Antibodies to cyclic citrullinized peptide in rheumatoid arthritis


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Abstract

Aim. To estimate a diagnostic value of antibodies to cyclic citmllinized peptide (CCP) in rheumatoid
arthritis (RA).
Material and methods. The study was made of 85 RA patients. Of them, 48 patients had early RA,
i.e. of 8 month and less duration. The control group consisted of 35 patients with non-differentiated
arthritis (NBA) and 8 healthy donors. Concentrations of CCP antibodies, rheumatoid factor (RF)
IgM and RF IgA were measured with enzyme immunoassay (EIA).
Results. The level of CCP antibodies in RA patients (76.3 ± 43.8; median 100.0 U/ml) was significantly
higher than in NDA patients (25.1 ± 43.9; median 0.8 U/ml; p < 0.05) or in donors
(0.38 ± 0.36; median 0.2 U/ml; p < 0.05). A correlation was found between the CCP antibodies level
and that ofRF IgM (/ = 15.4; p = 0.001) and RF IgA (/ = 10.3; p = 0.001). Sensitivity (82%)
and specificity (90%) of CCP antibodies in RA diagnosis was higher than these parameters for RF
IgM and IgA (78%o, 86%> and 72%, 83%, respectively). Simultaneous tests for CCP antibodies, RF
IgM and RF IgA led to a 93% specificity. CCP antibodies were detected in 50% patients seronegative
by RF IgM and in 62% patients seronegative by IgA. Detection of CCP antibodies was closely associated
with early RA (x2 = 30.8;p = 0.0001).
Conclusion. The EI A for CCP antibodies is a sensitive and specific serological test for early RA diagnosis.

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