title: Reliable and cost-effective serodiagnosis of rheumatoid arthritis.
abstract: Early diagnosis of patients with rheumatoid arthritis (RA) optimises therapeutic benefit and the probability of achieving disease remission. Notwithstanding clinical acumen, early diagnosis is dependent on access to reliable serodiagnostic procedures, as well as on the discerning application and interpretation of these. In the case of RA, however, no disease-specific serodiagnostic procedure is available due to the multi-factorial and polygenic nature of this autoimmune disorder. This has resulted in the development of an array of serodiagnostic procedures based on the detection of autoantibodies reactive with various putative autoantigens. Other procedures based on measurement of elevations in the concentrations of systemic biomarkers of inflammation, most commonly acute phase reactants and cytokines/chemokines, are used as objective indices of disease activity. Following a brief overview of RA research in African populations, the current review is focused on those autoantibodies/biomarkers, specifically rheumatoid factor, anti-citrullinated peptide antibodies and C-reactive protein, which are currently recognised as being the most reliable and cost-effective with respect to disease prediction and diagnosis, as well as in monitoring activity and outcome.
authors: Department of Immunology, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, 5 Bophelo Rd, PO Box X323, Pretoria, South Africa. pieter.meyer@up.ac.za.|Tshwane Academic Division, National Health Laboratory Service, PO Box X323, Pretoria, 0001, South Africa. pieter.meyer@up.ac.za.
authors: Pieter W A
authors: PW
authors: Meyer
authors: Department Internal Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, 9th Floor Steve Biko Academic Hospital, Dr Savage Road, Pretoria, 0002, South Africa.
authors: Mahmood M T M
authors: MM
authors: Ally
authors: Department of Immunology, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, 5 Bophelo Rd, PO Box X323, Pretoria, South Africa.
authors: Ronald
authors: R
authors: Anderson
mesh_terms: D000349:Africa / Q000453:epidemiology; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002017:Budgets; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D017048:Health Care Costs; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D010456:Peptides, Cyclic / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D012698:Serologic Tests / Q000191:economics*; D012720:Severity of Illness Index
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D018836:Inflammation Mediators; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor
keywords: Anti-citrullinated peptide antibodies; Autoantibodies; C-reactive protein; Inflammatory biomarkers; Rheumatoid factor