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Objective To investigate the value of G6PI in the diagnosis of rheumatoid arthritis(RA).Methods The clinical data of 130 cases of patients with RA treated in the hospital from August 2011 to August 2013 were statistically analyzed.In addition to that,85 non-RA patients with other rheumatic diseases were recruited as non-RA group and 60 healthy people were recruited as control group.Results Serum G6PI,anti-CCP antibodies and RF concentrations of RA group were significantly higher than those of non-RA group and control group(P <0.05),the RF concentrations of non-RA group was significantly higher than those of con-trol group(P <0.05).The positive rates of G6PI,anti-CCP antibodies and RF tests were 67.7%(88/130),52.3%(68/130)and 75.4% (98/130)respectively in RA group,which were significantly higher than those in non-RA and control group(P <0.05),the serum RF concentrations in non-RA group were significantly higher than control group(P <0.05).The sensitivity,negative predic-tive value and Youden index of G6PI were significantly higher than those of anti-CCP and RF(P <0.05).Serum G6PI concentra-tions of RA patients was positively correlated with those of RF(r=0.732,P <0.05).Conclusion G6PI detection can be used in the diagnosis of RA,and is of great value.
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Objective:To investigate the diagnostic values of anti-cyclic citrullinated peptides antibody ( anti-CCP ) and rheumatoid factor( RF) in rheumatoid arthritis( RA) ,and analyse the clinical relevance of prognosis,drug reaction and bone destruction between anti-CCP and RA.Methods: Serum anti-CCP was detected by enzyme-linked immunosorbent assay ( ELISA ) , and RF was detected by immune rate nephelometry.Results:The sensitivity and specificity of anti-CCP in RA were 83.0%and 96.7%,while the sensitivity and specificity of RF in RA were 76.0%and 70.0%.When joint detect anti-CCP and RF,with anti-CCP or RF positive as a positive determination,with anti-CCP and RF negative as a negative judgment,the combined sensitivity was 87.0%,higher than that of detection alone.The combined specificity was 98.3%, higher than that of single detection.There were big different concentrations of anti-CCP among RA patients before treatment, three months after treatment and six months after treatment.There were significant differences between bone erosion and non-bone erosion in RA patients.And the more serious joint damage,the higher the concentrations of anti-CCP.As for treatment,anti-CCP concentrations declined.Conclusion:Combined detection of anti-CCP and RF can significantly improve the diagnosis and differential diagnosis of RA.The concentration of anti-CCP can change with effective treatment,then dynamic monitoring can be used as study drug efficacy.At the same time,the level of anti-CCP in patients with RA can reflect the degree of bone erosion,and serious bone destruction who was poor treatment effect.
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Dentro de las enfermedades autoinmunes, la Artritis Reumatoide es una de las más estudiadas, dada su alta prevalencia. Numerosos estudios han reportado como posible mecanismo gatillante la existencia de una respuesta inmune contra el Colágeno tipo II. El presente trabajo busca contribuir al conocimiento y significación de este proceso, a través de la determinación de diferentes auto-anticuerpos en sujetos con Artritis Reumatoide (diagnosticados bajo criterios del American College of Rheumatology) y en sujetos con artralgias inespecíficas en comparación con sujetos normales. Para esto, se realizó un estudio descriptivo, de corte transversal, en el que se determinó la presencia, en sueros, de anticuerpos anti-colágeno tipo II y de anticuerpos anti-Péptidos Cíclicos Citrulinizados (CCP) por ELISA y de Anticuerpos anti-sinovial por Inmunofluorescencia Indirecta (IFI) con métodos previamente estandarizados de acuerdo a procedimientos convencionales. No se encontró diferencia significativa entre los promedios de los niveles de los anticuerpos anti-colágeno tipo II en los 3 grupos; sin embargo, la distribución de los títulos de anticuerpos presenta, en los tres grupos, curvas de frecuencia de tipo bi-modal cuyos perfiles son totalmente diferentes entre ellos. En este orden, se identificó un subgrupo conformado por el 20 por ciento del grupo con Artritis Reumatoide quienes presentaban anticuerpos anti-colágeno tipo II con niveles muy altos, por encima de las dos desviaciones estándar; dichos sujetos correspondían a adultos jóvenes (edad promedio 41 años) que no recibieron tratamiento inmunosupresor. No se encontró ninguna correlación entre los niveles de anticuerpos anti-colágeno tipo II, los anticuerpos anti-CCP, y los de anticuerpos anti-sinovial. Se discute la significación de estos hallazgos.
Between the Autoimmune Diseases, Rheumatoid Arthritis (RA) is one of the most studied, due to its high prevalence. Several studies have reported as possible shooting mechanism the existence of an immune response against Collagen type II. The present work look for contributing to the knowledge and meaning of the autoimmune process through determinations of different serum antibodies in subjects with Rheumatoid Arthritis (diagnosed under the American College of Rheumatology criteria) and in subjects with unspecific arthralgia in comparison with normal subjects. For this purpose, a transversal descriptive study was carried out, determining the presence of anti-collagen type II antibodies, anti-CCP (Citrulinated Cyclic Peptides) antibodies and anti-synovial antibodies by indirect immuno fluorescence (IFI) in sera, using previously standardized methods according to conventional procedures. No significant differences was found between the averages of the levels of anti-collagen type II in the 3 groups; however, the distribution of the antibody titles shows, in the three groups, curves of frequency of a bi-modal type, with profiles totally different between them. In this order, inside the group with Rheumatoid Arthritis it was identified a subgroup formed by the 20 percent of the subjects that presents very high levels of anti-collagen type II Antibodies (over the two standard deviations), made by young adults (average age 41 years) that did not receive inmunosuppresive treatment. It was not found relationship between the levels of anti-collagen type II antibodies, anti-CCP antibodies and anti-synovial antibodies. The significance of these findings is discussed.
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Anticuerpos/análisis , Artritis ReumatoideRESUMEN
Objective To determine the prevalence of antibodies to cyclic citrullinated peptides (antiCCP) in patients with juvenile-onset systemic lupus erythematosus (JSLE) and its potential clinical significance. Methods Anti-CCP was measured in sera from patients with JSLE (n=47), juvenile idiopathic arthritis (JIA, n=54) and the sera from age-matched healthy children (n=40) using the third generation of anti-CCP ELISA commercial kit. The association of anti-CCP with other laboratory parameters and clinical features, especially arthritic symptoms in JSLE was also analyzed. T-test, Mann-Whitney U test, Chi-square and Fisher's exact test were used for statistical analysis. Results Out of the 47 JSLE patients, 6 (13%) were anti-CCP positive, which was significantly higher than that of the healthy controls( 13% vs 0, P＜0.05 ), but not different from that of the JIA group (26%, P=0.098). RF was more prevalent in JSLE patients with anti-CCP than patients without (83% vs 15%, P＜0.01 ), but there was no difference in other laboratory parameters and the clinical features ineluding the occurrence of arthritis (67% vs 51%, P＞0.05). As one of the initial symptoms, arthritis was observed in 25 of 47 JSLE patients and no one had developed deforming arthropathy.There was no statistical difference in anti-CCP positivity between JSLE patients with and without articular involvement ( 16% vs 9%, P＞0.05 ). Anti-CCP was not detected in any of the 3 patients with JSLE who had experienced joint pain and limited activity during 3 years follow-up. Conclusion Anti-CCP could be detected in patients with JSLE. It is noteworthy when differentiate from juvenile idiopathic arthritis, but the presence of anti-CCP does not relate with the occurrence of arthritis at presentation and persistence of arthritis in JSLE.
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Objective To investigate the clinical significance of anti-cyclic citrullinated peptides antibodies (anti-CCP) in systemic lupus erythematosus (SLE) patients with arthritis.and to explore the association of anti-CCP with erosive arthritis in SLE patients.Methods Serum samples from 138 SLE patients were examined for anti-CCP with the second generation anti-CCP detection commericial kit.The association between anti-CCP antibodies and clinical features as well as laboratory parameters.especially arthritis,in these SLE patients were analyzed.Results The frequency of anti-CCP was 13.8% (19/138) in this group of SLE patients.Seventy of 138 SLE patients had experienced arthritis.of whom 14 were anti-CCP positive.Anti-CCP antibodies were more frequently detected in SLE patients with arthritis than those without arthritis (20% vs 7.4%,P＜0.05).A statistical correlation between anti-CCP and rheumatoid factor (RF) was found in SLE patients with arthritis (r=0.36,P=0.002).The frequency of arthritis was significantly higher in SLE patients with anti-CCP than without (73.7% vs 47.1%,P＜0.05).Eight out of 138 SLE patients showed ioint erosions on radiographs.When compared with anti-CCP negative patients,erosive arthritis occurred more often in anti-CCP positive patients (35.7% vs 5.4%.P＜0.001).Interestingly.two patients without anti-CCP and RF but with erosive arthritis were anti-RA33 antibodies positive.All 8 SLE patients with erosive arthritis in our study fulfilled 1987 ACR criteria for RA.With regard to other clinical and laboratory features.there were no differences between SLE patients with or without arthritis or between patients with positive and negative anti-CCP antibodies.Conclusions Anti-CCP antibodies have a prevalence of 13.8% in our group of SLE patients and its presence is closely associated with arthritis.Moreover,the presence of anti-CCP antibodies may be a good marker to predict the outcome of SLE arthropathy.
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Antibodies to citrullinated peptides are highly specific for rheumatoid arthritis (RA) and represent a significant risk factor for undifferentiated polyarthritis. This prognostic ability may be related to the very diagnostic performance of these autoantibodies, since RA is a more erosive disease than other forms of arthritis. The present study evaluated an association of antibodies to citrullinated peptides and the rate of joint destruction in patients with a well-established diagnosis of RA. Seventy-one patients with RA were evaluated in 1994 and again in 2002 (functional class, joint count, Health Assessment Questionnaire score, hands X-ray). Autoantibodies (rheumatoid factor (RF), anti-perinuclear factor, anti-cyclic citrullinated peptide (CCP) antibodies) and Sharp's index were analyzed blindly. Delta Sharp was calculated as the difference in Sharp's index obtained in 1994 and 2002. During the follow-up the Health Assessment Questionnaire score increased from 0.91 ± 0.74 to 1.39 ± 0.72 (P < 0.001). Similarly, the number of swollen joints increased from 4.6 ± 5.71 to 6.4 ± 4.1 (P = 0.002). The frequency of autoantibodies and anti-CCP titer remained stable; however, serum RF concentration increased from 202.8 ± 357.6 to 416.6 ± 636.5 IU/mL (P = 0.003). Sharp's index increased from 56.7 ± 62.1 to 92.4 ± 80.9 (P < 0.001). No correlation was observed between Delta Sharp and the presence of RF, anti-perinuclear factor, and anti-CCP antibodies at baseline. Antibodies to citrullinated epitopes are specific and early markers for the diagnosis of RA but do not seem to be associated with the rate of joint destruction in patients with a well-established diagnosis of RA.