The Role of Collagen Triple-Helix Repeat-Containing 1 (CTHRC1) as a Diagnostic Biomarker for Rheumatoid Arthritis

Abstract

Background Many patients are seronegative for anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF), and there is a need for novel serological biomarkers to help close this serological gap and improve early diagnosis. The purpose of this study was to determine whether plasma levels of the collagen triple helix repeat containing 1 (CTHRC1) protein can serve as a blood-based biomarker for improved diagnosis of rheumatoid arthritis (RA) patients. Objective Evaluate the levels of the collagen triple helix repeat containing-1 (CTHRC1) protein in RA patients' serum in order to detect its role as a diagnostic biomarker in Rheumatoid Arthritis patients & determine its value in assessment of disease activity in Rheumatoid Arthritis patients. Methods This study included twenty five adult patients with clinical evidence of rheumatoid arthritis and twenty five healthy matched age and sex as control subjects. All underwent history taking, clinical examination, assessment of disease activity with modified Disease Activity 28 (DAS28), Laboratory investigations including Complete blood count (CBC), erythrocytes sedimentation rate (ESR), C-Reactive Protein (CRP), Liver function tests, Kidney function tests, qualitative assessment of RF, anti CCP Ab and CTHRC1 serum levels. Special attention had been given to patients (nine out of twenty five patients) diagnosed in early disease process (1-2 months). Results Serum levels of CTHRC1 were significantly higher in patients than control group (p > 0,001) with sensitivity of 100% and specificity of 88%. It showed significant positive correlation with Anti-CCP (r = 0.498) (p < 0.011) and with RF (t= -6.489) (p <<0.001) as diagnostic markers for RA. Serum levels of CTHRC1 showed statistically significant difference between patients in early, late disease process and controls. Conclusion serum CTHRC1 level was higher in RA patients which serve as a diagnostic marker for RA with statistically significant correlation with early disease process highlighting its role as a diagnostic marker for RA.