, IL-17 and IL-18 were positively correlated with the monitoring indicators of CRP and DAS28 in the low,middle and high RA activi-ty groups.Conclusion MMP-3,IL-17 and IL-18 participate in the occurrence and development process of RA;The detection of ser-um ACCP antibody,MMP-3,IL-17 and IL-18 has a certain value in the judgment of disease activity,and prevention and treatment in the patients with RA.
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Objective To explore the diagnostic value of anti-cyclic citrullinated peptide (CCP) 3.1 IgG/IgA antibody detected by enzyme-linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA).Methods The ELISA was used to measure the anti-CCP3.1 antibody in the serum of 169 RA patients,100 patients with other rheumatic diseases (including systemic lupus erythematosus,Sjogren's syndrome and osteoarthritis) and 72 healthy controls.The diagnostic value of CCP3.1 was assessed and compared with the second generation of anti-CCP IgG (CCP2) antibody,the correlations between anti-CCP3.1 antibody and the clinical and laboratory parameters were analyzed.Two-independent samples t test,chi-square test and Spearman's correlation were adopted for statistical analysis.Results ① The average cut-off concentration of anti-CCP3.1 antibody was (1122±1429) U/ml in RA,(13±14) U/ml in other rheumatic diseases and (6±5) U/ml in healthy controls.② The area under curve of ROC for anti-CCP3.1 antibody and anti-CCP2 antibody were 0.923 and 0.936 respectively.There was no difference between the sensitivity (82％ vs 79％)and specificity (97％ vs 99％) of anti-CCP3.1 antibody and anti-CCP2 antibody.The Kappa values between anti-CCP3.1 antibody and anti-CCP2 antibody was 0.763.③ We also found that anti-CCP3.1 antibody was positive in 20％(7/35) of anti-CCP2 antibody negative,43％(18/42) of RF negative,62％(47/76) of AKA negative,71％(49/69) of APF negative and 13％ of autoantibodies negative patients,indicated that antiCCP3.1 antibody had a potential value in the diagnosis of serum negative patients with RA.④ The presence of anti-CCP3.1 antibody was correlated with RF,HRF-IgG,APF,AKA,GPI and IgA (P＜0.05),except disease activity.Conclusion The sensitivity of anti-CCP3.1 antibody is slightly higher than anti-CCP2 antibody.The Anti-CCP3.1 antibody is a very valuable parameter for the diagnosis of RA,especially in serum negative patients.
ABSTRACT
Objective The aim of this study was to assess the relationship between the level of anti-CCP antibody and cardiovascular(CV) risk in rheumatoid arthritis(RA) patients.Methods A total of 78 RA patients were enrolled in the study.They were divided into two groups:40 cases with CV comphtations which were secondary from RA and 38 cases with no complications.The anti-CCP antibody was diagnosed by enzyme - linked immunoabsorbent assay(ELISA) and rheumatoid factor(RF) were assessed by immunoturbidimetry method.The relationship between the levels of the two sera auto-antibodies and CV disease associated with RA was analyzed.Results The results showed that the level of anti-CCP antibody in RA-CV disease group was significantly higher than that in simple RA group(74.6％ VS 87.3％ ).Compared with the simple RA group,the level of anti-CCP antibody in the RA-CV disease group was higher,and with significant difference between the two groups( x2 =5.07,9.04,6.48,all P ＜ 0.05 ).RF positive rate was 95.8％ of the patients with RA-CV disease while it was 76.5％ in simple RA group,and the difference between the two groups was statistically significant( x2 =33.41,26.05,34.14,all P ＜ 0.05 ).The morbidi ty between the different level of RF had remarkable difference.In RA patients with CV complations,we compared antiCCP antibody and RF by Spearman analysis,whish showed no relationship between them ( r =0.301,P =0.174 ).Conclusion The results indicated that CV disease secondary from RA was more common in old patients.In RA patients the high level of anti-CCP antibody and RF maybe play an important role in the appearance of CV disease.