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Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis
BACKGROUND: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been of diagnostic value in Northern European Caucasian patients with rheumatoid arthritis (RA). In these populations, anti-CCP antibodies are associated with the HLA-DRB1 shared epitope. We assessed the diagnostic value of ant...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876231/ https://www.ncbi.nlm.nih.gov/pubmed/17448247 http://dx.doi.org/10.1186/1471-2474-8-37 |
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author | Alexiou, Ioannis Germenis, Anastasios Ziogas, Athanasios Theodoridou, Katerina Sakkas, Lazaros I |
author_facet | Alexiou, Ioannis Germenis, Anastasios Ziogas, Athanasios Theodoridou, Katerina Sakkas, Lazaros I |
author_sort | Alexiou, Ioannis |
collection | PubMed |
description | BACKGROUND: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been of diagnostic value in Northern European Caucasian patients with rheumatoid arthritis (RA). In these populations, anti-CCP antibodies are associated with the HLA-DRB1 shared epitope. We assessed the diagnostic value of anti-CCP antibodies in Greek patients with RA where the HLA shared epitope was reported in a minority of patients. METHODS: Using an enzyme-linked immunosorbent assay (ELISA) (CCP2) kit, we tested anti-CCP antibodies in serum samples from 155 Greek patients with RA, 178 patients with other rheumatic diseases, and 100 blood donors. We also determined rheumatoid factor (RF) and compared it to anti-CCP antibodies for area under the curve (AUC), sensitivity, specificity and likelihood ratios. RESULTS: Sensitivity of anti-CCP2 antibodies and RF for RA was 63.2% and 59.1%, and specificity was 95.0% and 91.2%, respectively. When considered simultaneously, the AUC for anti-CCP antibodies was 0.90 with 95% CI of 0.87 to 0.93 and the AUC for RF was 0.71 with 95% CI of 0.64 to 0.77. The presence of both antibodies increased specificity to 98.2%. Anti-CCP antibodies were positive in 34.9% of RF-negative RA patients. Anti-CCP antibodies showed a correlation with the radiographic joint damage. Anti-CCP-positive RA patients had increased the swollen joint count and serum CRP concentration compared to anti-CCP-negative RA patients (Mann-Whitney U test, p = 0.01, and p < 0.001, respectively). However, no correlation was found between anti-CCP antibodies and DAS28 score (r = 0.13, p = 0.12). CONCLUSION: In Greek patients with RA, anti-CCP2 antibodies exhibit a better diagnostic value than RF and a correlation with radiological joint damage and therefore are useful in everyday rheumatology practice. |
format | Text |
id | pubmed-1876231 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-18762312007-05-22 Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis Alexiou, Ioannis Germenis, Anastasios Ziogas, Athanasios Theodoridou, Katerina Sakkas, Lazaros I BMC Musculoskelet Disord Research Article BACKGROUND: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been of diagnostic value in Northern European Caucasian patients with rheumatoid arthritis (RA). In these populations, anti-CCP antibodies are associated with the HLA-DRB1 shared epitope. We assessed the diagnostic value of anti-CCP antibodies in Greek patients with RA where the HLA shared epitope was reported in a minority of patients. METHODS: Using an enzyme-linked immunosorbent assay (ELISA) (CCP2) kit, we tested anti-CCP antibodies in serum samples from 155 Greek patients with RA, 178 patients with other rheumatic diseases, and 100 blood donors. We also determined rheumatoid factor (RF) and compared it to anti-CCP antibodies for area under the curve (AUC), sensitivity, specificity and likelihood ratios. RESULTS: Sensitivity of anti-CCP2 antibodies and RF for RA was 63.2% and 59.1%, and specificity was 95.0% and 91.2%, respectively. When considered simultaneously, the AUC for anti-CCP antibodies was 0.90 with 95% CI of 0.87 to 0.93 and the AUC for RF was 0.71 with 95% CI of 0.64 to 0.77. The presence of both antibodies increased specificity to 98.2%. Anti-CCP antibodies were positive in 34.9% of RF-negative RA patients. Anti-CCP antibodies showed a correlation with the radiographic joint damage. Anti-CCP-positive RA patients had increased the swollen joint count and serum CRP concentration compared to anti-CCP-negative RA patients (Mann-Whitney U test, p = 0.01, and p < 0.001, respectively). However, no correlation was found between anti-CCP antibodies and DAS28 score (r = 0.13, p = 0.12). CONCLUSION: In Greek patients with RA, anti-CCP2 antibodies exhibit a better diagnostic value than RF and a correlation with radiological joint damage and therefore are useful in everyday rheumatology practice. BioMed Central 2007-04-20 /pmc/articles/PMC1876231/ /pubmed/17448247 http://dx.doi.org/10.1186/1471-2474-8-37 Text en Copyright © 2007 Alexiou et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Alexiou, Ioannis Germenis, Anastasios Ziogas, Athanasios Theodoridou, Katerina Sakkas, Lazaros I Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title | Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title_full | Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title_fullStr | Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title_full_unstemmed | Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title_short | Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis |
title_sort | diagnostic value of anti-cyclic citrullinated peptide antibodies in greek patients with rheumatoid arthritis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876231/ https://www.ncbi.nlm.nih.gov/pubmed/17448247 http://dx.doi.org/10.1186/1471-2474-8-37 |
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