scholarly journals Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis

2004 ◽  
Vol 63 (9) ◽  
pp. 1079-1084 ◽  
Author(s):  
I Vallbracht
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Clinical Value ◽  
Cyclic Citrullinated Peptide ◽  
Rheumatoid Factor Isotypes ◽  
Citrullinated Peptide ◽  
Peptide Antibodies

scholarly journals Relationship Between Rheumatoid Factor Isotypes and IgG Anti-Cyclic Citrullinated Peptide Antibodies

2010 ◽  
Vol 37 (8) ◽  
pp. 1582-1588 ◽  
Author(s):  
TROY D. JASKOWSKI ◽  
HARRY R. HILL ◽  
KATHERINE L. RUSSO ◽  
GABRIELLA LAKOS ◽  
ZOLTAN SZEKANECZ ◽  
...  
Keyword(s):  
Rheumatoid Factor ◽  
Lupus Erythematosus ◽  
Blood Donors ◽  
Clinical Value ◽  
Serum Samples ◽  
Cyclic Citrullinated Peptide ◽  
Rheumatoid Factor Isotypes ◽  
To Come ◽  
Testing Algorithm ◽  
Citrullinated Peptide

Objective.To validate in a general patient population (GPP) the clinical value of measuring rheumatoid factor (RF) isotypes in relationship to IgG anti-cyclic citrullinated peptide (CCP) antibodies (CCP2 and CCP3).Methods.Serum samples were obtained as follows: 1021 GPP, for whom RF was ordered for diagnosis, 137 with rheumatoid arthritis (RA), 100 healthy blood donors (HBD), and 50 with systemic lupus erythematosus. Turbidimetry and ELISA were utilized for RF screening, and individual RF isotypes and IgG anti-CCP antibodies were measured by ELISA; RF IgG was measured after pepsin digestion.Results.We validated the generally accepted 90%–98% positive predictive value (PPV) and about 68% sensitivity of the anti-CCP2 test on our diagnosed cohorts as 96% (95% CI 89–99) and 65% (95% CI 56–73), respectively. The 282 RF IgM+ specimens identified in the GPP were subdivided into 3 subsets: (1) 83 as RF IgM+ IgG+ IgA+ with 63% (95% CI 51–73) anti-CCP2+ (i.e., sensitivity similar to the RA cohort); (2) 50 as RF IgM+ IgG− IgA+ with significantly fewer anti-CCP2+ (22%; 95% CI 12–36); and (3) about half as IgM+ IgG− IgA− with just 3% (95% CI 1–8) anti-CCP2+, i.e., not significantly different from the 1% (95% CI 0–5) in HBD. Thus, the chance for a specimen in the GPP to be anti-CCP2+ (i.e., to come from an RA patient) was increased by 7- and 21-fold, respectively, by identifying RF IgA and IgG in addition to IgM. About one-third of anti-CCP− RA patients in our cohort were RF IgM+ IgG+ IgA+, reflected as 3.4% in the anti-CCP2− GPP. The agreement between anti-CCP2 and anti-CCP3 was significantly higher for RF+ RA and GPP patients, 86% (95% CI 78–93) and 83% (95% CI 73–91), respectively, than for the RF− RA (27%; 95% CI 6–61), RF− GPP (4%; 95% CI 0–19), and non-RA controls. Anti-CCP2 but not anti-CCP3 significantly distinguished the HBD from the GPP (95% CI).Conclusion.Measurement of the 3 isotypes of RF may increase by 7- to 21-fold the chance of making the serologic diagnosis of RA; a testing algorithm is proposed. The anti-CCP antibody response appears significantly less peptide-specific in the presence of IgM RF than in its absence.

scholarly journals Rheumatoid Factors: Clinical Applications

2013 ◽  
Vol 35 ◽  
pp. 727-734 ◽  
Author(s):  
Francesca Ingegnoli ◽  
Roberto Castelli ◽  
Roberta Gualtierotti
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Subjects ◽  
Therapeutic Strategy ◽  
Clinical Applications ◽  
Rheumatoid Factors ◽  
Cyclic Citrullinated Peptide ◽  
Rheumatoid Factor Isotypes ◽  
Form Part ◽  
Citrullinated Peptide ◽  
Peptide Antibodies

Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy.

Anti-citrullinated peptide antibodies and rheumatoid factor isotypes in the diagnosis of rheumatoid arthritis: an assessment of combined tests

2014 ◽  
Vol 436 ◽  
pp. 237-242 ◽  
Author(s):  
Maria Infantino ◽  
Mariangela Manfredi ◽  
Francesca Meacci ◽  
Piercarlo Sarzi-Puttini ◽  
Cristian Ricci ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Rheumatoid Factor ◽  
Rheumatoid Factor Isotypes ◽  
Citrullinated Peptide ◽  
Peptide Antibodies
Sign in / Sign up

Export Citation Format

Share Document