7- DIAGNOSTIC VALUE OF ANTIBODIES TO CITRULLINE CONTAINING PEPTIDES IN PATIENTS WITH RHEUMATOID ARTHRITIS IN SOUTHERN IRAQ43

• Main Authors: THURAYA J MEZAL, ADNAN T AL-KHAFAJI, HASSAN J HASONY, ALI M BARAKAT
• Format: Article
• Language: English
• Published: university of basrah 2009-06-01
• Series: Basrah Journal of Surgery
• Subjects: rheumatoid; arthritis
• Online Access: https://bjsrg.uobasrah.edu.iq/article_55269_8df6f0d0965cd639b843f497215fc2e1.pdf

A serological study has been done in Al-Nassiriyha, southern Iraq, from December 2006 to August 2007 designed to determine the frequency of anti-cyclic citrullinated peptide antibody (anti-CCP) in a group of patients with rheumatoid arthritis for specific period of time compared with other rheumatic diseases and healthy controls. Also to show the diagnostic value of anti-CCP antibody in relation to other markers [rheumatoid factor (RF), antinuclear factor (ANF), C-reactive protein (CRP) and cytokines such as interleukin–6 (IL-6), tumor necrosis factor–α (TNF-α)] to discriminate between those patients with and without RA. Blood samples were taken from 121 patients with rheumatoid arthritis, 88 patients of other rheumatic diseases from AL-Hussein Teaching Hospital in AL-Nassiriyah and 120 healthy controls from medical personnel and school students who were healthy. All the information was taken from the patients and controls. An Enzyme-linked immunosorbent assay was used for estimation of anti-CCP, IL-6, TNF-α and slide agglutination test for the estimation of RF, CRP and ANF. The seropositivity to anti-CCP in RA patients group was 61.2% among them 23% with low levels of anti-CCP, 25% with moderate levels and 51.3% with high levels (> 60 units /ml.).The high levels of anti-CCP persist for long durations up to 10 years (54.7%). However, anti-CCP was rarely detected among non- RA rheumatic diseases and healthy controls (2.3% and 2.5% respectively). Anti-CCP showed the greater specificity (97.6%) and sensitivity (61.2%) compared to the other marker used in this study. The overall agreement between the tested parameters in their ability to detect RA patient was higher for anti-CCP combined to IL-6 (91.7%) in comparison to the effect of other markers combination. Although anti-CCP was more common in RA patient with 2-10 years duration of illness, anti-CCP, IL-6 and TNF-α positivity as estimated by ELISA were persistently with high titers regardless the duration of illness. The majority of RA patients with high anti-CCP levels were among stage three of clinical RA. Smoking has a positive relation to the increased levels of all tested parameters compared to the non-smokers.