Title: Autoantibodies and Wrist Synovitis in Early Rheumatoid Arthritis, Ultra-Sonographic Study
Authors: Ahmed Fathy Abogamal, Ahmed Fathy Abdalaziz , Yusuf Nassar, Maged A H Shoukeer
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.36
Abstract
Several autoantibodies has been linked to rheumatoid arthritis, diagnosis but its relation to joint synovitis needs to be evaluated.
Aim of the work: To investigate the relation between rheumatoid factor, anti-cyclic citrullinated peptide, and anti-mutated citrullinated vimentin and ultrasound detected wrist synovitis in female patients with early rheumatoid arthritis.
Patients and Methods: 80 female patients with early rheumatoid arthritis presenting at outpatient rheumatology clinics of AL-AZHAR University Hospitals Egypt through 2015-2016, were assessed for DAS28, rheumatoid factor, anti-cyclic citrullinated protiens (Anti CCP), anti-mutated citullinated vimentin (Anti MCV), and ultrasound quantification of wrist synovitis using gray scale and power Doppler.
Results: A significant positive correlation has been found between the Anti MCV and DAS28, where p> 0.05. A highly significant correlation found between Anti MCV, synovitis in gray scale and power Doppler were p> 0.01. Correlation study of Anti CCP, shows a highly significant correlation found between Anti CCP, DAS28, and synovitis in gray scale and power Doppler were p> 0.01. While rheumatoid factor fails to have any significant correlation with ultrasound parameters.
Conclusion: Anti CCP, and anti MCV are significantly correlated with wrist synovitis in female patients with early rheumatoid arthritis with superior correlation to anti CCP with the clinical activity.
Keywords: rheumatoid arthritis; rheumatoid factor; Anti CCP; anti MCV; ultrasound.
References
1. Richard D. &Brasington, Jr. Clinical features of rheumatoid arthritis, RHEU-MATOLOGY, text book 5th edition, MOSBY ELSEVIER, 2006, 829- 838.
2. Dörner T, Egerer K, Feist E, Burmester GR: Rheumatoid factor revisited. CurrOpinRheumatol 2004; 16: 246-53.
3. Arnett FC, Edworthy SM, Bloch DA et al.: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-24.
4. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/ European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69:1580-8
5. Taylor P, Gartemann J, Hsieh J,et al. A systematic review of serum biomarkers anti-cyclic citrullinated peptide and rheum-atoid factor as tests for rheumatoid arthritis. Autoimmune Dis 2011;2011: 815038.
6. Vallbracht I, Rieber J, OppermannM,et al. Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis.Ann Rheum Dis 2004;63:1079–84.
7. Goldbach-Mansky R, Lee J, McCoy A,et al. Rheumatoid arthritis associated autoantibodies in patients with synovitis of recent onset. Arthritis Res2000;2:236–43
8. Van Venrooij WJ, Van Beers JJBC, Pruijn GJM: Anti-CCP antibody, a marker for the early detection of rheumatoid arthritis. Ann NY Acad Sci2008, 1143:268-285.
9. Van der Helm-van Mil AH, Verpoort KN, Breedveld FC, Toes REM, Huizinga TWJ: Antibodies to citrullinated proteins and differences in clinical progression of rheumatoid arthritis. Arthritis Res Ther2005, 7:R949-R958
10. Skriner K, Adolph K, Jungblut PR, Burmester GR: Association of citrullinated proteins with synovial exosomes. Arthritis Rheum2006, 54:3809-3814.
11. Bianchi S, Martinoli C: Ultrasound of the Musculoskeletal System. Springer -Verlag, Berlin, Heidelberg 2007: 349–405.
12. Van Der Heijde DMFM, Van't Hof MA, Van Riel PLCM, Van Der Putte LBA (1993): Development of a disease activity score based on judgement in clinical practice by rheumatologists. J. Rheumatol; 20:579-81.
13. Naredo E, Rodriguez M, Campos C, et al. Validity, reproducibility and responsive-eness of a twelve-joint simplified power dopplerultrasonographic assessment of joint inflammation in rheumatoid arthritis. Arthritis Rheum 2008; 59:515-522.
14. Ellegaard K, Torp-Pedersen S, Terslev L, Danneskiold-Samsoe B, Henriksen M, Bliddal H. Ultrasound Colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis assessment of current validity. Rheumatology (Oxford) 2009; 48: 254-257.
15. Syversen SW, Gaarder PI, Goll GL, et al. High anticycliccitrullinated peptide levels and an algorithm of four variables predict radiographic progression in patients with rheumatoid arthritis: results from a 10-year longitudinal study. Ann Rheum Dis 2008;67:212–217.
16. Meyer O, Labarre C, Dougados M, et al. Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage. Ann Rheum Dis 2003; 62:120–126.
17. Snir O, Widhe M, Hermansson M, Lindberg J, et al. Antibodies to Several Citrullinated Antigens Are Enriched in the Joints of Rheumatoid Arthritis Patients. ARTHRITIS & RHEUMATISM. 62, 2010, 44–52.
18. Watad A, Amital H. ACPAs Are Much More Than Diagnostic Autoantibodies. Rambam Maimonides Med J 2016;7 (4)m;1-5.
19. Khandpur R, Carmona-Rivera C, Viveka-nandan-Giri A, et al. NETs are a source of citrullinatedautoantigens and stimulate inflammatory responses in rheumatoid arthritis. SciTransl Med 2013;5:17.
20. Al-Shukaili A, Al-Ghafri S, Al-Marhoobi S, and Alkaabi J. Evaluation of Anti-Mutated Citrullinated Vimentin Antib-odies, Anti-Cyclic Citrullinated Peptide Antibodies and Rheumatoid Factor in Omani Patients with Rheumatoid Arthritis. International Journal of Rheumatology 2012, 1-5.