Serum Anti-Cyclic Citrullinated Peptide (Anti_CCP) Antibody Level in Rheumatoid Arthritic Patients with and without Nodal Osteoarthritis


ABSTRACT:BACKGROUND:Rheumatoid Arthritis (RA) is chronic systemic inflammatory disease affects synovial joints , articular structures and extra articular , the prevalence rate occurs aprox in about 1% of population Anti citrullinated peptide/protein antibody (Anti-CCP) antibody are autoantibodies(antibodies directed against one or more of the individuals own proteins) frequently detected in RA patients during inflammation. citrulline is incorporated enzymatically into proteins .The current study is a trail to ensure that Anti-CCP marker is more specific and sensitive for diagnosis of RA patients and to detect the effect of the presence of other disease like NOA on Anti-CCP valueOBJECTIVE:Evaluation of Anti-CCP Ab level in RA patients with and without NOA.The serum level of Accp_Ab is estimated using ELISA technique in patients with RA and NOA.SUBJECTS AND METHODS:The studied group includes 30 RA patients (24 females and 6 males), who fulfilled four or more of the 1987 ACR criteria compared with 30 RA+NOA patients (23 females and 7 males) also fulfilled four or more of the 1987 ACR criteria for the classification of Rheumatoid arthritis and nodal osteoarthritis group. Blood samples were taken from three groups to analyze and measure the serum levels of Anti-CCP.RESULTS:Result of investigations were compared with that for the 30 apparently healthy control individuals who matched the patient´s group in age and sex.The result of the study showed that majority of patients is females (80%) for RA patients and (76.6%) for RA+NOA patients (with females: males 4:1 & 3.28:1 for RA and RA+NOA respectively). Moreover, the mean age for RA, RA+NOA and control groups are: 48.03±12.95y, 51.3±11.8y and 37.43±12.57years respectively.It was observed from the result that there is a higher positivity of Anti-CCP in the patients sera( 76.7% for RA+NOA cases and 70% for RA cases) in comparison with healthy control group (0.0%) so there is highly significant difference (p<0.001).While the quantitative estimation of Anti-CCP antibodies showed that its level was higher among sera of RA+NOA patients in addition to RA patients (53.59±33.29 RU/ml and 52.28±48.99 RU/ml respectively) in comparison with healthy control group 2.88±2.50 RU/ml.CONCLUSION:We found that Anti-CCP is a good & specific marker for diagnosis of RA & RA can be differentiated from other disease by measuring this marker.Moreover, Anti-CCP Ab level in RA patients does not significantly affected by the presence of NOA.