Comparison of the diagnostic potential of three anti-citrullinated protein antibodies as adjuncts to rheumatoid factor and CCP in a cohort of South African rheumatoid arthritis patients
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Authors
Meyer, Pieter Willem Adriaan
Ally, Mahmood Moosa Tar Mahomed
Hodkinson, Bridget
Anderson, Ronald
Tikly, Mohammed
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Publisher
Springer
Abstract
PURPOSE : A retrospective comparison of the prevalence and diagnostic value of anti-Sa, anti-CEP-1, and anti-MCV autoantibodies relative to those of the established autoantibodies, composite RF and anti-CCP-IgG used routinely for RA diagnosis as a component of the ACR 2010 criteria, in a cohort of disease-modifying anti-rheumatic drug naïve African RA patients (n = 75).
METHODS : Serum concentrations of anti-Sa, anti-CEP-1 and anti-MCV autoantibodies were measured using ELISA procedures, while anti-CCP-IgG antibodies were determined by fluorescence enzyme immunoassay, and composite RF by latex-enhanced laser nephelometry.
RESULTS : The seropositivity frequencies of anti-Sa, anti-CEP-1 and anti-MCV antibodies for the RA patients were 82, 72, 85%, respectively, while that of anti-CCP-IgG and RF was 87% for both. Overall, anti-MCV demonstrated the best specificity, positive predictive value (PPV), odds ratio and positive likelihood ratio of all the types of autoantibody tested.
CONCLUSION : These observations in this unique cohort of RA patients indicated novel associations of all three autoantibodies in regard to HLA-SE risk alleles, disease severity and tobacco use that were not reported before. Elevated anti-Sa titers designated a propensity of higher disease and high-risk alleles in our cohort. Anti-CEP-1 association with HLA-SE homozygosity and high-risk alleles is also novel in this group. Of note, measurement of anti-MCV antibodies on presentation, either as an adjunctive or even as a stand-alone test, surpassed all other biomarkers investigated here and, therefore, may add value to clinical management.
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Keywords
Biomarkers, Anti-citrullinated peptide antibodies (ACPAs), Rheumatoid arthritis (RA), Rheumatoid factor (cRF), Anti-citrullinated peptide (anti-CCP), Anti-Sa, Anti-CEP-1, Anti-MCV, South Africa (SA), Specificity, Sensitivity, Predictive value, Laser nephelometry, Fluorescence analysis, Autoantibody, Cyclic citrullinated peptide antibody, Immunoglobulin G antibody, MCV antibody
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Citation
Meyer, P.W.A., Ally, M.T.M., Hodkinson, B. et al. Comparison of the diagnostic potential of three anti-citrullinated protein antibodies as adjuncts to rheumatoid factor and CCP in a cohort of South African rheumatoid arthritis patients. Rheumatology International (2018) 38: 993-1001. https://doi.org/10.1007/s00296-018-4036-y.