A Comparative Assessment of the Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibodies and Rheumatoid Factor in Rheumatoid Arthritis

Abstract

Rheumatoid arthritis is a systemic, chronic inflammatory autoimmune disease affecting many tissues but principally attacking the joints. Auto antibodies such as rheumatoid factor and anti-cyclic Citrullinated peptide antibodies have important diagnostic value. This cross-sectional analytical study was performed at a single medical institution in central Iran (Shahid Sadoughi Hospital, Yazd, Iran) in order to compare the diagnostic value of anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis. Serum levels of anti-cyclic citrullinated peptide antibodies were determined by enzyme-linked immunosorbent assay, and levels of rheumatoid factor were determined by turbidimetry on a latex-enhanced agglutination assay in 266 patients with rheumatoid arthritis and 134 patients with non-rheumatoid arthritis rheumatic diseases.Among the 266 patients with rheumatoid arthritis, 188 patients (70.7%) were tested positive for anti-cyclic citrullinated peptide antibodies, and 123 patients (46.2%) were tested positive for rheumatoid factor. The sensitivity, specificity, positive predictive value and negative predictive value of anti-cyclic citrullinated peptide antibodies for diagnosing rheumatoid arthritis were 70.76%, 85.07%, 90%, and 59% respectively. Those for rheumatoid factor were 46.26%, 90.29%, 90%, and 45% respectively. The anti-cyclic Citrullinated peptide antibodies measurement is a useful test for diagnosing rheumatoid arthritis. Due to its high positive predictive value and negative predictive value, it is an important diagnostic test and gives accurate diagnosis of the disease. However, this does not mean that anti-cyclic citrullinated peptide antibodies can replace rheumatoid factor in the diagnosis of rheumatoid arthritis, because not all rheumatoid arthritis patients have anti-cyclic Citrullinated peptide antibodies. The two tests therefore appear to be complementary.

Analyses of Human and Rat Clinical Parameters in Rheumatoid Arthritis Raise the Possibility of Use of Crude Aloe vera Gel in Disease Amelioration

“…When compared to data of other populations, it was found that in case of the Korean population, 80.56% of the RA patients were found to be RF positive while 19.44 were RF negative [17]. In a similar study conducted on the Iranian population, it was found that 66.5% of the RA patients were RF positive while 33.5 were negative [18]. In another study based on Turkish patients, it was found that 53.335 were RF positive while 46.67 were RF negative [19].…”

Combination of Serological Tests (Anti-CCP Antibody, Rheumatoid Factor IgM ELISA and Latex Test) are more Useful in Detection of Rheumatoid Arthritis

“…One explanation for the discrepancy is that the differences in the patient populations (mainly disease duration) among these studies might have some influence on the results. Another study showed that the specificity and sensitivity of anti-CCP antibodies may depend on the patient's race (Binesh et al, 2014). It is also probably inevitable that sensitivity and specificity of laboratory tests will vary between studies as there will be local variations in the application of clinical diagnostic criteria.…”

Improved serological detection of rheumatoid arthritis: a highly antigenic mimotope of carbonic anhydrase III selected in a murine model by phage display

“…These antibodies present specificities in the range of 65 % to 100 % (mean of 93.4 %) and sensitivities in the range of 42 % to 92.2 % (mean of 64.3 %) [ 9 , 64 – 71 ]. RF testing presents specificities in the range 85 % to 90.29 % and sensitivities in the range 46.26 % to 90 % [ 72 – 74 ]. The diagnostic parameters for the M12 peptide for RA diagnosis presented specificity of 91 % and sensitivity of 84.3 %, which is very close to the mean of values reported for antiCCP and RF antibodies, the two most currently used serum biomarkers for RA.…”