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

Authors: & THURAYA J MEZAL --- ADNAN T AL-KHAFAJI --- HASSAN J HASONY --- ALI M BARAKAT
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 43-50
Publisher: Basrah University جامعة البصرة

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Abstract

A serological study has been done in Al-Nassiriyha, southern Iraq, from December 2006 toAugust 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 comparedwith other rheumatic diseases and healthy controls. Also to show the diagnostic value ofanti-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 otherrheumatic diseases from AL-Hussein Teaching Hospital in AL-Nassiriyah and 120 healthycontrols from medical personnel and school students who were healthy. All the information wastaken from the patients and controls.An Enzyme-linked immunosorbent assay was used for estimation of anti-CCP, IL-6, TNF-α andslide agglutination test for the estimation of RF, CRP and ANF. The seropositivity to anti-CCP inRA patients group was 61.2% among them 23% with low levels of anti-CCP, 25% withmoderate levels and 51.3% with high levels (> 60 units /ml.).The high levels of anti-CCP persistfor 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 showedthe greater specificity (97.6%) and sensitivity (61.2%) compared to the other marker used in thisstudy. The overall agreement between the tested parameters in their ability to detect RA patientwas higher for anti-CCP combined to IL-6 (91.7%) in comparison to the effect of other markerscombination. Although anti-CCP was more common in RA patient with 2-10 years duration ofillness, anti-CCP, IL-6 and TNF-α positivity as estimated by ELISA were persistently with hightiters regardless the duration of illness. The majority of RA patients with high anti-CCP levelswere among stage three of clinical RA. Smoking has a positive relation to the increased levelsof all tested parameters compared to the non-smokers.

Keywords

RHEUMATOID --- ARTHRITIS

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