Evaluation of Anti-CCP Antibodies and Rheumatoid Factor for the Laboratory Diagnosis of Rheumatoid Arthritis

Background: 1-Assess the correlation between Anti-cyclic citralliuated peptide (anti-CCP2) antibodies concentration with some clinical and laboratory parameters of rheumatoid arthritis (RA): 2-Evaluate the differences in the clinical and serological parameters between antiCCP2+ve and anti-CCP2-ve patients and Rheumatoid factor (RF+ve and RF-ve) patients. 3-Assess the relationship between smoking history and the detection of anti-CCP2 and RF auto antibodies. Subject and Methods: This is a case-control study carried out on 55 patients with established RA attending the Rheumatology ward of Ibn-Sina Teaching Hospital in Nineveh Governorate during the period from 1st November 2010 to the 1st June 2011 and 35 apparently healthy individuals as a control. Anti-CCP2 antibodies were measured using enzyme linked immunosorbent assay (ELISA).The RF was tested by latex agglutination and ELISA. C-reactive protein (CRP) was measured by Latex agglutination test. Patients' demographic data, disease activity and duration and erythrocyte sedimentation rate (ESR) were also recorded
Results: Anti-CCP2 antibodies were found significantly associated with RF, total swollen joints (TSJ) and total tender joints (TTJ) counts (p <0.05) while the correlation with ESR, CRP, disease activity score 28 (DAS28) and disease duration was not significant (p>0.05). In RA patients with smoking history and joints deformity, anti-CCP2antibodies was more often detected. The same results were obtained for RF seropositivity. It was also found that the differences between RF+ve and RF-ve groups were comparable to those between anti-CCP2+ve and anti-CCP-2ve groups except for ESR and CRP.
Conclusions: The study suggests that the seropositivity of RF is inflammation driven, whereas, the appearance of anti-CCP antibodies might suggests pathophysiological properties and a possible contribution to on-going immune activation