Anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis.
OBJECTIVE
Prevalence and clinical significance of anti-cyclic citrullinated peptide (CCP) antibodies in Indian patients with juvenile idiopathic arthritis (JIA).


METHODS
Anti-CCP antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 78 patients with JIA which included all 3 major subtypes of the disease: pauciarticular, polyarticular afld systemic onset. Values above 5 relative units were taken as positive. Associations between anti-CCP antibodies and clinical and laboratory and radiological parameters were determined.


RESULTS
Anti-CCP antibodies were positive in only 2 of 34 (5.9%) patients with pauciarticular JIA and 3 of 17 (17.6%) of systemic,.pnset JIA, whereas it was positive in 13 of 27 (48.1%) of polyarticular JIA patients (p < 0.001). Furthermore, it was seen that among patients with polyarticular JIA, RF-lgM positive patients had higher rate of anti-CCP antibody positivity with 7 of 8 (87.5%) patients having positive anti-CCP antibody (p<0.001). Similarly, patients with erosions (11/19; p<0.001) and deformities (5/-10; p<0.001) were found to have significant association with anti-CCP antibody positivity.


CONCLUSIONS
Anti-CCP antibodies could be detected more frequently in the sera of JIA patients with severe manifestations like-erosions and deformity. It was also more significantly associated with seropositive polyarticular JIA than other types. It can be presumed from these results that anti-CCP antibodies can be used as a marker to predict severe course of JIA at the onset to guide optimal aggressive therapy.
Clinical Immunology and Rheumatology Services, New Delhi, India. guptarajiva@hotmail.com
R
R
Gupta
M M
MM
Thabah
B
B
Vaidya
S
S
Gupta
R
R
Lodha
S K
SK
Kabra
D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology; D001171:Arthritis, Juvenile / Q000145:classification / Q000175:diagnosis* / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002956:Citrulline / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D008297:Male; D010456:Peptides, Cyclic / Q000276:immunology*; D011237:Predictive Value of Tests; D055815:Young Adult
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D007075:Immunoglobulin M; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D002956:Citrulline