Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis

Selçuk Kaya; Mehmet Karabey; Ayşegül Aksoy Gökmen; Gökhan Kabadayı

Araştırma Makalesi

Romatoit Artrit Öntanılı Hasta Serumlarında Anti CCP ve RF ‘ün Değerlendirilmesi

Yıl 2021, Cilt: 6 Sayı: 1, 1 - 6, 31.03.2021

Selçuk Kaya Mehmet Karabey Ayşegül Aksoy Gökmen Gökhan Kabadayı

Öz

Romatoid artrit (RA), tendon kılıfı ve eklemlerde inflamasyon, ağrı ve kas zayıflıkları ile karakterize, kronik ve inflamatuar bir hastalıktır. Bu çalışmada İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Tıbbi Mikrobiyoloji Laboratuarına Romatoit artrit ön tanısıyla gelen hastalarda anti CCP ve RF'ün birbiri ve tanıya yardımcın testler (CRP, WBC, PLT ve Sedimentasyon) ile ilişkisnin değerlendirilmesi amaçlanmıştır.
Ocak 2017-Ağustos 2018 tarihleri arasında RA öntanısıyla gönderilen toplam 5399 hasta çalışmaya dahil edilmiştir. Anti CCP düzeyleri Enzim Immunoassay metodu ile ORGENTEC diagnostica GMBH marka kit kullanılarak Allegria cihazında, RF düzeyleri ise Türbidimetrik metodu ile Abbott Architect C16000 cihazında üretici firmanın talimatları doğrultusunda araştırıldı.
Anti CCP 498(%9.2) hastada RF ise 4213(%78) hastada pozitif çıkmıştır. Anti-CCP pozitif olan 498 hastanın 43(%8,6)’ünde RF negatif bulunmuştur. RF pozitif bulunan 4213 hastanın 3758(%89,2)’inde anti CCP negatif bulunmuştur. Anti CCP değerleri ile RF, PLT ve sedimentasyon ve RF ise WBC, PLT ve sedimentasyon ile anlamlı bir korelasyon saptanmıştır.
Anti-CCP ayrıca yüksek spesifitesi nedeniyle RA’yı diğer RF pozitif olabilen artrit formlarından da ayırt etmede kullanılabilir. Çalışmamızda RA’li hastaların bir bölümünde RF negatif olup anti-CCP pozitif sonuç vermiştir, bundan dolayı seronegatif RA’li hastalarda RA tanısını koymada fayda sağlamaktadır. RA hastalarında sedimentasyon yüksekliği tanıyı desteklerken, CRP testinin yararı sınırlı bulunmuştur.

Kaynakça

1. Bouysset M, Tourné Y, Tillmann K. Foot and ankle in rheumatoid arthritis .p.179-206, 2nd ed. Elsevier,2011.
2. Verma MK, Sobha K. Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects. Inflamm Res. 64(9):647–59, 2015.
3. Capkin E, Cakirbay H, Karkucak M, Topbas M, Serdaroglu M, Guler M, et al. Prevalence of rheumatoid arthritis in the eastern Black Sea region of Turkey. Int J Rheum Dis. 13(4):380–4, 2010.
4. Aletaha D, Ward MM, Machold KP, Nell VPK, Stamm T, Smolen JS. Remission and active disease in rheumatoid arthritis: Defining criteria for disease activity states. Arthritis Rheum. 52(9):2625–36, 2005.
5. Fallis A. Harrison’s Principles of Internal Medicine. p.1689–99. 1st.ed. J Chem Inf Model, 2015.
6. Girbal-Neuhauser E, Durieux JJ, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritisassociated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
7. Schellekens GA, De Jong B, Van Den Hoogen F, Van de Putte L, van Venrooij WJ. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. Journal of Clinical Investigation 1998;101(1):273.
8. Girbal-Neuhauser E, Durieux J-J, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritisassociated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
9. Vossenaar ER, van Venrooij WJ. Anti-CCP antibodies, a highly specific marker for (early) rheumatoid arthritis. Clin Appl Immunol Rev. 4(4):239–62, 2004.
10. Shah A, Clair EWS, 2015. Rheumatoid Arthritis. In: Harrison's principles of internal medicine Eds: Kasper DL, Hauser SL, Jameson JL et al. New York: McGraw-Hill Education, p. 2136-249.
11. Akar S, 2013. Romatoid Artrit. In: Harrison's principles of internal medicine Türkçe Eds: Kasper DL, Hauser SL, Jameson JL et al, 17th ed. İzmir, p. 2083- 92.
12. Gümüşdiş G. Romatoid Artrit. In: Gümüşdiş G ve Doğanavşargil E. (edr). Klinik Romatoloji, İzmir: Deniz Matb, 1999; 269-79.
13. Ergin S. Romatoid Artrit ve Sjogren Sendromu. Beyazova M, Gökce-Kutsal Y (edr). Fiziksel Tıp ve Rehabilitasyon Cilt 2. Güneş Kitabevi Ltd. Şti, Ankara, 2000; 1549-76.
14. Konice M, Eryavuz M. Romatoid Artrit. Tuzun F. Eryavuz M. Akarırmak U (edr). Hareket Sistemi Hastalıkları Nobel Tıp Kitabevi. İstanbul, 1997;85-98.
15. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-24.
16. Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis. Mikrobiyol Bul 2003; 37: 163-70.
17.Arıdoğan BC, Kaya S, Savaş S, Çetin ES, Akkuş S, Demirci M. Romatoid artritin serolojik tanısında ve hastalık aktivitesinin değerlendirilmesinde anti-CCP (cyclic citrullinated peptid) antikorlarının rolü. Mikrobiyoloji Bul 2008;42:669-674.
18. Aridoğan BC, Çetin ES, Yildirim M, Kaya S, Ceyhan AM, Demirci M, Savas S, Ural O and Akkus S. Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis, brucellar arthritis and Behcet’s disease. African Journal of Microbiology Research 2011; 5(19): 2975-2979.

Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis

Yıl 2021, Cilt: 6 Sayı: 1, 1 - 6, 31.03.2021

Selçuk Kaya Mehmet Karabey Ayşegül Aksoy Gökmen Gökhan Kabadayı

Öz

Rheumatoid arthritis (RA) is a chronic and inflammatory disease characterized by inflammation, pain and muscle weakness in the tendon sheath and joints. In this study, it was aimed to evaluate the relationship of anti-CCP and RF values with each other and with other diagnostic assisting test results (CRP, WBC, PLT, and Sedimentation) in patients who have been pre-diagnosed with rheumatoid arthritis in Izmir Katip Çelebi University Atatürk Training and Research Hospital Medical Microbiology Laboratory.

A total of 5399 patients who have pre-diagnosed as RA between January 2017 and August 2018 were included in the study. Anti-CCP levels were investigated with the Enzyme Immunoassay method by using the ORGENTEC Diagnostica GMBH kit via the Alegria instrument. The RF levels were investigated with the Turbidimetric method by Abbott Architect C16000 instrument according to the manufacturer's instructions.

Anti-CCP was positive in 498 (9.2%) patients and RF positive in 4213 (78%) patients. RF was found to be negative in 43 (8.6%) of 498 patients identified as anti-CCP positive. In addition, anti-CCP was negative in 3758 (89.2%) of 4213 patients who were identified as RF positive. A significant correlation was found between anti-CCP values and RF, PLT, and sedimentation values, and between RF values and WBC, PLT and sedimentation values.

In addition, Anti-CCP can be used to distinguish RA from other RF positive arthritis forms due to its high specificity. In our study, RF was determined as negative in some of the patients diagnosed with RA, while anti-CCP was determined as positive. Therefore, it helps to diagnose RA in patients with seronegative RA. While the increase in the sedimentation values in RA patients supports the diagnosis, the benefit of the CRP test was found to be limited.

Anahtar Kelimeler

Anti CCP, , Romatoid artrit (RA), , RF, , CRP, , sedimentasyon

Kaynakça

1. Bouysset M, Tourné Y, Tillmann K. Foot and ankle in rheumatoid arthritis .p.179-206, 2nd ed. Elsevier,2011.
2. Verma MK, Sobha K. Understanding the major risk factors in the beginning and the progression of rheumatoid arthritis: current scenario and future prospects. Inflamm Res. 64(9):647–59, 2015.
3. Capkin E, Cakirbay H, Karkucak M, Topbas M, Serdaroglu M, Guler M, et al. Prevalence of rheumatoid arthritis in the eastern Black Sea region of Turkey. Int J Rheum Dis. 13(4):380–4, 2010.
4. Aletaha D, Ward MM, Machold KP, Nell VPK, Stamm T, Smolen JS. Remission and active disease in rheumatoid arthritis: Defining criteria for disease activity states. Arthritis Rheum. 52(9):2625–36, 2005.
5. Fallis A. Harrison’s Principles of Internal Medicine. p.1689–99. 1st.ed. J Chem Inf Model, 2015.
6. Girbal-Neuhauser E, Durieux JJ, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritisassociated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
7. Schellekens GA, De Jong B, Van Den Hoogen F, Van de Putte L, van Venrooij WJ. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. Journal of Clinical Investigation 1998;101(1):273.
8. Girbal-Neuhauser E, Durieux J-J, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritisassociated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
9. Vossenaar ER, van Venrooij WJ. Anti-CCP antibodies, a highly specific marker for (early) rheumatoid arthritis. Clin Appl Immunol Rev. 4(4):239–62, 2004.
10. Shah A, Clair EWS, 2015. Rheumatoid Arthritis. In: Harrison's principles of internal medicine Eds: Kasper DL, Hauser SL, Jameson JL et al. New York: McGraw-Hill Education, p. 2136-249.
11. Akar S, 2013. Romatoid Artrit. In: Harrison's principles of internal medicine Türkçe Eds: Kasper DL, Hauser SL, Jameson JL et al, 17th ed. İzmir, p. 2083- 92.
12. Gümüşdiş G. Romatoid Artrit. In: Gümüşdiş G ve Doğanavşargil E. (edr). Klinik Romatoloji, İzmir: Deniz Matb, 1999; 269-79.
13. Ergin S. Romatoid Artrit ve Sjogren Sendromu. Beyazova M, Gökce-Kutsal Y (edr). Fiziksel Tıp ve Rehabilitasyon Cilt 2. Güneş Kitabevi Ltd. Şti, Ankara, 2000; 1549-76.
14. Konice M, Eryavuz M. Romatoid Artrit. Tuzun F. Eryavuz M. Akarırmak U (edr). Hareket Sistemi Hastalıkları Nobel Tıp Kitabevi. İstanbul, 1997;85-98.
15. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-24.
16. Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis. Mikrobiyol Bul 2003; 37: 163-70.
17.Arıdoğan BC, Kaya S, Savaş S, Çetin ES, Akkuş S, Demirci M. Romatoid artritin serolojik tanısında ve hastalık aktivitesinin değerlendirilmesinde anti-CCP (cyclic citrullinated peptid) antikorlarının rolü. Mikrobiyoloji Bul 2008;42:669-674.
18. Aridoğan BC, Çetin ES, Yildirim M, Kaya S, Ceyhan AM, Demirci M, Savas S, Ural O and Akkus S. Anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis, brucellar arthritis and Behcet’s disease. African Journal of Microbiology Research 2011; 5(19): 2975-2979.

Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Klinik Tıp Bilimleri
Bölüm	Araştırma Makaleleri
Yazarlar	Selçuk Kaya 0000-0002-8637-6345 Mehmet Karabey 0000-0002-7394-186X Ayşegül Aksoy Gökmen 0000-0001-6407-4592 Gökhan Kabadayı Bu kişi benim
Yayımlanma Tarihi	31 Mart 2021
Yayımlandığı Sayı	Yıl 2021 Cilt: 6 Sayı: 1

Kaynak Göster

APA	Kaya, S., Karabey, M., Aksoy Gökmen, A., Kabadayı, G. (2021). Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis. Journal of Immunology and Clinical Microbiology, 6(1), 1-6.
AMA	Kaya S, Karabey M, Aksoy Gökmen A, Kabadayı G. Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis. J Immunol Clin Microbiol. Mart 2021;6(1):1-6.
Chicago	Kaya, Selçuk, Mehmet Karabey, Ayşegül Aksoy Gökmen, ve Gökhan Kabadayı. “Evaluation of Anti-CCP and RF in Pre-Diagnosed Patient Serums of Rheumatoid Arthritis”. Journal of Immunology and Clinical Microbiology 6, sy. 1 (Mart 2021): 1-6.
EndNote	Kaya S, Karabey M, Aksoy Gökmen A, Kabadayı G (01 Mart 2021) Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis. Journal of Immunology and Clinical Microbiology 6 1 1–6.
IEEE	S. Kaya, M. Karabey, A. Aksoy Gökmen, ve G. Kabadayı, “Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis”, J Immunol Clin Microbiol, c. 6, sy. 1, ss. 1–6, 2021.
ISNAD	Kaya, Selçuk vd. “Evaluation of Anti-CCP and RF in Pre-Diagnosed Patient Serums of Rheumatoid Arthritis”. Journal of Immunology and Clinical Microbiology 6/1 (Mart 2021), 1-6.
JAMA	Kaya S, Karabey M, Aksoy Gökmen A, Kabadayı G. Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis. J Immunol Clin Microbiol. 2021;6:1–6.
MLA	Kaya, Selçuk vd. “Evaluation of Anti-CCP and RF in Pre-Diagnosed Patient Serums of Rheumatoid Arthritis”. Journal of Immunology and Clinical Microbiology, c. 6, sy. 1, 2021, ss. 1-6.
Vancouver	Kaya S, Karabey M, Aksoy Gökmen A, Kabadayı G. Evaluation of Anti-CCP and RF in pre-diagnosed Patient Serums of Rheumatoid Arthritis. J Immunol Clin Microbiol. 2021;6(1):1-6.