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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...

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Autores principales: Alexiou, Ioannis, Germenis, Anastasios, Ziogas, Athanasios, Theodoridou, Katerina, Sakkas, Lazaros I
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
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.
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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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