Anticuerpos anti-CCP en artritis reumatoidea: relación con características clínicas, citocinas Th1/Th2 y HLA-DRB1.

Translated title of the contribution: Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis: relation with clinical features, cytokines and HLA-DRB1

Paula A. Correa, Gabriel J. Tobón, Gustavo Citera, José Cadena, Emilce Schneeberger, Jose Camargo Galvis, José A. Maldonado-Cocco, Juan Manuel Anaya

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The specificity and sensitivity of anti-cyclic citrullinated peptide antibodies (anti-CCP) was examined in Latin-American patients with rheumatoid arthritis (RA). The variables considered included: 1) relation with the activity of disease, 2) extra-articular manifestations (EAM), 3) synthesis of cytokines (IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma) and IgM and IgA rheumatoid factor (RF), and 4) the association with HLA-DRB1 polymorphism. Seventy-nine RA patients were assessed (69 with established RA, and 10 with recent-onset RA not receiving any treatment), 56 with ankylosing spondylitis (AS), 25 with systemic lupus erythematosus (SLE), 50 with primary Sjögren's syndrome (pSS), and 10 healthy individuals. Of the 69 patients with established RA, 36 were reexamined 2 years later. The activity of the RA was measured by criteria adopted by the American College of Rheumatology. Anti-CCP2, RF and cytokines levels were determined by ELISA. HLA genotypes were established by first, PCR sequence amplification using sequence-specific primers and then, complete sequencing of the product. Anti-CCP antibodies were observed in 96% of patients with RA during the first evaluation and in 86% at the second evaluation (p = 0.12). No significant change in antibody titre was observed between the two evaluations (131 +/- 58.7 and 130.6 +/- 67.1 IU, respectively). The overall sensitivity and specificity was 94% and 92%, respectively; however, at titres > 60 IU, the values were 84% and 95%, respectively. The anti-CCP likelihood ratio positive test was 12 and the likelihood ratio negative test was 0.06. The positive predictive value was 87%, and the negative predictive value was 96%. Anti-CCP antibodies were observed in 12% of SLE and pSS patients, in 2% of AS patients, and in 10% of healthy controls. In RA patients, these antibodies were not associated with the activity of disease, EAM or HLA-DRB1 alleles; no significant correlation was observed between antibody titre and cytokines level. Although anti-CCP antibodies have potential as a diagnostic tool for RA, they are not useful for monitoring clinical activity or predicting the clinical course of disease. Antibody synthesis is HLA-DRB1 independent and not correlated with Th1/Th2 cytokines.

Original languageSpanish
Pages (from-to)140-152
Number of pages13
JournalBiomédica : revista del Instituto Nacional de Salud
Volume24
Issue number2
StatePublished - 2004
Externally publishedYes

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HLA-DRB1 Chains
Rheumatoid Arthritis
Cytokines
Antibodies
Rheumatoid Factor
Ankylosing Spondylitis
Systemic Lupus Erythematosus
Anti-Idiotypic Antibodies
Joints
cyclic citrullinated peptide
Sensitivity and Specificity
Interleukin-12
Interleukin-4
Interleukin-10
Immunoglobulin A
Polymorphism
Immunoglobulin M
Amplification
Tumor Necrosis Factor-alpha
Enzyme-Linked Immunosorbent Assay

Cite this

Anticuerpos anti-CCP en artritis reumatoidea : relación con características clínicas, citocinas Th1/Th2 y HLA-DRB1. / Correa, Paula A.; Tobón, Gabriel J.; Citera, Gustavo; Cadena, José; Schneeberger, Emilce; Camargo Galvis, Jose; Maldonado-Cocco, José A.; Anaya, Juan Manuel.

In: Biomédica : revista del Instituto Nacional de Salud, Vol. 24, No. 2, 2004, p. 140-152.

Research output: Contribution to journalArticle

Correa, PA, Tobón, GJ, Citera, G, Cadena, J, Schneeberger, E, Camargo Galvis, J, Maldonado-Cocco, JA & Anaya, JM 2004, 'Anticuerpos anti-CCP en artritis reumatoidea: relación con características clínicas, citocinas Th1/Th2 y HLA-DRB1.', Biomédica : revista del Instituto Nacional de Salud, vol. 24, no. 2, pp. 140-152.
Correa, Paula A. ; Tobón, Gabriel J. ; Citera, Gustavo ; Cadena, José ; Schneeberger, Emilce ; Camargo Galvis, Jose ; Maldonado-Cocco, José A. ; Anaya, Juan Manuel. / Anticuerpos anti-CCP en artritis reumatoidea : relación con características clínicas, citocinas Th1/Th2 y HLA-DRB1. In: Biomédica : revista del Instituto Nacional de Salud. 2004 ; Vol. 24, No. 2. pp. 140-152.
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abstract = "The specificity and sensitivity of anti-cyclic citrullinated peptide antibodies (anti-CCP) was examined in Latin-American patients with rheumatoid arthritis (RA). The variables considered included: 1) relation with the activity of disease, 2) extra-articular manifestations (EAM), 3) synthesis of cytokines (IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma) and IgM and IgA rheumatoid factor (RF), and 4) the association with HLA-DRB1 polymorphism. Seventy-nine RA patients were assessed (69 with established RA, and 10 with recent-onset RA not receiving any treatment), 56 with ankylosing spondylitis (AS), 25 with systemic lupus erythematosus (SLE), 50 with primary Sj{\"o}gren's syndrome (pSS), and 10 healthy individuals. Of the 69 patients with established RA, 36 were reexamined 2 years later. The activity of the RA was measured by criteria adopted by the American College of Rheumatology. Anti-CCP2, RF and cytokines levels were determined by ELISA. HLA genotypes were established by first, PCR sequence amplification using sequence-specific primers and then, complete sequencing of the product. Anti-CCP antibodies were observed in 96{\%} of patients with RA during the first evaluation and in 86{\%} at the second evaluation (p = 0.12). No significant change in antibody titre was observed between the two evaluations (131 +/- 58.7 and 130.6 +/- 67.1 IU, respectively). The overall sensitivity and specificity was 94{\%} and 92{\%}, respectively; however, at titres > 60 IU, the values were 84{\%} and 95{\%}, respectively. The anti-CCP likelihood ratio positive test was 12 and the likelihood ratio negative test was 0.06. The positive predictive value was 87{\%}, and the negative predictive value was 96{\%}. Anti-CCP antibodies were observed in 12{\%} of SLE and pSS patients, in 2{\%} of AS patients, and in 10{\%} of healthy controls. In RA patients, these antibodies were not associated with the activity of disease, EAM or HLA-DRB1 alleles; no significant correlation was observed between antibody titre and cytokines level. Although anti-CCP antibodies have potential as a diagnostic tool for RA, they are not useful for monitoring clinical activity or predicting the clinical course of disease. Antibody synthesis is HLA-DRB1 independent and not correlated with Th1/Th2 cytokines.",
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