McLendon Clinical Laboratories, University of North Carolina Hospitals, Chapel Hill, NC, USA.
J Clin Immunol. 2012 Feb;32(1):131-7. doi: 10.1007/s10875-011-9610-y. Epub 2011 Nov 10.
Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases. The presence of antibodies to cyclic citrullinated peptide (CCP) is better at discriminating RA patients and is also associated with significantly more disease activity compared to serum rheumatoid factor. In this study, we assessed two new automated second generation tests to detect the presence of anti-CCP antibodies in 226 serum samples submitted to the Clinical Immunology Laboratory for anti-CCP antibody testing. We compared CCP antibody results on these samples obtained using the ImmunoCAP 250 (Phadia) and the Architect i2000SR (Abbott Laboratories) instruments to our currently used CCP IgG third generation manual ELISA (Inova Diagnostics). One hundred and fifty-four samples were negative while 52 were positive by all three tests. Eighteen samples were negative by the automated tests but weakly/moderately positive by manual ELISA yielding an overall concordance of 79%. When we compared the discordant test results to patient diagnosis, we observed a better correlation with clinical RA diagnosis for the new automated tests compared to the manual ELISA. These two new anti-CCP antibody tests have the benefit of automation and may have better positive predictive value for the diagnosis of RA than our current manual ELISA.
类风湿关节炎（RA）是最常见的系统性自身免疫性疾病之一。抗环瓜氨酸肽（CCP）抗体的存在更能区分 RA 患者，并且与显著更多的疾病活动相关，与血清类风湿因子相比。在这项研究中，我们评估了两种新的自动化第二代检测方法，以检测 226 份血清样本中抗 CCP 抗体的存在，这些样本提交给临床免疫学实验室进行抗 CCP 抗体检测。我们将使用 ImmunoCAP 250（Phadia）和 Architect i2000SR（Abbott Laboratories）仪器在这些样本上获得的 CCP 抗体结果与我们目前使用的 CCP IgG 第三代手动 ELISA（Inova Diagnostics）进行比较。154 个样本为阴性，52 个样本为所有三种检测方法均为阳性。18 个样本为自动化检测方法阴性，但手动 ELISA 为弱阳性/中度阳性，总体一致性为 79%。当我们将不一致的检测结果与患者诊断进行比较时，我们观察到新的自动化检测方法与临床 RA 诊断的相关性更好，与手动 ELISA 相比。这两种新的抗 CCP 抗体检测方法具有自动化的优势，与我们目前的手动 ELISA 相比，可能对 RA 的诊断具有更好的阳性预测值。
