Diagnostic utility of anti-cyclic citrullinated peptide antibodies for very early rheumatoid arthritis.

Abstract

OBJECTIVE:

To compare the diagnostic utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies with other serological markers including rheumatoid factor (RF), anti-agalactosyl immunoglobulin G (IgG) antibody, and matrix metalloproteinase (MMP)-3 in very early rheumatoid arthritis (RA).

METHODS:

Serum concentrations of anti-CCP antibodies, RF, anti-agalactosyl IgG antibody, and MMP-3 were measured in 262 patients with RA ("total RA") including 55 patients with disease duration of less than 6 months who had not been treated before entry ("very early RA") and 116 patients with rheumatic diseases other than RA.

RESULTS:

The diagnostic sensitivity of anti-CCP antibodies was 82.4% in total RA and 67.3% in very early RA and was lower than that of RF (84.0% total RA, 83.6% very early RA) and anti-agalactosyl IgG antibody (90.5%, 90.9%), whereas specificity, positive predictive value, and diagnostic accuracy were the best among markers tested both in total RA and in very early RA. The presence of either anti-CCP antibodies or RF increased the sensitivity, but any combination of serological markers was not significantly better in diagnostic accuracy than anti-CCP antibodies alone. The rates of RF-positive subjects in anti-CCP antibody-negative patients both in total RA (43.5%) and in very early RA (61.1%) were higher than those of anti-CCP antibody-positive subjects in RF-negative patients (38.1% and 22.2%, for total RA and early RA, respectively).

CONCLUSION:

Measurement of anti-CCP antibodies, by itself, is useful for the diagnosis of RA; however, combined use of anti-CCP antibodies with RF may be more useful than either method alone for the diagnosis of very early RA.

• Authors: Toshihiro Matsui, Kota Shimada, Naoko Ozawa, Hiromi Hayakawa, Futoshi Hagiwara, Hisanori Nakayama, Shoji Sugii, Yoshinori Ozawa, Shigeto Tohma
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 33 Issue 12 Pg. 2390-7 (Dec 2006) ISSN: 0315-162X [Print] Canada
• PMID: 16924694 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Biomarkers
• Immunoglobulin G
• Peptides, Cyclic
• agalactosyl IGG
• cyclic citrullinated peptide
• Rheumatoid Factor
• Matrix Metalloproteinase 3

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthritis, Infectious (diagnosis)
• Arthritis, Rheumatoid (diagnosis, immunology)
• Autoantibodies (blood, immunology)
• Biomarkers (blood)
• Diagnosis, Differential
• Early Diagnosis
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Immunoglobulin G (blood)
• Lupus Erythematosus, Systemic (diagnosis)
• Male
• Matrix Metalloproteinase 3 (blood)
• Middle Aged
• Peptides, Cyclic (immunology)
• Predictive Value of Tests
• Rheumatoid Factor (blood)