Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations

ORTANCIL, Özgür; ÖZDOLAP ÇOBAN, ŞENAY; KIRAN, Sibel; ARASLI, MEHMET

Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations

Özgür ORTANCIL, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Zonguldak, Türkiye)

ŞENAY ÖZDOLAP ÇOBAN, (Zonguldak Karaelmas Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Zonguldak, Türkiye)

Sibel KIRAN, (Bülent Ecevit Üniversitesi, Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, Zonguldak, Türkiye)

Mehmet ARASLI (Bülent Ecevit Üniversitesi Tıp Fakültesi, Çocuk İmmunoloji ve Alerji Bilim Dalı, Zonguldak, Türkiye)

Turkish Journal of Rheumatology(.)Archives of Rheumatology

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Yıl: 2011 Cilt: 26 Sayı: 3 Sayfa Aralığı: 193 - 198 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations

Öz:

Amaç: Bu çalışmada anti-siklik sitrulinli peptid (anti-CCP) antikorlar ile ekstra-artiküler tutulum (EAT) arasındaki ilişki araştırıldı.Hastalar ve yöntemler: Çalışmaya Ocak 2009 - Aralık 2009 tarihleri arasında ACR (American College of Rheumatology) tanı kriterlerine göre romatoid artrit (RA) tanısı konulan 67 hasta (53 kadın, 14 erkek; ort. yaş 57.4±13.5 yıl; dağılım 26-82 yıl) dahil edildi. Tüm hastaların yaşları, cinsiyetleri, hastalık süreleri ve EAT'leri (romatoid nodül, pulmoner nodül, pulmoner fibroz, keratokonjonktivitis sikka) kaydedildi ve romatoid faktör (RF) ve anti-CCP antikor pozitifliği ve serum RF seviyeleri değerlendirildi.Bulgular: Hastaların 28'inde (%41.8) EAT saptandı. Otuz dört hastada (%50.7) anti CCP antikorlar mevcuttu. AntiCCP antikor pozitifliği EAT'li 16 hastada (%57.1) saptanırken, EAT'si bulunmayan 18 hastada (%46.2) saptandı (p>0.05). Romatoid faktör pozitifliği EAT'li 23 (%82.1) hastada mevcut iken, EAT'si olmayan 30 hastada (%76.9) mevcuttu (p>0.05). Serum RF seviyeleri EAT'li hastalarda 176.5±201.7 IU/ml iken, EAT'siz hastalarda 114.1±144.8 IU/ml idi (p>0.05). Pulmoner fibrozisi olan hastaların ortalama serum RF titreleri pulmoner fibrozisi olmayanlara göre anlamlı şekilde daha yüksek (sırasıyla 237.8±204.8 IU/ml ve 118.9±158.6 IU/ml; p=0.036) idi.Sonuç: Romatoid artritli hastalarda EAT'lerin mortaliteyi ve morbiditeyi artırdığı bilinmektedir. Bu nedenle şiddetli hastalığı olan hastaların saptanmasına yardımcı olan belirleyiciler erken agresif tedaviye karar verilmesinde önemli rol oynamaktadır. Anti-CCP antikorları ile EAT arasındaki ilişkiyi araştıran çalışmalarda çelişkili sonuçlar bulunmuştur. Bu çalışmada CCP pozitifliği ile EAT varlığı arasında herhangi bir ilişki saptanmadı. Anti-CCP antikorları ile EAT arasındaki ilişkiyi değerlendirmek için daha fazla sayıda hasta içeren çalışmalara gereksinim olduğu düşüncesindeyiz

Anahtar Kelime:

Konular: Romatoloji

Romatoid Artritte Anti-Siklik Sitrulinli Peptid Antikorlar ve Bunların Ekstra-Artiküler Bulgular ile İlişkisi

Öz:

Objectives: In this study, we investigated the relationship between extra-articular manifestations (EAM) and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Patients and methods: Sixty-seven patients (53 females, 14 males; mean age 57.4±13.5 years; range 26 to 82 years) diagnosed with rheumatoid arthritis (RA) according to the ACR (American College of Rheumatology) criteria between January 2009 - December 2009 were included in the study. The age, gender, disease duration, and EAMs (rheumatoid nodules, pulmonary nodules, pulmonary fibrosis, keratoconjunctivitis sicca) of each patient were recorded, and the anti-CCP antibody and rheumatoid factor (RF) positivity and serum RF levels were evaluated. Results: Extra-articular manifestations were present in 28 (41.8%) of the patients. Anti-CCP antibodies were present in 34 (50.7%) patients. Positivity of anti-CCP antibodies was found in 16 (57.1%) patients with EAM compared to 18 (46.2%) patients without EAM (p>0.05). Rheumatoid factor positivity was found in 23 (82.1%) patients with EAM compared with 30 (76.9%) patients without EAM (p>0.05). The serum levels of RF were 176.5±201.7 IU/ml in the patients with EAM, and 114.1±144.8 IU/ml in the patients without EAM (p>0.05). The mean serum titers of RF were significantly higher in the patients with pulmonary fibrosis than in those without pulmonary fibrosis (237.8±204.8 IU/ml and 118.9±158.6 IU/ml respectively; p=0.036). Conclusion: It is known that EAMs increase morbidity and mortality in patients with rheumatoid arthritis. Thus, the markers that help identify patients with severe disease have an important role in making a decision for early aggressive treatment. Studies that investigate the relationship between anti-CCP antibodies and EAM have conflicting results. In this study, no relationship was found between the antibodies against citrullinated peptides and the presence of EAMs. We think that further studies with a larger sample size are necessary to evaluate the relationship between EAM and anti-CCP antibodies

Anahtar Kelime:

Konular: Romatoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

De Rycke L, Peene I, Hoffman IE, Kruithof E, Union A, Meheus L, et al . Rheumatoid factor and anticitrullinated protein antibodies in rheumatoid arthritis: diagnostic value, associations with radiological progression rate, and extra-articular manifestations . Ann Rheum Dis 2004;63:1587-93 .
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al . The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis . Arthritis Rheum 1988;31:315-24 .
van Jaarsveld CH, ter Borg EJ, Jacobs JW, Schellekens GA, Gmelig-Meyling FH, van Booma-Frankfort C, et al . The prognostic value of the antiperinuclear factor, anti- citrullinated peptide antibodies and rheumatoid factor in early rheumatoid arthritis . Clin Exp Rheumatol 1999;17:689-97 .
Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, et al . The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide . Arthritis Rheum 2000;43:155-63 .
Kroot EJ, de Jong BA, van Leeuwen MA, Swinkels H, van den Hoogen FH, van't Hof M, et al . The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis . Arthritis Rheum 2000;43:1831-5 .
van Zeben D, Hazes JM, Zwinderman AH, Cats A, van der Voort EA, Breedveld FC . Clinical significance of rheumatoid factors in early rheumatoid arthritis: results of a follow up study . Ann Rheum Dis 1992;51:1029-35 .
Jónsson T, Valdimarsson H . Clinical significance of rheumatoid factor isotypes in seropositive arthritis . Rheumatol Int 1992;12:111-3 .
Houssien DA, Jonsson T, Davies E, Scott DL . Clinical significance of IgA rheumatoid factor subclasses in rheumatoid arthritis . J Rheumatol 1997;24:2119-22 .
Houssien DA, Jónsson T, Davies E, Scott DL . Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens . Scand J Rheumatol 1998;27:46-53 .
Bas S, Genevay S, Meyer O, Gabay C . Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis . Rheumatology (Oxford) 2003;42:677-80 .
Dündar U, Evcik D, Çakır T, Aktepe O, Altındış M, Kavuncu V . Romatod artritli hastalarda anti-CCP antikorlarının hastalık aktivitesi ve radyolojik hasar ile ilişkisi . Turk J Rheumatol 2005;20:9-14 .
Turesson C, Jacobsson LT, Sturfelt G, Matteson EL, Mathsson L, Rönnelid J . Rheumatoid factor and antibodies to cyclic citrullinated peptides are associated with severe extra-articular manifestations in rheumatoid arthritis . Ann Rheum Dis 2007;66:59-64 .
Egerer K, Feist E, Burmester GR . The serological diagnosis of rheumatoid arthritis: antibodies to citrullinated antigens . Dtsch Arztebl Int 2009;106:159-63 .
Combe B, Eliaou JF, Daurès JP, Meyer O, Clot J, Sany J . Prognostic factors in rheumatoid arthritis . Comparative study of two subsets of patients according to severity of articular damage . Br J Rheumatol 1995;34:529-34 .
van der Heijde DM, van Riel PL, van Leeuwen MA, van 't Hof MA, van Rijswijk MH, van de Putte LB . Prognostic factors for radiographic damage and physical disability in early rheumatoid arthritis . A prospective follow-up study of 147 patients . Br J Rheumatol 1992;31:519-25 .
Forslind K, Ahlmén M, Eberhardt K, Hafström I, Svensson B; BARFOT Study Group . Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP) . Ann Rheum Dis 2004;63:1090-5 .
Vincent C, Nogueira L, Sebbag M, Chapuy-Regaud S, Arnaud M, Letourneur O, et al . Detection of antibodies to deiminated recombinant rat filaggrin by enzyme- linked immunosorbent assay: a highly effective test for the diagnosis of rheumatoid arthritis . Arthritis Rheum 2002;46:2051-8 .
Suzuki K, Sawada T, Murakami A, Matsui T, Tohma S, Nakazono K, et al . High diagnostic performance of ELISA detection of antibodies to citrullinated antigens in rheumatoid arthritis . Scand J Rheumatol 2003;32:197-204 .
van Venrooij WJ, Zendman AJ, Pruijn GJ . Autoantibodies to citrullinated antigens in (early) rheumatoid arthritis . Autoimmun Rev 2006;6:37-41 .
Goëb V, Jouen F, Gilbert D, Le Loët X, Tron F, Vittecoq O . Diagnostic and prognostic usefulness of antibodies to citrullinated peptides . Joint Bone Spine 2009;76:343-9 .
Kim SK, Park SH, Shin IH, Choe JY . Anti-cyclic citrullinated peptide antibody, smoking, alcohol consumption, and disease duration as risk factors for extraarticular manifestations in Korean patients with rheumatoid arthritis . J Rheumatol 2008;35:995-1001 . Alexiou I, Germenis A, Koutroumpas A, Kontogianni A, Theodoridou K, Sakkas LI . Anti-cyclic citrullinated peptide-2 (CCP2) autoantibodies and extra-articular manifestations in Greek patients with rheumatoid arthritis . Clin Rheumatol 2008;27:511-3 .
Korkmaz C, Us T, Kaşifoğlu T, Akgün Y . Anti-cyclic citrullinated peptide (CCP) antibodies in patients with long-standing rheumatoid arthritis and their relationship with extra-articular manifestations . Clin Biochem 2006;39:961-5 .
Vencovsk? J, Machácek S, Sedová L, Kafková J, Gatterová J, Pesáková V, et al . Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis . Ann Rheum Dis 2003;62:427-30 .
Bas S, Perneger TV, Mikhnevitch E, Seitz M, Tiercy JM, Roux-Lombard P, et al . Association of rheumatoid factors and anti-filaggrin antibodies with severity of erosions in rheumatoid arthritis . Rheumatology (Oxford) 2000;39:1082-8 .
Gordon DA, Stein JL, Broder I . The extra-articular features of rheumatoid arthritis . A systematic analysis of 127 cases . Am J Med 1973;54:445-52 .
Turesson C, O'Fallon WM, Crowson CS, Gabriel SE, Matteson EL . Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years . Ann Rheum Dis 2003;62:722-7 .
Turesson C, Jacobsson L, Bergström U, Truedsson L, Sturfelt G . Predictors of extra-articular manifestations in rheumatoid arthritis . Scand J Rheumatol 2000;29:358-64 .
Vandenbroucke JP, Breedveld FC, Hazes JM . Factors associated with the development of vasculitis in rheumatoid arthritis: results of a case-control study . Ann Rheum Dis 1996;55:190-2 .
Calgüneri M, Ureten K, Akif Oztürk M, Onat AM, Ertenli I, Kiraz S, et al . Extra-articular manifestations of rheumatoid arthritis: results of a university hospital of 526 patients in Turkey . Clin Exp Rheumatol 2006;24:305-8 .
Turesson C, Jacobsson L, Bergström U . Extra-articular rheumatoid arthritis: prevalence and mortality . Rheumatology (Oxford) 1999;38:668-74 .

APA	ORTANCIL Ö, ÖZDOLAP ÇOBAN Ş, KIRAN S, ARASLI M (2011). Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. , 193 - 198.
Chicago	ORTANCIL Özgür,ÖZDOLAP ÇOBAN ŞENAY,KIRAN Sibel,ARASLI MEHMET Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. (2011): 193 - 198.
MLA	ORTANCIL Özgür,ÖZDOLAP ÇOBAN ŞENAY,KIRAN Sibel,ARASLI MEHMET Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. , 2011, ss.193 - 198.
AMA	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. . 2011; 193 - 198.
Vancouver	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. . 2011; 193 - 198.
IEEE	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M "Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations." , ss.193 - 198, 2011.
ISNAD	ORTANCIL, Özgür vd. "Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations". (2011), 193-198.

APA	ORTANCIL Ö, ÖZDOLAP ÇOBAN Ş, KIRAN S, ARASLI M (2011). Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 26(3), 193 - 198.
Chicago	ORTANCIL Özgür,ÖZDOLAP ÇOBAN ŞENAY,KIRAN Sibel,ARASLI MEHMET Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. Turkish Journal of Rheumatology(.)Archives of Rheumatology 26, no.3 (2011): 193 - 198.
MLA	ORTANCIL Özgür,ÖZDOLAP ÇOBAN ŞENAY,KIRAN Sibel,ARASLI MEHMET Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.26, no.3, 2011, ss.193 - 198.
AMA	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2011; 26(3): 193 - 198.
Vancouver	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2011; 26(3): 193 - 198.
IEEE	ORTANCIL Ö,ÖZDOLAP ÇOBAN Ş,KIRAN S,ARASLI M "Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 26, ss.193 - 198, 2011.
ISNAD	ORTANCIL, Özgür vd. "Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Their Relationship with Extra-Articular Manifestations". Turkish Journal of Rheumatology(.)Archives of Rheumatology 26/3 (2011), 193-198.