Link between Dimethyl arginine Derivats and Acpa Antibodies in Patients with Rheumatoid Arthritis

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Introduction: When establishing new diagnostic method for detection of the endothelial dysfunction in Rheumathoid arthritis (RA), it is necessary to compare the diagnostic values with other laboratory variables. Aim: The aim of this study is to determine the association between the asymmetric dimethylarginine (ADMA) and anti-cyclic citrullinated peptide antibodies (ACPA, Anti-CCP2) of the second generation in RA and to explain their connection in the process of citrulination of autoantigens in RA. Also, to determine the association between ADMA and the acute phase reactants: Rheumatoid factor (RF), C-reactive protein (CRP), as well as the index of disease intensity (DAS28) in early diagnosis in non-treated RA patients and to determine whether the amount of ADMA changes in the course of the evolution of disease. Methods: Using the ELISA method (DLD-Diagnostika-GMBH for ADMA and Bio Systems S.A. Reagens and Instruments Costa Brava 30, Barselona, Spain), the sera of 70 subjects have been examined (35 RA not-treated, 35 healthy control group). Results: Of 35 patients with RA, presence of ADMA was detected in 13 patients (37.14%); RF was present in 17 patients (48.57%), while anti-CCP2 antibodies were present in 23 patients (65.71%). Of 18 patients who were RF negative, ADMA was detected in 9 patients (50%), while 11 patients (31.43%) were anti-CCP2 positive. In 17 RF positive patients with RA, ADMA was detected in 4 patients, while 12 patients (34.28%) were anti-CCP2 and RF positive. In the healthy control group 8 patients (22.85%) showed ADMA positivity. There was moderate correlation between ADMA and anti-CCP2 antibodies in the group of patients with RA (r=0.34). Conclusion: There was an association between ADMA and anti-CCP2 antibodies of the second generation in patients with RA.