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Erschienen in: Rheumatology International 12/2007

01.10.2007 | Original Article

Diagnostic performances of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis

verfasst von: Rim Sghiri, Elyes Bouagina, Hela Zaglaoui, Hajer Mestiri, Latifa Harzallah, Imed Harrabi, Mehdi Ghannouchi, Faycel Mokhtar, Ibtissem Ghedira

Erschienen in: Rheumatology International | Ausgabe 12/2007

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Abstract

To evaluate the rheumatoid arthritis (RA) diagnostic performances of anti-cyclic citrullinated peptide antibodies (anti-CCP). Anti-CCP was detected by an enzyme linked immunosorbent assay in 164 patients with RA and 343 controls. In addition, anti-CCP predictive value for radiological damage were investigated in 37 recent-onset RA patients followed up prospectively for 2 years. Radiological damages were assessed by Sharp method modified by van der Heijde. The sensitivity of anti-CCP was 78.7% and the specificity was 95.6%. The positive predictive value and the negative predictive value were 90.2% and 90.3%, respectively. Anti-CCP were detected in sera of 79.3% of patients with recent onset RA and 78.3% of patients with long disease duration. In univariate and multivariate analyses, anti-CCP were not predictive for radiological damage. Our study confirms the high diagnostic performances of anti-CCP in RA. They are very useful to aid the diagnostic of RA in clinical practice.
Literatur
1.
Zurück zum Zitat Pincus T (1998) Aggressive treatment of early rheumatoid arthritis to prevent joint damage. Bull Rheum Dis 47:2–7PubMed Pincus T (1998) Aggressive treatment of early rheumatoid arthritis to prevent joint damage. Bull Rheum Dis 47:2–7PubMed
2.
Zurück zum Zitat Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS (1988) The American Rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRef Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS (1988) The American Rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRef
3.
Zurück zum Zitat van Schaardenburg D, Lagaay AM, Otten HG, Breedveld FC (1993) The relation between class-specific serum rheumatoid factors and age in the general population. Br J Rheumatol 32:546–549PubMedCrossRef van Schaardenburg D, Lagaay AM, Otten HG, Breedveld FC (1993) The relation between class-specific serum rheumatoid factors and age in the general population. Br J Rheumatol 32:546–549PubMedCrossRef
4.
Zurück zum Zitat Aho K, Palusuo T, Kurki P (1994) Marker antibodies of rheumatoid arthritis: diagnostic and pathogenetic implications. Semin Arthritis Rheum 23:379–387PubMedCrossRef Aho K, Palusuo T, Kurki P (1994) Marker antibodies of rheumatoid arthritis: diagnostic and pathogenetic implications. Semin Arthritis Rheum 23:379–387PubMedCrossRef
5.
Zurück zum Zitat Niehuis RLF, Mandema EA (1964) A new serum factor in patients with rheumatoid arthritis: the antiperinuclear factor. Ann Rheum Dis 23:302–303 Niehuis RLF, Mandema EA (1964) A new serum factor in patients with rheumatoid arthritis: the antiperinuclear factor. Ann Rheum Dis 23:302–303
6.
Zurück zum Zitat Sebbag M, Simon M, Vincent C, Masson-Bessiere C, Girbal E, Durieux JJ, Serre (1995) The antiperinuclear factor and the so-called antikeratin antibodies are the same rheumatoid arthritis-specific autoantibodies. J Clin Invest 95:2672–2679PubMed Sebbag M, Simon M, Vincent C, Masson-Bessiere C, Girbal E, Durieux JJ, Serre (1995) The antiperinuclear factor and the so-called antikeratin antibodies are the same rheumatoid arthritis-specific autoantibodies. J Clin Invest 95:2672–2679PubMed
7.
Zurück zum Zitat Dubucquoi S, Solau-Gervais E, Lefranc D, Marguerie L, Sibilia J, Goetz J, Dutoit V, Fauchais AL, Hachulla E, Flipo RM, Prin L (2004) Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis 63:415–419PubMedCrossRef Dubucquoi S, Solau-Gervais E, Lefranc D, Marguerie L, Sibilia J, Goetz J, Dutoit V, Fauchais AL, Hachulla E, Flipo RM, Prin L (2004) Evaluation of anti-citrullinated filaggrin antibodies as hallmarks for the diagnosis of rheumatic diseases. Ann Rheum Dis 63:415–419PubMedCrossRef
8.
Zurück zum Zitat Vallbracht I, Rieber J, Oppermann M, Forger F, Siebert U, Helmke K (2004) Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis. Ann Rheum Dis 63:1079–1084PubMedCrossRef Vallbracht I, Rieber J, Oppermann M, Forger F, Siebert U, Helmke K (2004) Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis. Ann Rheum Dis 63:1079–1084PubMedCrossRef
9.
Zurück zum Zitat van der Heijde DM, van Riel PL, van Leeuwen MA, van ‘t Hof MA, van Rijswijk MH, van de Putte LB (1992) Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis: a prospective follow-up study of 147 patients. Br J Rheumatol 31:519–525PubMedCrossRef van der Heijde DM, van Riel PL, van Leeuwen MA, van ‘t Hof MA, van Rijswijk MH, van de Putte LB (1992) Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis: a prospective follow-up study of 147 patients. Br J Rheumatol 31:519–525PubMedCrossRef
10.
Zurück zum Zitat Schellekens GA, de Jong BA, van den Hoogen FH, van de Putte LB, van Venrooij WJ (1998) Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. J Clin Invest 101:273–281PubMedCrossRef Schellekens GA, de Jong BA, van den Hoogen FH, van de Putte LB, van Venrooij WJ (1998) Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. J Clin Invest 101:273–281PubMedCrossRef
11.
Zurück zum Zitat Bizzaro N, Mazzanti G, Tonutti E, Villalta D, Tozzoli R (2001) Diagnostic accuracy of the anti-citrulline antibody assay for rheumatoid arthritis. Clin Chem 47:1089–1093PubMed Bizzaro N, Mazzanti G, Tonutti E, Villalta D, Tozzoli R (2001) Diagnostic accuracy of the anti-citrulline antibody assay for rheumatoid arthritis. Clin Chem 47:1089–1093PubMed
12.
Zurück zum Zitat Suzuki K, Sawada T, Murakami A, Matsui T, Tohma S, Nakazono K, Takemura M, Takasaki Y, Mimori T, Yamamoto K (2003) High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol 32:197–204PubMedCrossRef Suzuki K, Sawada T, Murakami A, Matsui T, Tohma S, Nakazono K, Takemura M, Takasaki Y, Mimori T, Yamamoto K (2003) High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis. Scand J Rheumatol 32:197–204PubMedCrossRef
13.
Zurück zum Zitat Sauerland U, Becker H, Seidel M, Schotte H, Willeke P, Schorat A, Schluter B, Domschke W, Gaubitz M (2005) Clinical utility of the anti-CCP assay: experiences with 700 patients. Ann N Y Acad Sci 1050:314–318PubMedCrossRef Sauerland U, Becker H, Seidel M, Schotte H, Willeke P, Schorat A, Schluter B, Domschke W, Gaubitz M (2005) Clinical utility of the anti-CCP assay: experiences with 700 patients. Ann N Y Acad Sci 1050:314–318PubMedCrossRef
14.
Zurück zum Zitat Correa PA, Tobon GJ, Citera G, Cadena J, Schneeberger E, Camargo JF, Maldonado-Cocco JA, Anaya JM (2004) Anti cyclic citrullinated antibodies in rheumatoid arthritis: relation with clinical features, cytokines and HLA-DRB1. Biomedica 24:140–152PubMed Correa PA, Tobon GJ, Citera G, Cadena J, Schneeberger E, Camargo JF, Maldonado-Cocco JA, Anaya JM (2004) Anti cyclic citrullinated antibodies in rheumatoid arthritis: relation with clinical features, cytokines and HLA-DRB1. Biomedica 24:140–152PubMed
15.
Zurück zum Zitat Avouac J, Gossec L, Dougados M (2006) Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 65:845–851PubMedCrossRef Avouac J, Gossec L, Dougados M (2006) Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 65:845–851PubMedCrossRef
16.
Zurück zum Zitat Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ (2000) The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 43:155–163PubMedCrossRef Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, van Venrooij WJ (2000) The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 43:155–163PubMedCrossRef
17.
Zurück zum Zitat Rantapaa-Dahlqvist S, de Jong BA, Berglin E, Hallmans G, Wadell G, Stenlund H, Sundin U, van Venrooij WJ (2003) Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 48:2741–2749PubMedCrossRef Rantapaa-Dahlqvist S, de Jong BA, Berglin E, Hallmans G, Wadell G, Stenlund H, Sundin U, van Venrooij WJ (2003) Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 48:2741–2749PubMedCrossRef
18.
Zurück zum Zitat Nielen MM, van Schaardenburg D, Reesink HW, van de Stadt RJ, van der Horst-Bruinsma IE, de Koning MH, Habibuw MR, Vandenbroucke JP, Dijkmans BA (2004) Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum 50:380–386PubMedCrossRef Nielen MM, van Schaardenburg D, Reesink HW, van de Stadt RJ, van der Horst-Bruinsma IE, de Koning MH, Habibuw MR, Vandenbroucke JP, Dijkmans BA (2004) Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum 50:380–386PubMedCrossRef
19.
Zurück zum Zitat Kasapcopur O, Altun S, Aslan M, Karaarslan S, Kamburoglu-Goksel A, Saribas S, Arisoy N, Kocazeybek B (2004) Diagnostic accuracy of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis. Ann Rheum Dis 63:1687–1689PubMedCrossRef Kasapcopur O, Altun S, Aslan M, Karaarslan S, Kamburoglu-Goksel A, Saribas S, Arisoy N, Kocazeybek B (2004) Diagnostic accuracy of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis. Ann Rheum Dis 63:1687–1689PubMedCrossRef
20.
Zurück zum Zitat Low JM, Chauhan AK, Kietz DA, Daud U, Pepmueller PH, Moore TL (2004) Determination of anti-cyclic citrullinated peptide antibodies in the sera of patients with juvenile idiopathic arthritis. J Rheumatol 31:1829–1833PubMed Low JM, Chauhan AK, Kietz DA, Daud U, Pepmueller PH, Moore TL (2004) Determination of anti-cyclic citrullinated peptide antibodies in the sera of patients with juvenile idiopathic arthritis. J Rheumatol 31:1829–1833PubMed
21.
Zurück zum Zitat Brunner J, Sitzmann FC (2006) The diagnostic value of anti-cyclic citrullinated peptide (CCP) antibodies in children with juvenile idiopathic arthritis. Clin Exp Rheumatol 2:449–451 Brunner J, Sitzmann FC (2006) The diagnostic value of anti-cyclic citrullinated peptide (CCP) antibodies in children with juvenile idiopathic arthritis. Clin Exp Rheumatol 2:449–451
22.
Zurück zum Zitat van Rossum M, van Soesbergen R, de Kort S, ten Cate R, Zwinderman AH, de Jong B, Dijkmans B, van Venrooij WJ (2003) Anti-cyclic citrullinated peptide (anti-CCP) antibodies in children with juvenile idiopathic arthritis. J Rheumatol 30:825–828PubMed van Rossum M, van Soesbergen R, de Kort S, ten Cate R, Zwinderman AH, de Jong B, Dijkmans B, van Venrooij WJ (2003) Anti-cyclic citrullinated peptide (anti-CCP) antibodies in children with juvenile idiopathic arthritis. J Rheumatol 30:825–828PubMed
23.
Zurück zum Zitat Vander Cruyssen B, Hoffman IE, Zmierczak H, Van den Berghe M, Kruithof E, De Rycke L, Mielants H, Veys EM, Baeten D, De Keyser F (2005) Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. Ann Rheum Dis 64:1145–1149PubMedCrossRef Vander Cruyssen B, Hoffman IE, Zmierczak H, Van den Berghe M, Kruithof E, De Rycke L, Mielants H, Veys EM, Baeten D, De Keyser F (2005) Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. Ann Rheum Dis 64:1145–1149PubMedCrossRef
24.
Zurück zum Zitat Bogliolo L, Alpini C, Caporali R, Scire CA, Moratti R, Montecucco C (2005) Antibodies to cyclic citrullinated peptides in psoriatic arthritis. J Rheumatol 32:511–515PubMed Bogliolo L, Alpini C, Caporali R, Scire CA, Moratti R, Montecucco C (2005) Antibodies to cyclic citrullinated peptides in psoriatic arthritis. J Rheumatol 32:511–515PubMed
25.
Zurück zum Zitat Inanc N, Dalkilic E, Kamali S, Kasapoglu-Gunal E, Elbir Y, Direskeneli H, Inanc M (2007) Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 26:17–23 Inanc N, Dalkilic E, Kamali S, Kasapoglu-Gunal E, Elbir Y, Direskeneli H, Inanc M (2007) Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 26:17–23
26.
Zurück zum Zitat Mediwake R, Isenberg DA, Schellekens GA, van Venrooij WJ (2001) Use of anti-citrullinated peptide and anti-RA33 antibodies in distinguishing erosive arthritis in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis 60:67–68PubMedCrossRef Mediwake R, Isenberg DA, Schellekens GA, van Venrooij WJ (2001) Use of anti-citrullinated peptide and anti-RA33 antibodies in distinguishing erosive arthritis in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis 60:67–68PubMedCrossRef
27.
Zurück zum Zitat Gottenberg JE, Mignot S, Nicaise-Rolland P, Cohen-Solal J, Aucouturier F, Goetz J, Labarre C, Meyer O, Sibilia J, Mariette X (2005) Prevalence of anti-cyclic citrullinated peptide and anti-keratin antibodies in patients with primary Sjogren’s syndrome. Ann Rheum Dis 64:114–117PubMedCrossRef Gottenberg JE, Mignot S, Nicaise-Rolland P, Cohen-Solal J, Aucouturier F, Goetz J, Labarre C, Meyer O, Sibilia J, Mariette X (2005) Prevalence of anti-cyclic citrullinated peptide and anti-keratin antibodies in patients with primary Sjogren’s syndrome. Ann Rheum Dis 64:114–117PubMedCrossRef
28.
Zurück zum Zitat Tobon GJ, Correa PA, Anaya JM (2005) Anti-cyclic citrullinated peptide antibodies in patients with primary Sjogren’s syndrome. Ann Rheum Dis 64:791–792PubMedCrossRef Tobon GJ, Correa PA, Anaya JM (2005) Anti-cyclic citrullinated peptide antibodies in patients with primary Sjogren’s syndrome. Ann Rheum Dis 64:791–792PubMedCrossRef
29.
Zurück zum Zitat Wener MH, Hutchinson K, Morishima C, Gretch DR (2004) Absence of antibodies to cyclic citrullinated peptide in sera of patients with hepatitis C virus infection and cryoglobulinemia. Arthritis Rheum 50:2305–2308PubMedCrossRef Wener MH, Hutchinson K, Morishima C, Gretch DR (2004) Absence of antibodies to cyclic citrullinated peptide in sera of patients with hepatitis C virus infection and cryoglobulinemia. Arthritis Rheum 50:2305–2308PubMedCrossRef
30.
Zurück zum Zitat Sene D, Ghillani-Dalbin P, Limal N, Thibault V, van Boekel T, Piette JC, Cacoub P (2006) Anti-cyclic citrullinated peptide antibodies in hepatitis C virus associated rheumatological manifestations and Sjogren’s syndrome. Ann Rheum Dis 65:394–397PubMedCrossRef Sene D, Ghillani-Dalbin P, Limal N, Thibault V, van Boekel T, Piette JC, Cacoub P (2006) Anti-cyclic citrullinated peptide antibodies in hepatitis C virus associated rheumatological manifestations and Sjogren’s syndrome. Ann Rheum Dis 65:394–397PubMedCrossRef
31.
Zurück zum Zitat Symmons D, Harrison B (2000) Early inflammatory polyarthritis: results from the norfolk arthritis register with a review of the literature. I. Risk factors for the development of inflammatory polyarthritis and rheumatoid arthritis. Rheumatology 39:835–843PubMedCrossRef Symmons D, Harrison B (2000) Early inflammatory polyarthritis: results from the norfolk arthritis register with a review of the literature. I. Risk factors for the development of inflammatory polyarthritis and rheumatoid arthritis. Rheumatology 39:835–843PubMedCrossRef
32.
Zurück zum Zitat Scott DL (2000) Prognostic factors in early rheumatoid arthritis. Rheumatology 39(Suppl 1):24–29PubMed Scott DL (2000) Prognostic factors in early rheumatoid arthritis. Rheumatology 39(Suppl 1):24–29PubMed
33.
Zurück zum Zitat Meyer O, Labarre C, Dougados M, Goupille P, Cantagrel A, Dubois A, Nicaise-Roland P, Sibilia J, Combe (2003) Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 62:120–126PubMedCrossRef Meyer O, Labarre C, Dougados M, Goupille P, Cantagrel A, Dubois A, Nicaise-Roland P, Sibilia J, Combe (2003) Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 62:120–126PubMedCrossRef
34.
Zurück zum Zitat Jansen LM, van Schaardenburg D, van der Horst-Bruinsma I, van der Stadt RJ, de Koning MH, Dijkmans BA (2003) The predictive value of anti-cyclic citrullinated peptide antibodies in early arthritis. J Rheumatol 30:1691–1695PubMed Jansen LM, van Schaardenburg D, van der Horst-Bruinsma I, van der Stadt RJ, de Koning MH, Dijkmans BA (2003) The predictive value of anti-cyclic citrullinated peptide antibodies in early arthritis. J Rheumatol 30:1691–1695PubMed
35.
Zurück zum Zitat Bas S, Genevay S, Meyer O, Gabay C (2003) Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis. Rheumatology 42:677–680PubMedCrossRef Bas S, Genevay S, Meyer O, Gabay C (2003) Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis. Rheumatology 42:677–680PubMedCrossRef
36.
Zurück zum Zitat Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B, BARFOT Study Group (2004) Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis 63:1090–1095PubMedCrossRef Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B, BARFOT Study Group (2004) Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis 63:1090–1095PubMedCrossRef
37.
Zurück zum Zitat Lindqvist E, Eberhardt K, Bendtzen K, Heinegard D, Saxne T (2005) Prognostic laboratory markers of joint damage in rheumatoid arthritis. Ann Rheum Dis 64:196–201PubMedCrossRef Lindqvist E, Eberhardt K, Bendtzen K, Heinegard D, Saxne T (2005) Prognostic laboratory markers of joint damage in rheumatoid arthritis. Ann Rheum Dis 64:196–201PubMedCrossRef
38.
Zurück zum Zitat Kroot EJ, de Jong BA, van Leeuwen MA, Swinkels H, van den Hoogen FH, van’t Hof M, van de Putte LB, van Rijswijk MH, van Venrooij WJ, van Riel PL (2000) The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum 43:1831–1835PubMedCrossRef Kroot EJ, de Jong BA, van Leeuwen MA, Swinkels H, van den Hoogen FH, van’t Hof M, van de Putte LB, van Rijswijk MH, van Venrooij WJ, van Riel PL (2000) The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum 43:1831–1835PubMedCrossRef
Metadaten
Titel
Diagnostic performances of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis
verfasst von
Rim Sghiri
Elyes Bouagina
Hela Zaglaoui
Hajer Mestiri
Latifa Harzallah
Imed Harrabi
Mehdi Ghannouchi
Faycel Mokhtar
Ibtissem Ghedira
Publikationsdatum
01.10.2007
Verlag
Springer-Verlag
Erschienen in
Rheumatology International / Ausgabe 12/2007
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-007-0351-4

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