A new strategy for the early diagnosis of rheumatoid arthritis: a combined approach.
Rheumatoid arthritis [RA] is one of the most common and severe autoimmune rheumatic diseases, diagnosed primarily according to clinical manifestations and radiological reports. For many years, laboratory diagnosis of rheumatoid arthritis has relied on the detection of rheumatoid factor [RF], as established by the ACR criteria. A recent test to detect antibodies towards citrullinated peptides, called the anti-CCP assay, showed a similar sensitivity but a more elevated specificity than the RF test. Our intention was the recognition of an optimal diagnostic strategy that exhibits the highest sensitivity and specificity for RA detection. To this purpose, we examine the usefulness of autoantibodies in RA testing, evaluating the diagnostic performance of conventional and innovative assays for RF detection, and ELISA anti-CCP test, for anti-CCP antibodies detection, by a prospective study. Multiplex cytofluorimetric test appeared to be more sensitive and specific than nephelometric assay for RF detection. Hence, a novel combined approach, significantly increasing the diagnostic sensitivity for RA, was planned, employing the multiplex RF test in combination with the anti-CCP test.
Tedesco
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A
UOC di Patologia Clinica, D.E.A.II Umberto I, Nocera Inferiore, A.S.L.Salerno1, Italy; Dipartimento di Biologia Strutturale e Funzionale, Università di Napoli Federico II, via Cinthia, Napoli 80126, Italy.
D'Agostino
D
D
Soriente
I
I
Amato
P
P
Piccoli
R
R
Sabatini
P
P
D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002956:Citrulline / Q000737:chemistry / Q000276:immunology; D018450:Disease Progression; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D006801:Humans; D010455:Peptides / Q000737:chemistry / Q000276:immunology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood* / Q000276:immunology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D010455:Peptides; D002956:Citrulline; D012217:Rheumatoid Factor