Immunological markers of rheumatoid arthritis

Abstract

Rheumatoid arthritis (RA) is the most common connective tissue disease of autoimmune origin. The disease is characterized by chronic inflammation leading to bone erosions and organ involvement. RA is a progressive disease. It affects the quality of life, leading to disability and death mainly due to premature cardiovascular disease. Early diagnosis and appropriate treatment are essential for prognosis and quality of life improvement. In 2010 the American College of Rheumatology (ACR) and The European League Against Rheumatism (EULAR) established new RA classification criteria. Besides clinical symptoms it includes two immunologic criteria: rheumatoid factor (RF) and anti-citrullinated protein antibodies (anti-CCP antibodies). RF is the first well-known RA immunologic marker. It is observed in 80-85% of patients with RA. Elevated serum level of RF has been associated with increased disease activity, radiographic progression, and the presence of extraarticular manifestations. The sensitivity of RF is 50-90%, and specificity is 50-95%. Anti-CCP antibodies appear to be a more specific marker than RF. They are often present at the very beginning of the disease, or even years before the first symptoms. The prognostic value of anti-CCP antibodies is well established. High serum level of anti-CCP correlates with poor prognosis and early erosions of the joints. The sensitivity of anti-CCP2 is 48-80%, and specificity is 96-98%. New immunologic markers include anti-carbamylated protein antibodies (anti-CarP) and antibodies against heterogeneous nuclear ribonucleoproteins (anti-hnRNP A2/B1, RA33). Scientists aim to identify a highly sensitive and specific biomarker of the disease that not only has diagnostic and prognostic value but also may predict the response to treatment.

Issues of the presence of parasitic protozoa in surface waters

“…At the same time, it is effective only against Giardia, but it does not kill Cryptosporidium. Also, when using monochloramine, a similar relationship is noted [1,44,45]. Among the disinfection methods used, UV and ozonation appear to be more effective than chlorine compounds in relation to parasitic protozoa.…”

Diagnostic value of autoantibodies combined detection for rheumatoid arthritis

“…6,7,19 While the high specificity of anti-CCP is undisputed, RF is often considered a reasonably sensitive (81.61%) but relatively non-specific (44%) marker of RA. Correspondingly, a specific and sensitive serological test is needed.…”

“…Anti-CCP, which is extremely specific (86.73%) and has a reasonable sensitivity of 75.14% in this study, appears to be a good prognostic marker and has a high discriminating power between erosive and nonerosive RA. 6,7,19 While the high specificity of anti-CCP is undisputed, RF is often considered a reasonably sensitive (81.61%) but relatively non-specific (44%) marker of RA.…”

Dermoscopic patterns of filiform papillae of the tongue in patients with and without connective tissue autoimmune diseases

“…Manuel Gea González,” Mexico City; the study was approved by the Investigation and Research Ethics Committees of our hospital (#0641‐2008). The cases were diagnosed with one of the following autoimmune diseases: rheumatoid arthritis (per the 2010 American College of Rheumatology diagnostic criteria), systemic lupus erythematosus (per Tan et al …”

“…4,5 International Journal of Dermatology 2018, 57, 938-942 ª 2018 The International Society of Dermatology Filiform papillae cannot be appreciated in detail with the naked eye, necessitating the use of a dermatoscope to identify various structural changes. Architecturally, they consist of a central body that is surrounded by multiple cornified projections (3)(4)(5)(6)(7)(8), which several groups consider secondary to papillae that are composed of a central column of epithelial cells that express keratins that are similar to those in hair, and an outer ring of cells that express cytokeratins, as skin does. 6 The macroscopic patterns of filiform papillae are classified into four types: in type I, the papillae are conical or cylindrical (normal aspect); in type II, the papillae are not cornified; in type III, they are round; and in type IV, the papillae are absent.…”