Meta-Analysis: Diagnostic Accuracy of Anti-Cyclic Citrullinated Peptide Antibody for Juvenile Idiopathic Arthritis

Wang, Yan; Pei, Fengyan; Wang, Xingjuan; Sun, Zhiyu; Hu, Chengjin; Dou, Huan

doi:10.1155/2015/915276

Cited by 14 publications

(11 citation statements)

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“…LF has a higher sensitivity and specificity during the diagnosis of suspected UC than is the case in Crohn's disease [12] and only LF at baseline was associated with a significantly higher relative risk of flare (RR 1.69; p = 0.018), when compared to calprotectin, PMN, and CRP, which are also predictive of a flare [13]. Quantitative immunochemical fecal occult blood measurement is comparable to fecal LF and is easier and more useful than fecal calprotectin in predicting early relapse [14].…”

Section: Discussionmentioning

confidence: 92%

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

et al. 2018

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Background: There is a need to use noninvasive markers in refining the management of ulcerative colitis to reduce the number of unnecessary colonoscopies, which facilitates the follow-up of activity and the response to treatment. Aim: Postulation of a sensitive, specific, simple and noninvasive score to monitor disease activity in ulcerative colitis. Methods: A case-control study was conducted: 168 patients with ulcerative colitis, 40 healthy individuals, and 60 patients for validation. Patients were divided into new diagnosis (n = 50), clinical remission (n = 60), and relapse (n = 58). The main outcome measures if the score correlates with clinical, endoscopic and histopathological characteristics and if it correlates with deep remission. Results: A scoring system was established composed of lactoferrin at a cutoff of 148.5 μg/mL, neutrophil lymphocyte ratio at a cutoff of 2.35, erythrocyte sedimentation rate at the first hour at a cutoff of 29.5 mm/h, C-reactive protein at a cutoff of 3.85 mg/L, mean platelet volume at a cutoff of 8.8 fL, fecal white blood cells at a cutoff of 9 cells/HPF, and fecal red blood cells at a cutoff of 6 cells/HPF. A score ≥5 can detect 94% of cases of UC as determined by the receiver operating characteristic curve with a sensitivity of 94% and a specificity 100%, AUC 0.92, SE 0.05, p = 0.001, 95% CI 0.82–1.1. In the validation group, it identified severely affected patients with a sensitivity of 95% and a specificity of 85.7%. Conclusions: This easily applied and reproducible noninvasive activity score showed high performance in predicting disease activity and deep remission in ulcerative colitis.

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Section: Discussionmentioning

confidence: 92%

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

et al. 2018

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“…“Classic” serological markers, which include rheumatoid factor (RF), anticyclic citrullinated peptide autoantibodies (ACPA), and antinuclear antibodies (ANA) [ 12 ], are helpful in assigning patients into separate JIA subtypes or estimating risk of comorbidities (such as uveitis). However, they do not provide sufficient data on disease activity or response to treatment to predict the future course of the disease.…”

Section: Introductionmentioning

confidence: 99%

A Granulocyte-Specific Protein S100A12 as a Potential Prognostic Factor Affecting Aggressiveness of Therapy in Patients with Juvenile Idiopathic Arthritis

Orczyk

Smolewska

2018

Journal of Immunology Research

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Background Defining new prognostic biomarkers has become one of the most promising perspectives for the long-term care of patients with juvenile idiopathic arthritis (JIA). The new efficient indicators of disease activity and potential response to treatment are crucial in establishing new therapeutic plans in accordance with the “treat to target” strategy. One of the most studied proteins is called S100A12, which is an alarmin specific for granulocytes, considered as a marker of their activity. Materials and Methods Study involved 80 patients diagnosed with JIA. Children with systemic subtype were not included in the study. In 53 cases, blood samples were obtained in two time points. Results from the study group were compared to 29 age- and sex-matched healthy individuals. Results Serum S100A12 levels were higher in JIA than in healthy controls at the study baseline (11.67 ± 6.59 vs. 6.01 ± 2.33 ng/ml). There were no significant differences in S100A12 values between assessed subtypes of JIA. The highest concentrations were observed in patients within a disease flare. S100A12 levels were not dependent from using glucocorticosteroids. The studied protein appeared to be an efficient biomarker for JIA patients: 100% specificity as a diagnostic marker (cut-off level: 10.73 ng/ml) and 100% sensitivity as an indicator of exacerbations within a 3-month observation (cut-off level: 5.48 ng/ml). Conclusions S100A12 may become an important factor influencing decisions on aggressiveness of JIA therapy. Further elaboration on the clinical algorithm is necessary for that protein to be included in everyday practice.

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“…These citrullinated proteins (for example vimentin and fibrin) are targeted by anti‐CCP antibodies, resulting in the formation of immune complexes . Anti‐CCP positivity was found in 48% of RF + polyarticular JIA patients, in 6% of the RF − polyarticular and in 2% of the oligoarticular JIA subtypes in one study . A meta‐analysis of anti‐CCP in JIA showed a pooled sensitivity of only 12% in JIA, but the good diagnostic accuracy of this assay was mainly due to its perfect specificity (99%, Table ) .…”

Section: Biomarkers In the Other Subtypes Of Jiamentioning

confidence: 98%

“…Anti‐CCP positivity was found in 48% of RF + polyarticular JIA patients, in 6% of the RF − polyarticular and in 2% of the oligoarticular JIA subtypes in one study . A meta‐analysis of anti‐CCP in JIA showed a pooled sensitivity of only 12% in JIA, but the good diagnostic accuracy of this assay was mainly due to its perfect specificity (99%, Table ) . Therefore, a positive anti‐CCP antibody test in a patient with arthritis supports the diagnosis of JIA, but a negative test certainly does not exclude it.…”

Section: Biomarkers In the Other Subtypes Of Jiamentioning

confidence: 99%

Understanding inflammation in juvenile idiopathic arthritis: How immune biomarkers guide clinical strategies in the systemic onset subtype

2016

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The translation of basic insight in immunological mechanisms underlying inflammation into clinical practice of inflammatory diseases is still challenging. Here we describe how-through continuous dialogue between bench and bedside-immunological knowledge translates into tangible clinical use in a complex inflammatory disease, juvenile idiopathic arthritis (JIA). Systemic JIA (sJIA) is an autoinflammatory disease, leading to the very successful use of IL-1 antagonists. Further immunological studies identified new immune markers for diagnosis, prediction of complications, response to and successful withdrawal of therapy. Myeloid related protein (MRP)8, MRP14, S100A12, and Interleukin-18 are already used daily in clinic as markers for active sJIA. For non-sJIA subtypes, HLA-B27, antinuclear-antibodies, rheumatoid factor, erythrocyte sedimentation rate, and Creactive protein are still used for classification, prognosis or active disease. MRP8, MRP14, and S100A12 are now under study for clinical practice. We believe that with biomarkers, algorithms can soon be designed for the individual risk of disease, complications, damage, prediction of response to, and successful withdrawal of therapy. In that way, less time will be lost and less pain will be suffered by the patients. In this review, we describe the current status of immunological biomarkers used in diagnosis and treatment of JIA.Keywords: Biomarkers r Classification r Juvenile arthritis r Prognosis r Recurrence IntroductionJuvenile idiopathic arthritis (JIA) is the most common occurring chronic rheumatic disease in childhood with incidence rates varying from 1.6 to 23 and prevalence from 3.8 to 400 per 100 000 in the European population in 2010 [1]. JIA is a complex inflammatory disease with a multifactorial immune pathogenesis. Next to a certain genetic predisposition, environmental factors play a role leading to a chronic inflammatory response, which involves uncontrolled activation of both innate and adaptive immunities [2]. The resulting autoimmune assault targets primarily, though not excluCorrespondence: Dr. Joost F. Swart e-mail: jswart@umcutrecht.nl sively, synovial tissue, leading to chronic arthritis. The treatment for a patient with JIA nowadays still starts with low-dose or nonaggressive therapies and will only be escalated if it is failing after several months [3]. This leads to therapy failures of at least 50% in the first six months of treatment resulting in frustration, pain, and probably even damage to the treated tissue [4]. JIA patients would benefit from personalized treatment in which the individual prediction on therapy-response to certain drugs is taken into account in the choice of the anti-rheumatic therapy. As will be discussed below, over the past decade an increased understanding of the immunological mechanisms underlying JIA has led to the identification of immune biomarkers that can actually guide therapeutic strategies.Clinically, JIA therefore is defined as arthritis of unknown origin that starts before the age of 16, and persists...

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Meta-Analysis: Diagnostic Accuracy of Anti-Cyclic Citrullinated Peptide Antibody for Juvenile Idiopathic Arthritis

Cited by 14 publications

References 58 publications

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

A Granulocyte-Specific Protein S100A12 as a Potential Prognostic Factor Affecting Aggressiveness of Therapy in Patients with Juvenile Idiopathic Arthritis

Understanding inflammation in juvenile idiopathic arthritis: How immune biomarkers guide clinical strategies in the systemic onset subtype

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