Afzal Nadeem, Karim Sara, Mahmud Tafazzul-e-Haque, Sami Waqas, Arif Maria, Abbas Sarwar
Department of Immunology, University of Health Sciences, Lahore, Pakistan.
Clin Lab. 2011;57(11-12):895-9.
Rheumatoid arthritis is a common, world wide, systemic disease that affects mainly joints. Rheumatoid factor is the only marker to diagnose rheumatoid arthritis; however these antibodies are present in other disorders and even in up to 15% of the healthy population. Many auto antibodies have been reported to diagnose rheumatoid arthritis e.g. APF and AKA, etc. but they are not specific and due to tedious laboratory procedure, they have not been generally adopted. Anti-CCP antibodies have been reported for their high sensitivity and specificity. This study was planed to determine the prevalence of anti-CCP antibodies and RA factor in clinically diagnosed patients of rheumatoid arthritis.
Anti-CCP antibody was determined by ELISA technique and RA-factor was done by latex agglutination method.
Forty five patients, 36 female and 9 male, were recruited for this study. Twenty-five (55.6%) patents were positive for anti-CCP antibodies while 20 patients were negative for anti-CCP antibodies and comparison between anti-CCP positive and anti-CCP negative was statistically significant (p = < 0.01). Thirty-one (68%) patients were seropositive (SPRA) for RA while 14 (31%) patients were seronegative (SNRA). Among SPRA patients, 18 were positive for anti-CCP antibody and among 14 SNRA patients, 7 patients had anti-CCP antibody and the difference between these two groups was not statistically significant.
Anti-CCP antibody and RA-factor should be used concomitantly to diagnose RA.
类风湿性关节炎是一种常见的、全球性的主要影响关节的全身性疾病。类风湿因子是诊断类风湿性关节炎的唯一标志物;然而,这些抗体也存在于其他疾病中,甚至在高达15%的健康人群中也有发现。许多自身抗体已被报道可用于诊断类风湿性关节炎,例如抗核周因子(APF)和抗角蛋白抗体(AKA)等,但它们并不具有特异性,并且由于实验室操作繁琐,尚未被广泛采用。抗环瓜氨酸肽(CCP)抗体因其高敏感性和特异性而被报道。本研究旨在确定临床诊断的类风湿性关节炎患者中抗CCP抗体和类风湿因子的患病率。
采用酶联免疫吸附测定(ELISA)技术检测抗CCP抗体,采用乳胶凝集法检测类风湿因子。
本研究招募了45名患者,其中女性36名,男性9名。25名(55.6%)患者抗CCP抗体呈阳性,20名患者抗CCP抗体呈阴性,抗CCP抗体阳性组和阴性组之间的比较具有统计学意义(p = < 0.01)。31名(68%)患者类风湿因子血清阳性(SPRA),14名(31%)患者类风湿因子血清阴性(SNRA)。在SPRA患者中,18名抗CCP抗体呈阳性,在14名SNRA患者中,7名患者有抗CCP抗体,这两组之间的差异无统计学意义。
抗CCP抗体和类风湿因子应联合使用以诊断类风湿性关节炎。