Serum anti-CCP Research Articles

A Case of Posterior Scleritis with Negative Rheumatoid Factor and Positive Anti-Cyclic Citrullinated Peptide Antibody Status: Case Report

Background: Posterior scleritis is a potentially vision threatening condition which is often underdiagnosed due to varied clinical presentation, several non-infectious inflammatory diseases can cause this disorder, although infectious diseases should be ruled out. Case presentation: A 56 years-old-female with acute unilateral decreased vision in right eye and positive history for rheumatoid arthritis (RA) was referred, based on ophthalmic examination the diagnosis of posterior scleritis was considered. The only positive inflammatory marker was found is high serum titer of Anti-Cyclic Citrullinated Peptide (Anti-CCP). Conclusion: This is the first case of posterior scleritis with only positive Anti-CCP. Elevated serum Anti-CCP titer may be considered as risk factor for inflammatory scleritis in patient with RA.

STUDY OF BIOCHEMICAL MARKERS IN ARTHRITIS PATIENTS

Introduction: The most prevalent kind of arthritis is osteoarthritis. It happens when joints are overworked and most commonly affects the elderly, although it can also affect persons who have had joint injuries or who are overweight. The weight-bearing joints, such as the knees, hips, foot, and spine, are the ones most prone to osteoporosis. It's a loss of cartilage that leads to inflammation and unpleasant motions.Arthritis is a disease that causes one or more joints to swell and become tender. The most typical symptoms of arthritis are joint pain and stiffness, which usually worsen with age.
 Aim: Study of Biochemical Markers in Arthritis Patients
 Material and Method: The study included 40 patients, 20 men and 20 females, ranging in age from 25 to 50 years old from Central India. All of the people in the study were healthy, with no congenital anomalies, inflammation, trauma, or orthopedic treatment.
 Result: comparison between Arthritis female and Arthritismale subject’s serum Anti CCP value are raised in Arthritis female subjects compare to male subjects the data show that statistically significant p-valve are P < 0.01.
 Conclusion: In Arthritis patients, Anti-CCP has become a key serologic marker. It can be utilized as a test for early identification of RA, differential diagnosis between RA and ASO other rheumatic or immunological disorders, prognosis prediction, and therapy outcome evaluation.
 Keywords: Anti-CCP, Arthritis, Osteoarthritis, subchondral, ASO

ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODIES VERSUS ANTI-MUTATED CITRULLINATED VIMENTIN ANTIBODIES IN JUVENILE IDIOPATHIC ARTHRITIS

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood and is of unknown etiology. Anti-cyclic citrullinated peptide antibodies (Anti CCP) and anti-mutated citrullinated vimentin antibodies (Anti MCV) may help in diagnosis of JIA. Objective: Measurement of anti CCP and anti MCV level in JIA patients, and healthy persons to assess its possible role in diagnosis. Patients and methods: This study included 70 patients with JIA, and 20 healthy volunteers with matched age and sex. We assessed serum anti CCP and anti MCV level in both groups by enzyme linked immunosorbent assay (ELISA). This study carried out over a period from July, 2019 to December, 2019. Results: Serum anti-CCP and anti-MCV level showed a statistical significant difference between control and patient groups. Conclusion: Anti-CCP as well as anti-MCV antibodies may be helpful in the diagnosis of JIA and should clearly be taken into consideration.

Synovial Anti Cyclic Citrullinated Peptide Antibodies in Comparison with Serum Antibodies in Early and Late Rheumatoid Arthritis

Aim: The study objective was to evaluate the diagnostic value of synovial fluid anti cyclic citrullinated peptide (sf-anti CCP) in comparison to serum anti CCP (s-anti CCP) in early and late rheumatoid arthritis and to clarify its correlation with disease activity. Methods: In this cross-sectional study a total of 45 patients aged between 18 and 70 years with rheumatoid arthritis (RA) according to the ACR criteria were enrolled. Twenty six patients had a disease duration of more than 2 years (late RA) whereas 19 cases were referred to as early RA (<2 yrs). Baseline characteristics and laboratory studies including complete blood count (CBC), erythrocyte sedimentation rate (ESR) in addition to anti CCP and rheumatoid factor (RF) levels in the serum and synovial fluid were recorded. Disease activity was assessed according to disease activity score of 28 joints - ESR (DAS28 - ESR). Results: Serum and synovial fluid anti CCP correlated significantly (p<0.001, r=0.6). Sf-anti CCP also significantly correlated with sf-RF (p=0.02, r=0.34). No correlation was found between sf-anti CCP and disease activity according to DAS28-ESR (p=0.38, r=0.13). There also was no statistically significant difference between early and late RA in terms of sf-anti CCP (p=0.9). Conclusion: The diagnostic value of sf-anti CCP for RA is similar to s-anti CCP. Therefore, sf-anti CCP can be useful if RA is suspected. The current study did not show any difference in sf-anti CCP between early and late RA and revealed no correlation with disease activity.

Correlation of hs-CRP Levels with Anti-CCP And Rheumatoid Factor Among Clinically Suspected Rheumatoid Arthritis Cases

Objective: Despite the wide availability of markers to diagnose the established disease of RA, there is lack of evidence for the suitability of any of these established biomarkers for diagnosing the disease at an early stage of its pathogenesis. Hs-CRP has the potential to be useful as a predictor of early inflammation in clinically suspected RA cases. Methods: 80 patients (40: anti-CCP positive; 40: anti-CCP negative) irrespective of their age and gender were enrolled. RF status and hs-CRP levels were determined in these patients. Correlation of hs-CRP levels with anti-CCP was done. Results: Mean anti-CCP levels among RF positive and negative cases were 410 U/ml and 62.4 U/ml respectively. Among both the groups of anti-CCP positive and negative patients, majority had hs-CRP levels between 50-60 mg/l. Hs-CRP levels were more than 6 mg/l in majority of the suspected arthritis cases irrespective of the anti-CCP or RF status. Mean hs-CRP levels were 50.8 and 43.6 mg/l among anti-CCP positive and negative cases respectively by unpaired t-test. There was no correlation between serum anti-CCP and hs-CRP levels among both anti-CCP negative and positive cases. Conclusions: Hs-CRP when used alone or in combination with other established markers, can aid in the early diagnosis, prediction of course of disease and assessment of response to treatment in RA cases.

Study on the effect and predictive to bronchiectasis combined with rheumatoid arthritis

Objective: To explore the clinical characteristics of bronchiectasis(BR)coexisting in patients with rheumatoid arthritis (RA). Methods: One hundred and forty-eight bronchiectasis patients were retrospectively analyzed. These cases were all diagnosed in the Respiratory Department of Shanghai Pulmonary Hospital and Shanghai Gongli Hospital of Pudong New Area during Jan. 2012 to Dec.2015.The patients consisted of 74 males and 74 females, aging from 45 to 79 [mean(65±11)] years. In these patients, coexisting rheumatoid arthritis was found in 34 males and 36 females, aging from 45 to 79[mean(68±12)] years(RA-BR group). Patients with bronchiectasis alone consisted of 40 males and 38 females, aging from 49 to 76 [mean(63±10)] years (BR alone group). Data between the 2 groups of patients were compared, including general clinical features, serum anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF), chest high-resolution CT (HRCT), and lung function . FACED scores were used to assess the severity of bronchiectasis. Meanwhile, we analyzed the correlation between anti-CCP and FACED scores in the 2 groups. Results: We observed an increase of serum anti-CCP in RA-BR patients compared with BR alone patients (196±68 versus 64±26, P<0.05). In addition, FACED scores in RA-BR patients were higher than those in BR patients (5.2±1.8 versus 3.1±1.4 , P< 0.05). Positive correlations between serum anti-CCP levels and FACED scores (r=0.678, r=0.461, P<0.05) in both RA-BR and BR alone groups were observed in this study. Conclusions: The disease severity scores of RA-BR patients were higher than those of patients with BR alone. Levels of serum anti-CCP may act as a predictor for the diagnosis and prognosis of bronchiectasis in patients with RA.

Anti-CCP is Associated with Greater Disease Burden in Kashmiri Population with Rheumatoid Arthritis

Aim: To analyse the diagnostic value of anti-cyclic Citrullinated Peptide (anti-CCP) and to associate it with disease severity in patients with rheumatoid arthritis in Kashmiri population. Methods: The serum levels of anti-CCP levels were measured in 150 RA patients and 30 healthy controls by ELISA technique. Result: 118 (78.66%) patients were positive for anti-CCP while none of the healthy controls were positive for the test. The mean ± SD serum anti-CCP levels were significantly (p 20 mm/h (p = 0.01), RF positivity (p = 0.0001) and High DAS28 Score (p = 0.0001). Conclusion: Serum anti-CCP is a very accurate marker for RA diagnosis and the patients with higher levels of anti-CCP have more aggressive form of disease. Therefore, its early detection may help clinicians in early diagnosis and appropriate management of the disease.

Significance of Anti-cyclic Citrullinated Peptide Autoantibodies in Immune-mediated Inflammatory Skin Disorders with and without Arthritis.

Background:Anti-cyclic citrullinated peptides (CCPs) are autoantibodies directed against citrullinated peptides. Rheumatoid factor (RF), an antibody against the Fc portion of IgG, is known to form immune complexes and contribute to the etiopathogenesis of various skin disorders. C-reactive protein (CRP), an acute-phase protein, increases following secretion of interleukin-6 from macrophages and T cells. Anti-CCP, RF, and CRP are well-established immune-markers, their diagnostic potential in immune-mediated skin disorders remains less widely studied.Aims and Objectives:To determine the correlation between anti-CCP, RF, and CRP in immune-mediated inflammatory skin diseases.Materials and Methods:About 61 clinically diagnosed cases of various immune-mediated skin diseases (psoriasis [n = 38], connective tissue diseases such as systemic lupus erythematosus and systemic sclerosis [n = 14], and immunobullous disorders including pemphigus vulgaris and pemphigus foliaceus [n = 9]) were included in the study. These patients were subclassified on the basis of presence or absence of arthritis. Arthritis was present in nine cases of psoriasis and seven connective tissue disorder patients. Detection of serum anti-CCP was done using enzyme-linked immunosorbent assay, whereas CRP and RF levels were detected using latex agglutination technique.Results:Of the 61 specimens, 14.75% had elevated serum anti-CCP levels. RF and CRP levels were elevated in 18.03% and 39.34% specimens, respectively. RF was elevated in 13.16% of inflammatory and 42.88% of connective tissue disorders, whereas anti-CCP was raised in 10.53% of inflammatory and 35.71% of connective tissue disorders. CRP positivity was highest in connective tissue disorders (50%), followed by 39.47% in inflammatory and 22.22% in immunobullous conditions. In none of the immunobullous patients, anti-CCP or RF levels were found to be elevated. Association of the presence of arthritis with elevated anti-CCP was found to be statistically significant.Conclusions:Although anti-CCP, RF, and CRP levels are valuable markers of chronic immune-mediated skin disorders, elaborate studies enrolling a larger number of patients are required to validate these diagnostic markers.

LEVELS OF ANGIOGENESIS-REGULATORY CHEMOKINES IN THE SYNOVIAL FLUID OF PATIENTS WITH RHEUMATOID ARTHRITIS

The role of chemokines in the immunopathogenesis of rheumatoid arthritis (RA) has been actively investigated in recent years. Angiogenic and angiostatic chemokines are important mediators of angiogenesis in the development and extent of pannus. Peripheral blood and synovial fluid (SF) is a major biomaterial in clinical and immunological studies. At the same time, it is the SF test that may yield the most informative results since that gives an idea of the processes that occur locally within a joint. Objective: to perform a comparative analysis of the levels of a number of CXC, CC, and CX3C chemokines in the SF of patients with RA, osteoarthritis (OA), and joint injuries. Subjects and methods. The multiplex analysis using xMAP technology (Luminex, USA) was used to analyze levels of CXC, CC, and CX3C chemokines in SF and serum of patients with RA (n = 20), OA (n = 9) and controls (n = 9). Results and discussion. The SF levels of CCL24/eotaxin-2, as well as those of the angiostatic chemokines CXCL9/MIG, CXCL10/IP10, CXCL11/ITAC, and CXCL13/BCA-1 were higher in the RA group than in the control and OA groups. There was a direct correlation between SF levels of CCL5/RANTES and DAS28, as well as patient global disease activity assessment on visual analogue scale, and that between the level of CCL2/MCP-1 in the SF and that of anticyclic citrullinated peptide (anti-CCP) antibodies in the serum. The SF concentrations of CXCL5/ENA78 and CXCL7/NAP-2 were shown to depend on the presence of serum anti-CCP. Serum CXCL13/BCA-1 levels were higher in RA than those in OA, as that of CXCL7/NAP-2 than in the control group.

Significance of serum anti-cyclic citrullinated peptide antibodies in diagnosis of juvenile idiopathic arthritis

Objective To investigate the clinical significance of serum anti-cyclic citrullinated peptide(anti-CCP) antibodies in diagnosis of juvenile idiopathic arthritis(JIA). Methods Serum anti-CCP antibodies of 68 children suspected of JIA with fever and arthritis of unknown causes were determined by ELISA,and comprehensive analysis was carried out with clinical data and related laboratory findings. Results Among the 68 children suspected of JIA,there were 10 cases of polyarticular JIA,13 cases of systemic onset JIA,8 cases of oligoarticular JIA and 13 cases of enthesitis related JIA.There were 11 cases of other rheumatoid diseases,8 cases of neoplastic diseases of blood and 5 cases of infectious diseases.The serum anti-CCP level in children suspected of polyarticular JIA was significantly higher than those in children suspected of systemic onset JIA,oligoarticular JIA and enthesitis related JIA(P0.05).With serum anti-CCP ≥15.8 RU/mL as the positive threshold value,the area under receiver operating characteristic curve was 0.80,and the sensitivity and specificity in diagnosis of polyarticular JIA were 80% and 67.6% respectively.The serum anti-CCP level was positively related to serum C-reaction protein level in children suspected of polyarticular JIA(r=0.764,P=0.017). Conclusion Serum anti-CCP can be used for the diagnosis of polyarticular JIA,and 15.8 RU/mL may be a suitable cut-off level.

Is serum anti-cyclic citrullinated peptide level useful in the diagnosis of rheumatoid arthritis?

BackgroundTo find out whether serum level of anti-cyclic citrullinated peptides (anti-CCP) could be useful in the diagnosis of rheumatoid arthritis (RA). MethodsThe study was performed against 1972 patients who visited Hanyang University Medical Center and were tested positive for anti-CCP. ResultsWhen test results were classified into 6 groups according to the anti-CCP level, diagnostic rates of RA in each group were distributed from 73.6% to 77.2%. The increase of serum level did not have any correlation with the diagnostic rate of RA. ConclusionsThe level of serum anti-CCP was not useful in the diagnosis of RA.

Serum anti-cyclic citrullinated peptide antibodies may predict disease activity in rheumatoid arthritis

To define the relationship between serum anti-cyclic citrullinated peptide antibodies (anti-CCP) and disease activity, and to construct a new disease activity index by using anti-CCP in rheumatoid arthritis (RA). One hundred and five RA patients were included. Disease activity based on DAS28-ESR and serum anti-CCP was measured. There was correlation between serum anti-CCP and DAS28-ESR. (R (2) = 0.71, P value < 0.01). New disease activity index was developed by replacing anti-CCP with ESR in DAS28-ESR. There was correlation between new model and DAS28-ESR. (R (2) = 0.91, P value < 0.01) The new composite index best cut-off values corresponding to DAS28-ESR values of 2.6, 3.2, and 5.1 were 3.21, 3.38, and 4.74, respectively. There was agreement between new model and DAS28-ESR for determination of patients in different disease activity categories. (Kappa = 0.71, P value < 0.01). The new disease activity index that applies serum anti-CCP may predict disease activity in RA.

P280 - Faecal calprotectin remains stable in inactive Crohn's disease patients

P280 - Faecal calprotectin remains stable in inactive Crohn's disease patients

P281 - The prevalence of antibodies against cyclic citrullinated peptide (anti-CCP) is low in patients with inflammatory bowel disease with or without arthritis

P281 - The prevalence of antibodies against cyclic citrullinated peptide (anti-CCP) is low in patients with inflammatory bowel disease with or without arthritis

THE INFLUENCE OF ADIPOKINES ON BONE MINERAL DENSITY IN ELDERLY MEN

disease duration; 10.25±4.61 years), and 19 healthy subjects (mean age; 40.26±5.11 years) served as controls. Anti-CCP antibodies and Anti-MCV antibodies were measured using ELISA. Results: In all RA patients, mean antiCCP level was 69.07±90.43 U/ml and anti-MCV level was 665.77±1040.19 U/ml. In patients with AS, the mean anti-CCP level was 10.7±5.22 U/ml and anti-MCV level was 40.54±20.15 U/ml. In healthy controls, the mean anti-CCP level was 11.11±7.65 U/ml, anti-MCV level was 23.12±12.04 U/ml. In patients with active RA, the mean serum anti-CCP level was 100.54±98.07 U/ml and anti-MCV level was 998.74±1154.93 U/ml. In patients with inactive RA, the mean serum anti-CCP level was 8.77±1.55 U/ml and anti-MCV level was 27.59±23.10 U/ml. According to these results; In patients with RA, the mean serum anti-MCV and anti-CCP levels were significantly high compared to patients with AS and healthy controls (p=0.002, p=0.001, p=0.002, p=0.001 respectively). The mean serum anti-MCV and antiCCP levels were significantly higher in active patients with RA than in inactive patients with RA patients (p=0.001 and p=0.001 respectively). In inactive patients with RA, the mean serum anti-MCV and anti-CCP levels were similar in patients with AS and healthy controls patients (p=0.484, p=0.308, p=0.09 and p=0.222 respectively). The mean serum anti-MCV levels were correlated with DAS 28 (r=0.531, p=0.001), VAS score (r=0.332, p=0.01), ESR (r=0.458, p=0.001), serum CRP levels (r=0.568, p=0.01), serum RF levels (r=0.529, p=0.001), swollen joints number (r=0.525, p=0.001) and tender joints number (r=0.638, p=0.001). Conclusion: As a result; measurement of serum anti-MCV levels is useful for diagnosis of RA and combined use of anti-MCV and RF may be more useful prognostic factor than either method alone, RF and anti-CCP.

TO ASSESS THE SENSITIVITY AND SPECIFICITY OF SERUM ANTICYCLIC CITRULLINATED PEPTIDE ANTIBODY IN PATIENTS WITH RHEUMATOID ARTHRITIS IN A COMMUNITY HOSPITAL IN LAHORE, PAKISTAN

OBJECTIVES: To compare the sensitivity and specificity of serum anti-Cyclic Citrullinated Peptideantibody (anti-CCP) with serum rheumatoid factor in diagnosing rheumatoid arthritis (RA) in acommunity hospital in Lahore, Pakistan.DESIGN: Cross-sectional analytical study.PLACE &amp; DURATION OF STUDY: Subjects were recruited from Fatima Memorial Hospital,Rheumatology Outpatient Department from January, 2010 to December, 2010. The research work wasconducted at Department of Physiology and Cell Biology of University of Health Sciences, Lahore.SUBJECTS &amp; METHODS: Eighty diagnosed patients of rheumatoid arthritis and thirty normalhealthy controls were included in the study. After selection of subjects, written informed consent wasobtained. The venous blood sample was taken and secured in vacutainers. Serum was extracted bycentrifugation and stored at -20°C till analysis. Titers of anti-CCP and rheumatoid factor weredetermined by ELISA. The data obtained was analyzed by using SPSS version 16.0.RESULTS: The sensitivity and specificity of serum anti-CCP was found to be 58.6% and 86.7%respectively as compared to 47.5% and 83.3% for serum rheumatoid factor (RF) in diagnosingrheumatoid arthritis. Sensitivity of anti-CCP antibody in RF negative sub-group was 32.1%.CONCLUSION: Serum anti-CCP antibody is more sensitive and specific marker for diagnosis ofrheumatoid arthritis as compared to the rheumatoid factor.KEY WORDS: Rheumatoid Arthritis, Anti- Cyclic Citrullinated Peptide Antibody (ACCP), Rheumatoid Factor