title: Anti-cyclic citrullinated peptide antibody and rheumatoid factor isotypes in Iranian patients with rheumatoid arthritis: evaluation of clinical value and association with disease activity.
abstract: In this study we determined the frequency, sensitivity and specificity of anti cyclic citrullinated peptides (anti-CCP) IgG antibody, total rheumatoid factor (RF-T), and RF isotypes in Iranian patients with rheumatoid arthritis (RA) and their association with age, clinical and serological parameters. Anti-CCP and RF-T and RF isotypes level were measured in 418 patients and 399 healthy controls by enzyme-linked immunosurbant assay (ELISA). Additionally, serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), visual analog scale (VAS) and disease activity score (DAS28) were evaluated in RA patients. The anti-CCP was positive in 53.1% of RA patients and 4.7% of controls. The frequency of RF-T was 61.87% and 17.66% in RA patients and controls respectively. The prevalence of RF isotypes in RA patients was 46.52% for RF-IgM, 23.47% for RF-IgA and 21.74% for RF-IgG. 31.39% of RA patients were RF-IgM positive without RF-IgA and RF-IgG and 21.9% were positive for all three RF classes. The anti-CCP positive patients showed increased number of swollen joints. On the other hand, RF-T positive patients exhibited a longer disease duration, lower age of onset and also higher ESR, CRP level and increased swollen joints. RF-T titer was significantly higher in RA patients with active disease compared to remission, low and moderate active groups. The sensitivity and specificity were 53.1, 95.3 for anti-CCP antibody and 61.8, 82.3 for RF-T. Our results support that anti-CCP and RF titer maybe valuable in estimation of disease activity and other inflammatory parameters in RA patients.
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. yshakiba@gmail.com.
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Shakiba
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. s.koopah@yahoo.com.
authors.forename: Susan
authors.initials: S
authors.lastname: Koopah
authors.affiliation: Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. jamshida@sina.tums.ac.ir.
authors.forename: Ahmad Reza
authors.initials: AR
authors.lastname: Jamshidi
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. amirzara@tums.ac.ir.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Amirzargar
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. massoudah_2002@yahoo.com.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Massoud
authors.affiliation: Molecular Diagnostic Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. amir1kiani@yahoo.com.
authors.forename: Amir
authors.initials: A
authors.lastname: Kiani
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. nicknam_m@yahoo.com.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Nicknam
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. b_nazari@yahoo.com.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Nazari
authors.affiliation: Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran and Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran. nikbinbe@sina.tums.ac.ir.
authors.forename: Behrouz
authors.initials: B
authors.lastname: Nikbin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology*; D012217:Rheumatoid Factor / Q000097:blood*
chemical_list: D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor