title: Recognizing rheumatoid arthritis: oncoprotein survivin opens new possibilities: a population-based case-control study.
abstract: Survivin is a biomarker of cancer known for its anti-apoptotic and cell-cycle regulating properties. In the context of non-cancer pathology, high levels of survivin may be measured in blood and synovial fluid of patients with rheumatoid arthritis (RA) and associate with early joint damage and poor therapy response. The aim of the study was to investigate the value of survivin measurements in blood for diagnosis of RA in the frame of the Malaysian epidemiological investigation of rheumatoid arthritis (MyEIRA) study. The study enrolled RA patients from eight rheumatology centres in Peninsular Malaysia. The healthy controls matched by age, gender and ethnicity were recruited on the community basis from the residential area of the patients. Levels of survivin were measured in blood of RA patients (n = 1233) and controls (n = 1566) by an enzyme-linked immuno-sorbent assay (ELISA). The risk for RA was calculated as odds ratio (OR) and 95% confidence intervals in the individuals with high levels of survivin. The risk was calculated in relation to antibodies against cyclic citrullinated peptides (ACPA), detected by ELISA and HLA-DRB1 shared epitope (SE) alleles, identified by the polymerase chain reaction using sequence specific oligonucleotide method. High levels of survivin were detected in 625 of 1233 (50.7%) RA cases and in 85 of 1566 (5.4%) controls, indicating its high specificity for RA. Survivin was association with an increase in RA risk in the patients having neither SE-alleles nor ACPA (OR = 5.40, 95% CI 3.81-7.66). For the patients combining survivin, SE, and ACPA, the estimated risk for RA was 16-folds higher compared to the survivin negative patients with SE and ACPA(OR = 16.21, 95% CI 5.70-46.18). To conclude, detection of survivin in blood provides a simple test to improve diagnostic and to increase predictability for RA.
authors: From the Allergy and Immunology Research Center, Institute of Medical Research, Kuala Lumpur, Malaysia (TCL, SM, JSD); Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm (TCL); Department of Rheumatology and Inflammation Research, Institute of Medicine, the University of Gothenburg, Göteborg, Sweden (ME, MIB); Department of Medicine, Putrajaya Hospital, Putrajaya (HH); and Department of Medicine, Raja Perempuan Bainun Hospital, Ipoh, Perak, Malaysia (WS).
authors: Too
authors: T
authors: Chun-Lai
authors: Shahnaz
authors: S
authors: Murad
authors: Malin C
authors: MC
authors: Erlandsson
authors: Heselynn
authors: H
authors: Hussein
authors: Wahinuddin
authors: W
authors: Sulaiman
authors: Jasbir S
authors: JS
authors: Dhaliwal
authors: Maria I
authors: MI
authors: Bokarewa
mesh_terms: D000483:Alleles; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D000939:Epitopes / Q000235:genetics; D005260:Female; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D011237:Predictive Value of Tests; D000077022:Survivin
chemical_list: D001323:Autoantibodies; C107489:BIRC5 protein, human; D015415:Biomarkers; D000939:Epitopes; D059811:HLA-DRB1 Chains; D051034:Inhibitor of Apoptosis Proteins; D010456:Peptides, Cyclic; D000077022:Survivin
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