Anti-cyclic Citrullinated Peptide Antibody Levels Research Articles

Characteristics of primary Sjogren's syndrome with articular manifestations at initial treatment.

Articular manifestations have been reported in 19.3%-53.5% of patients with primary Sjogren's syndrome. Our aim was to profile the clinical characteristics of Chinese patients with primary Sjogren's syndrome who presented with articular manifestations at the time of initial treatment. We conducted a retrospective study of 129 primary Sjogren's syndrome patients admitted to the second Affiliated Hospital of Dalian Medical University between April 2016 and December 2021 for initial treatment. Clinical and serological features, extra-articular involvement, and initial treatment were compared between primary Sjogren's syndrome patients with and without articular manifestations. Fifty-seven (44.2%) primary Sjogren's syndrome patients had articular manifestations (mean age at diagnosis: 53.4 years), of which 42 (73.7%) presented with symmetrical distribution, 21 (36.8%) patients had rheumatoid factor positivity, and 11 (20.0%) patients had anti-cyclic citrullinated peptide antibodies positivity (mean 6.8 RU/mL); imaging examinations showed no signs of structural damage in these patients. The presence of articular manifestations showed positive correlation with anti-cyclic citrullinated peptide antibody level (odds ratio (OR) 1.01, 95% confidence interval (CI): 1.00-1.02; p = 0.049), C-reactive protein level (OR 1.15, 95% CI: 1.10-1.20; p = 0.000), and European League Against Rheumatism Sjogren syndrome disease activity index scores (OR 1.18, 95% CI: 1.11-1.25; p = 0.000). Ninety (69.8%) primary Sjogren's syndrome patients received hydroxychloroquine therapy. Hydroxychloroquine treatment was significantly less frequently used in articular manifestation patients (35 (70.0%) vs 55 (85.9%); p = 0.038). Symmetrical polyarthritis was the most common clinical manifestation of primary Sjogren's syndrome patients with articular manifestations in this cohort. Articular manifestations were associated with higher prevalence of C-reactive protein level, and European League Against Rheumatism Sjogren syndrome disease activity index score.

Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor and the Relationship between Periodontitis and Rheumatoid Arthritis

The purpose of this study is to determine the concentration of Rheumatic Factor (RF) and Anti-cyclic Citrullinated Peptide Antibody (ACPA) in serum and in Gingival Crevicular Fluid (GCF) and their dependence on the presence of periodontitis (P) and rheumatoid arthritis (RA). The study involved 81 patients divided into three groups: Group I – patients with P and without RA (with osteoarthritis) – 26 subjects; Group II – patients with P and RA – 30 subjects; Group III – patients with periodontal health (without P) and RA – 25 subjects. For all patients the levels of ACPA and RF (class IgM) have been analyzed by ELISA in serum and GCF. We found a significantly higher incidence of ACPA in the GCF positive individuals and significantly higher mean ACPA values in GCF in Group II patients compared to patients in Group I. We found a significant difference between the frequency of RF in the GCF positive patients in Group II compared to those in Group I as well as the RF in the GCF positive patients in Group II compared to those in Group III. In the study among the patients of Group II we found a significant correlation between the RF and ACPA concentrations in serum and the number of lost teeth. These results are associated with possible enhanced extraarticular synthesis of ACPA and RF in the periodontal tissues in patients with periodontitis and predisposed to RA. Evidence for the effect of RA on periodontitis is the correlation between the concentration of ACPA and RF in serum – biomarkers for RA and the number of lost teeth.

Musculoskeletal manifestations of leprosy.

A 32-year-old lady presented with a 1-month history of recurrent painful nodules over her legs and forearms (Fig. 1A), bilateral symmetric small- and large-joint polyarthritis, swelling of dorsal hands and feet, and dactylitis (Fig. 1B–D). The possibilities of sarcoidosis, tuberculosis, leprosy, SLE, lymphomatoid granulomatosis, and s.c. panniculitis-like T-cell lymphoma were considered. The patient did not have constitutional symptoms, lymphadenopathy, pulmonary or ocular involvement, thickened nerves, or an anaesthetic skin patch, and had no relevant medical family history. A skin biopsy from a nodule showed granulomatous inflammation of foamy macrophages and lymphocytes surrounding the neurovascular bundle (Fig. 1E). Her haemogram, liver and renal function tests, and electrolytes were normal. Her ESR was 42 mm and CRP 24.7 mg/dl, and RF, anti-cyclic citrullinated peptide antibody, ANA, serum angiotensin-converting enzyme levels, and viral markers were negative. A slit skin smear and PCR for Mycobacteriumleprae were positive. A diagnosis of lepra reaction—erythema nodosum leprosum with swollen hands and feet was made. She was treated with prednisolone (40 mg/day) and multidrug therapy (rifampicin, clofazimine and dapsone). All symptoms improved within days to weeks of starting treatment. Musculoskeletal manifestations in leprosy can either present acutely—lepra reaction, swollen hands and feet syndrome, tenosynovitis—or chronically—symmetric polyarthritis as in RA or Charcot’s arthropathy, and can mimic various rheumatic diseases [1]. Arthritis with skin nodules is rarely an initial presentation of Hansen's. Thickened nerves, anaesthetic skin patches, ear lobule infiltration, and anti-cyclic citrullinated peptide antibody levels may help in differentiating [2].

Knee alterations in rheumatoid arthritis: Comparison of US and MRI

ObjectiveThis study was designed to compare the diagnostic efficacy of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting changes in the knee of patients with rheumatoid arthritis (RA) and discover the possible association between the serological index and bone erosion detected by US.Patients and methodsIn this retrospective study, the US images and MRI findings of the knee in patients with RA from December 2017 to January 2020 were evaluated. Diagnostic outcomes were compared. The rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate, and anti-cyclic citrullinated peptide antibody (ACPA) levels of the patients were recorded. The relation between laboratory index and US findings was analyzed by multivariable logistic regression.ResultsUS showed remarkable accuracy, sensitivity, and specificity in diagnosing synovitis, bone erosion, and soft tissue swelling. In terms of reliability, the agreement between US and MRI was moderate to almost perfect. Meanwhile, a positive association between ACPA level and bone erosion was observed in patients with RA.ConclusionsUS may have a role as the initial imaging modality in patients with RA. Patients with higher ACPA levels may need more active treatment because they are more likely to have bone erosion detected by US.

Does periodontitis affect the treatment response of biologics in the treatment of rheumatoid arthritis?

BackgroundRheumatoid arthritis (RA) and periodontitis (PD) have been suggested to share many clinical and pathological features. However, few reports have investigated the relationship between the degree of PD and the treatment response to RA.This study aimed to examine the relationship between the extent of PD and the treatment response to biologics in RA patients using FDG-PET/CT.MethodsSixty RA patients (male, n = 14; female, n = 46; average age, 58.3 years) treated with biologic agents were included in this study. FDG-PET/CT was performed at baseline and 6 months after the initiation of biological therapy. The maximum standardized uptake value (SUVmax) was used as a representative value for the assessment of the FDG uptake in periodontal tissue and joints including the bilateral shoulders, elbows, wrists, hip, knees, and ankle joints. The Disease Activity Score (DAS) 28-CRP and the following clinical parameters were assessed: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide antibody (ACPA), rheumatoid factor (RF), and matrix metalloproteinase 3 (MMP-3). The relationship between the treatment response of RA and the baseline SUVmax of the periodontal tissue was evaluated.ResultsThe baseline periodontal SUVmax was related to patient age (r = 0.302, p = 0.009) and the ACPA level (r = 0.265, p = 0.025). The DAS28-CRP, CRP, ESR, MMP-3, and joint SUVmax values were significantly decreased after 6 months of biological therapy. However, the mean periodontal SUVmax, ACPA, and RF showed no significant changes after treatment. There was a significantly negative correlation between the baseline periodontal SUVmax and the treatment response of DAS28-CRP (r = − 0.369, p = 0.004).ConclusionThere was a negative correlation between the extent of PD at baseline and the treatment response of RA patients who received biological therapy. The evaluation of the periodontal condition is considered to be an essential part for the management of RA.

Hyperbaric oxygen in animal model of rheumatoid arthritis: Analysis Of HIF-1α, ACPA and IL-17a.

Antigen and collagen-induced arthritis (ACIA) is animal model of rheumatoid arthritis. The aim of this study was to identify the effect of different doses of hyperbaric oxygen (HBO) exposure in reducing inflammation on ACIA through analysis hypoxia inducible factor-1α (HIF-1α), anticyclic citrullinated peptide antibody (ACPA) and interleukine 17a (IL-17a). 24 male Balb/C mice were divided into 3 groups, 8 mice did not receive HBO exposure as a control group (G1) and 16 mice received HBO exposure as treatment group (G2 and G3). G2 was ACIA which was exposed to HBO 2.4 ATA O2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days. G3 was ACIA which was exposed to HBO 2.4 ATA O2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 5 consecutive days, break 5 days, 5 consecutive days.ACPA and IL-17a were measured by enzyme-linked immunosorbent assay (ELISA) technique. The expression of HIF-1α was measured by immunohistochemistry technique. There was significant decrease of ACPA levels, IL-17a levels and HIF-1α expression (P< 0.05) in G2 and G3 compared to G1. There was not significant decrease of ACPA levels (P> 0.05), there was significant decrease of IL-17a levels and HIF-1α expression (P<0.05) in G2 compared to G3. G2 was a group with a higher oxygen partial pressure than G3. HBO 2.4 ATAO2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days more effective in reducing inflammation than exposure 5 consecutive days, break 5 days, 5 consecutive days in ACIA. HBO has therapeutic potential for the treatment of RA.

ACPA IN SALIVA AND THEIR ASSOCIATION WITH PERIODONTITIS AND RHEUMATOID ARTHRITIS

Anti-cyclic citrullinated peptide antibodies (ACPA) are formed by the action of host-generated antigens and are part of the etiology of rheumatoid arthritis (RA). They are a sensitive and highly specific indicator of RA.&#x0D; MATERIALS AND METHODS&#x0D; In the study involved 105 subjects aged 32 to 85 years (Mean age 50,6 ±13,07), divided into four groups: Group I – with periodontitis (P) and without RA, with diagnosed osteoarthritis – 26 patients; Group II – with P and RA – 28 patients; Group III – without P and with RA – 26 patients; Group IV – without P and without RA – 25 individuals. All patients underwent clinical and laboratory tests for the diagnosis of RA and osteoarthritis, a clinical periodontal examination, and unstimulated whole saliva was collected.&#x0D; RESULTS&#x0D; We found significantly higher salivary ACPA levels in RA patients compared to healthy subjects (p &lt;0.0001). In P patients we found significantly higher levels of ACPA in saliva than in healthy subjects (p &lt;0.0001). Among P patients, we found a significant correlation between ACPA concentration in saliva and the following indicators: PISA; PD; BOP, respectively (p&lt;0.001), (p =0.003), (p =0.007). Among RA patients, our results showed a significant correlation of ACPA concentration in saliva with the following indicators: serum ACPA concentration (p &lt;0.0001); serum RF concentration (p &lt;0.0001); DAS-28 (CRP) (p=0.009).&#x0D; CONCLUSION&#x0D; Based on the established correlation between salivary ACPA levels and RA indicators, a high concentration of ACPA in saliva may be suggested as an easily accessible indicator of RA, but further studies are needed to ascertain this possibility. The established association between periodontal parameters and salivary ACPA levels confirms the effect of periodontal inflammation on salivary ACPA concentration and justifies the treatment of P as a way of preventing and controlling RA.

Ebola-Specific CD8+ and CD4+ T-Cell Responses in Sierra Leonean Ebola Virus Survivors With or Without Post-Ebola Sequelae.

Ebola virus (EBOV) disease has killed thousands of West and Central Africans over the past several decades. Many who survive the acute disease later experience post-Ebola syndrome, a constellation of symptoms whose causative pathogenesis is unclear. We investigated EBOV-specific CD8+ and CD4+ T-cell responses in 37 Sierra Leonean EBOV disease survivors with (n = 19) or without (n = 18) sequelae of arthralgia and ocular symptoms. Peripheral blood mononuclear cells were infected with recombinant vesicular stomatitis virus encoding EBOV antigens. We also studied the presence of EBOV-specific immunoglobulin G, antinuclear antibodies, anti-cyclic citrullinated peptide antibodies, rheumatoid factor, complement levels, and cytokine levels in these 2 groups. Survivors with sequelae had a significantly higher EBOV-specific CD8+ and CD4+ T-cell response. No differences in EBOV-specific immunoglobulin G, antinuclear antibody, or anti-cyclic citrullinated peptide antibody levels were found. Survivors with sequelae showed significantly higher rheumatoid factor levels. EBOV-specific CD8+ and CD4+ T-cell responses were significantly higher in Ebola survivors with post-Ebola syndrome. These findings suggest that pathogenesis may occur as an immune-mediated disease via virus-specific T-cell immune response or that persistent antigen exposure leads to increased and sustained T-cell responses.

Tumour necrosis factor alpha promotes secretion of 14-3-3\u03b7 by inducing necroptosis in macrophages

Background14-3-3η is an intracellular protein also detected in the serum and synovial fluid of patients with rheumatoid arthritis (RA). It is closely related to disease activity and anti-cyclic citrullinated peptide antibody levels. However, the main source of 14-3-3η and the mechanism of its release into the extracellular space remain unclear. Addressing these two points was the main goal of the current study.MethodsThe source of 14-3-3η was investigated by immunostaining RA synovial tissue. Fibroblast-like synoviocytes, CD4+ cells, and macrophages were selected as candidates among the various cell types in the synovial tissue. Phosphorylation of mixed-lineage kinase domain-like pseudokinase (MLKL) and cell death of macrophages were studied by phalloidin staining and electron microscopy after stimulation with an oxidative stress inducer (diamide) or tumour necrosis factor (TNF)-α. Extracellular 14-3-3η protein levels were examined by western blotting.ResultsMacrophages from the synovial tissue from RA, but not osteoarthritis, showed dense and widespread cytoplasmic staining for the 14-3-3η protein, co-localized with peptidylarginine deiminase 4. Swelling and membrane rupture of macrophages were induced by treatment with TNF-α, but not interleukin (IL) 6/soluble IL-6 receptor (sIL-6R). Increased MLKL phosphorylation followed by necroptosis was also induced in TNF-α-stimulated macrophages. Necrostatin-1, a necroptosis inhibitor, antagonized MLKL phosphorylation. High levels of 14-3-3η were detected in the culture supernatants of macrophages stimulated with diamide and TNF-α, but not IL-6/sIL-6R.ConclusionsMacrophages that highly express 14-3-3η undergo TNF-α-induced necroptosis with damage to the cellular structure, resulting in the secretion of 14-3-3η into the extracellular space. The current study provides a novel mechanism for 14-3-3η level increase in the RA synovial fluid.

Fire-needle Acupuncture Intervention Relieves Ankle-joint Inflammatory Reactions Possibly by Down-regulating Serum TNF-α and Anti-cyclic Citrullinated Peptide Antibody Levels in Collagen-induced Arthritis Rats

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)．. 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. The ankle diameter and serum concentrations of TNF-α and ACPA were significantly increased in the model group compared to the control group (P<0.05), and X-ray film showed swollen and deformed tarsus joints, and narrowing of the joint space. After the intervention, the ankle diameter, serum TNF-α and ACPA levels were considerably decreased in both medication and fire-needle groups compared with the model group (P<0.05). Meanwhile, the joint swelling and bone deformity became relatively milder. There were no significant differences between the medication and fire-needling groups in the ankle diameter and the contents of serum TNF-α and ACPA (P>0.05). 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.

The Association of Anti-Aminoacyl-Transfer Ribonucleic Acid Synthetase Antibodies in Patients With Rheumatoid Arthritis and Interstitial Lung Disease.

This study aims to analyze the distribution and clinicopathological characteristics of anti-aminoacyl-transfer ribonucleic acid (tRNA) synthetase (ARS) antibodies in rheumatoid arthritis patients. We retrospectively studied the anti-ARS antibody levels in 228 RA patients' (44 males, 184 females; mean age 62.9±14.0 years; range 23 to 88 years) sera from their medical charts. We determined the association with anti-cyclic citrullinated peptide antibody levels, interstitial lung disease (ILD), rheumatoid factor, and methotrexate or biological disease modifying antirheumatic drug treatments. Anti-ARS antibodies were detected in 14 RA patients (6.1%). ILD complications were significantly higher among anti-ARS antibody-positive patients (57.1% vs 22.4%, p<0.05). Levels of anti-threonyl-tRNA-synthetase (anti-PL-7) and anti-alanyl-tRNA-synthetase (anti-PL-12), two anti-ARS antibodies, were higher in RA patients with concurrent ILD (both p<0.05). Myositis and ILD worsening were not observed in three anti-ARS antibody- positive patients despite biological disease modifying antirheumatic drug administration. There was no difference in anti-cyclic citrullinated peptide and rheumatoid factor specificities between patients with or without ARS antibodies. Anti-ARS antibodies were detected in RA patients, with higher prevalence in patients with concurrent ILD. RA patients, specifically those with ILD complications, should be tested for anti-ARS antibodies.

Relationship between Serum 25-Hydroxyvitamin D Levels, Disease Activity and Anti-Cyclic Citrullinated Peptide Antibody Levels in Indian Rheumatoid Arthritis Patients

To evaluate the 25-OH vitamin D status in Rheumatoid Arthritis (RA) patients and to assess the relationship between serum 25-OH vitamin D levels with disease activity and anti-cyclic citrullinated peptide antibody levels.

Role of Serum cartilage oligomeric matrix protein (COMP) in the diagnosis of rheumatoid arthritis (RA): A case-control study.

ObjectiveTo analyse the role of serum cartilage oligomeric matrix protein (COMP) levels in the differential diagnosis of rheumatoid arthritis (RA).MethodsThis case–control study analysed the clinical and laboratory characteristics of patients with RA and healthy control subjects. The diagnostic ability of COMP for RA was evaluated by comparing it with anti-cyclic citrullinated peptide antibody levels. The sensitivity, specificity, positive and negative predictive values were calculated.ResultsThe study enrolled 82 patients with RA and 34 healthy control subjects. The serum COMP level was significantly higher in patients with RA compared with control subjects (mean ± SD 29.51 ± 9.21 ng/ml versus 17.85 ± 5.55 ng/ml, respectively). The serum COMP level was significantly higher in patients with active RA compared with patients with RA in remission (mean ± SD 33.08 ± 8.80 ng/ml versus 24.94 ± 7.65 ng/ml, respectively). The cut-off value for COMP to discriminate patients with RA from healthy individuals was 21.51 ng/ml (sensitivity 0.817, specificity 0.882, positive predictive value 0.944, negative predictive value 0.667, and accuracy 0.836).ConclusionThe serum COMP level has the potential to be used as a biological marker for differentiating between patients with RA and healthy individuals.

Serum Vitamin D Level is Inversely Associated With Anti-Cyclic Citrullinated Peptide Antibody Level and Disease Activity in Rheumatoid Arthritis Patients.

This study aims to assess the relationship between serum vitamin D and anti-cyclic citrullinated peptide (anti-CCP) antibody levels, as well as disease activity in patients with newly diagnosed rheumatoid arthritis (RA). These measurements were conducted between January 2014 and June 2014. Serum 25-hydroxy vitamin D (25-OH-D), anti- CCP antibody, and erythrocyte sedimentation rates were measured in a cohort of 154 patients (66 males, 88 females; mean age 53.5±12.4; range 29 to 79 years) with early RA. A control group of 60 healthy participants (25 males, 35 females; mean age 51.4±10.3; range 25 to 75 years) was only evaluated for serum 25-OH-D levels. Disease activity was measured by calculating the 28-Joint Disease Activity Score. Blood samples were drawn from cubital veins. After centrifugation, serum was collected and stored under minus 20 degrees. Vitamin D deficiency was more prevalent in RA group compared with control group (48.70% vs. 30.00%, p<0.05). Serum 25-OH-D levels were lower in RA group (19.46±8.20 ng/mL) than control group (23.18±6.71 ng/mL) (p<0.05). In the RA group, serum 25-OH-D levels were negatively correlated to anti-CCP antibody levels (rs= -0.360, p<0.001), erythrocyte sedimentation rate (rs= -0.270, p<0.001), age of patients (rs= -0.602, p<0.001), and disease activity (rs= -0.249, p<0.05), respectively. Serum 25-OH-D level did not vary according to sex in the RA group. In control group, females had lower serum 25-OH-D level (p=0.001, rs=0.404). In addition, serum 25-OH-D level was also negatively associated with age in control group (p<0.001, rs= -0.578). There were no differences between RA group and control group in terms of age and sex ratio. Serum 25-OH-D level was negatively correlated to anti-CCP antibody level and disease activity, which implied the therapeutic role of serum 25-OH-D in RA.

Association between -174G/C and -572G/C interleukin 6 gene polymorphisms and severe radiographic damage to the hands of Mexican patients with rheumatoid arthritis: a preliminary report.

Several interleukin 6 gene (IL6) polymorphisms are implicated in susceptibility to rheumatoid arthritis (RA). It has not yet been established with certainty if these polymorphisms are associated with the severe radiographic damage observed in some RA patients, particularly those with the development of joint bone ankylosis (JBA). The objective of the present study was to evaluate the association between severe radiographic damage in hands and the -174G/C and -572G/C IL6 polymorphisms in Mexican Mestizo people with RA. Mestizo adults with RA and long disease duration (>5 years) were classified into two groups according to the radiographic damage in their hands: a) severe radiographic damage (JBA and/or joint bone subluxations) and b) mild or moderate radiographic damage. We compared the differences in genotype and allele frequencies of -174G/C and -572G/C IL6 polymorphisms (genotyped using polymerase chain reaction-restriction fragment length polymorphism) between these two groups. Our findings indicated that the -174G/C polymorphism of IL6 is associated with severe joint radiographic damage [maximum likelihood odds ratios (MLE_OR): 8.03; 95%CI 1.22-187.06; P = 0.03], whereas the -572G/C polymorphism of IL6 exhibited no such association (MLE_OR: 1.5; 95%CI 0.52-4.5; P = 0.44). Higher anti-cyclic citrullinated peptide antibody levels were associated with more severe joint radiographic damage (P = 0.04). We conclude that there is a relevant association between the -174G/C IL6 polymorphism and severe radiographic damage. Future studies in other populations are required to confirm our findings.

CHANGES IN THE LEVELS OF ANGIOTENSIN II, ALDOSTERONE, AND FIBROBLAST GROWTH FACTOR IN PATIENTS WITH RHEUMATOID ARTHRITIS IN RELATION TO CLINICAL FEATURES

Angiotensin II, aldosterone, and fibroblast growth factor (FGF) stimulate neoangiogenesis, fibroblast proliferation, and elaboration of proinflammatory cytokines, which in turn contributes to increased pannus mass and the development of joint tissue destruction in rheumatoid arthritis (RA). Objective: to establish the specific features of changes in the blood levels of angiotensin II, aldosterone, and FGF in patients with RA in relation to the duration and severity of the disease. Subjects and methods. Examinations were made in 194 patients diagnosed with RA without comorbidity; the patients’ mean age was 47.7±10.2 years; the disease duration was 3.82±3.43 years. DAS28 scores for RA were calculated based on C-reactive protein levels. An enzyme immunoassay was used to determine the serum levels of anti-cyclic citrullinated peptide antibodies (ACCPA), angiotensin II, aldosterone, and FGF. Results and discussion. All the examinees were ascertained to have increases in the concentration of angiotensin II and aldosterone in blood by twice and in that of FGF by 2.5 times compared to the controls (p 5 years and the concentrations of aldosterone and FGF in patients with long-term RA were twice as high as in those with early RA. In patients with high RA activity, the blood level of angiotensin II was 1.5-fold higher than in those with low and moderate disease activity (p < 0.05). In patients with a high blood ACCPA level, the concentrations of angiotensin II, aldosterone, and FGF were 20, 30, and 25%, respectively, higher than in those with low ACCPA levels. The correlation of DAS28 with blood angiotensin II levels increased with enhanced RA activity. The high aldosterone and FGF values in RA patients are associated with the progression of joint radiographic changes.

Association of Anti-cyclic Citrullinated Peptide Antibodies with Clinical and Radiological Disease Severity in Rheumatoid Arthritis

This study assessed an association of anti-cyclic citrullinated peptide antibodies (ACPA) with clinical and radiological disease severity in patients with rheumatoid arthritis (RA). Fifty patients diagnosed with RA as per 2010 revised American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) classification criteria were included in this cross-sectional study. Serum levels of ACPA, C-reactive protein (CRP) and rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), disease activity score with 28-joint counts and ESR (DAS28-ESR), patient's global assessment of disease activity using visual analogue scale (PtGA-VAS), modified health assessment questionnaire score (M-HAQ) and radiological damage in hands and feet (modified Larsen score) were determined. ACPA were positive in 48 (96%) and RF in 44 (88%) patients. Mean Larsen score was 19.82 ± 17.11 and mean DAS28-ESR 6.39 ± 1.59. A significant correlation of ACPA levels was seen with RF (p=0.03) and Larsen score (p=0.02) but not with DAS28-ESR (p=0.17) and M-HAQ (p=0.81). A significant correlation was seen between Larsen score and disease duration (p<0.0001), age (p=0.04), DAS28-ESR (p=0.001) and M-HAQ (p<0.0001). Multivariate analysis showed that painful joint count (p=0.003), ESR (p<0.001) and PtGA-VAS (p=0.009) were independently associated with clinical disease activity severity. Disease duration (p=0.01), ACPA levels (p=0.004) and DAS28-ESR (p=0.03) were independently associated with radiological joint damage. Serum ACPA levels correlate significantly with radiological severity of RA but not with clinical disease severity and are independently associated with radiological outcome.

AUTOANTIBODY LEVELS INFLUENCES THE NUMBER AND PHENOTYPE OF INFILTRATING NEUTROPHILS IN INFLAMED JOINTS OF PATIENTS WITH RHEUMATOID ARTHRITIS

AUTOANTIBODY LEVELS INFLUENCES THE NUMBER AND PHENOTYPE OF INFILTRATING NEUTROPHILS IN INFLAMED JOINTS OF PATIENTS WITH RHEUMATOID ARTHRITIS

Measurement of Anti-Cyclic Citrullinated Peptide, Leptin Hormone, and Lipoprotein (a) In Iraqi Female Patients with Rheumatoid Arthritis

Back ground:-Rheumatoid arthritis is one of the most common forms of inflammatory polyarthritis, with a prevalence of approximately 0.8% of adults worldwide, Rheumatoid arthritis patients may become disabled within few years if untreated that may lead to permanent disability. Different biomarkers have been assessed for the improved diagnosis of Rheumatoid arthritis, including a wide range of autoantibodies. However, only rheumatoid factor (RF) and anti-cyclic citrullinated peptide (ACCP) have gained wide acceptance.&#x0D; Aim of the study to investigate the levels of ACCP, Leptin, and Lipoprotein (a) in females with RA to provide information on possible pathophysiologic mechanisms, and to give recommendations for determination of these parameters in diagnosis and follow up of Rheumatoid arthritis patients.&#x0D; Patients and methods:- The study included Forty women with RA and Thirty apparently healthy women with matching age and weight as controls.The patients were selected at the outpatient clinic of Rheumatology &amp; Rehabilitation in Medical City/ Baghdad Teaching Hospital during the period from (May2013 ) to (December2013 ). &#x0D; Results:-The results showed that levels of ACCP antibodies in serum of patients with RA were significantly higher than in serum of healthy control. Also there were significant differences between mean of serum leptin level and Lp (a) in patients compared to the control group.&#x0D; Conclusion:- Serum biomarkers like ACCP, Leptin, &amp; Lipoprotein (a) assays are becoming increasingly available and may help in early diagnosis and assessment of complications in Rheumatoid arthritis patients.

AB0440 What effect does the presence of bronchiectasis have on CCP antibody levels in patients with rheumatoid arthritis?

BackgroundIt is well established that anti cyclic citrullinated peptide (CCP) antibodies are a marker of rheumatoid arthritis (RA) and are associated with greater articular damage [1]. There is increasing evidence...