Romatoid Artritte Hastalık Aktivitesi ile Anti-CCP İlişkisi

Raouf Rahim Merza; Dana Mohammed Tofiq; Najlaa Naser Radhi; Hawar Ali Ehsan Kaka Khan

doi:10.17826/cutf.92036

EN TR

The Association of Anti-CCP and Disease Activity in Rheumatoid Arthritis

Abstract

Purpose: To determine the value of Anti-CCP as predictor for disease activity in rheumatoid arthritis assessed by DAS-28, and to find the effect of smoking on disease activity in rheumatoid arthritis. Materials and Methods: One hundred patients with rheumatoid arthritis involved in this study, consisted of 88 female and 12 male who fulfilled the 2010 ACR-EULAR classification criteria for rheumatoid arthritis attending the rheumatology department in general hospital, or attended the center of rheumatology and rehabilitation in sulaimani city, for 6 months ( from October, 2012 to March, 2013). Thorough Demographic information of patients was recorded through history of age, sex, and history of smoking, disease duration, physical evaluation according to DAS-28. and serological test for RF and Anti-CCP. Results: There was highly significant association between DAS-28 and Anti-CCP value (p =0.0001). there was no significant correlation between DAS-28 and RF (p= 0.252),According to smoking there was highly significant association between smoking with Anti-CCP value and DAS-28 (p=0.003- 0.0001) respectively while there was no significant association between smoking and RF(p=0.15). Conclusion: A highly significant correlation was found between Anti-CCP value and disease activity in rheumatoid arthritis, smoker patients had higher value of Anti-CCP compared to non-smoker patients. Smokers demonstrated a more active and severe disease activity compared to non-smokers.

Keywords

Rheumatoid arthritis, DAS-28, Anti-CCP,RF.

Romatoid Artritte Hastalık Aktivitesi ile Anti-CCP İlişkisi

Öz

Amaç: DAS-28 ile belirlenen eklem iltihabında hastalığın aktivitesi için belirleyici olan Anti-CCP değerinin saptanması ve eklem iltihabının hastalık aktivitesinde sigara kullanımının etkisini belirlemektir. Materyal ve Method: 6 ay boyunca (2012 Ekim- 2013 Mart) Süleymaniye kentinde bulunan rehabilitasyon ve romatoloji merkezinde bulunmuş olan veya tam teşekküllü hastanenin romatoloji bölümünde bulunan, 2010 ACR-EULAR eklem iltihabı sınıflandırma kurallarına göre belirlenmiş, 88"i kadın 12"si erkek olmak üzere toplam 100 eklem iltihabı hastası çalışmaya dahil edildi. Hastaların yaş, cinsiyet, sigara kullanımı öyküsü, hastalık süreci, DAS-28"e göre fiziksel değerlendirmesi ve Anti-CCP ve RF için serolojik test sonuçları gibi kapsamlı demografik bilgileri kaydedildi. Bulgular: DAS-28 ile Anti-CCP değeri arasında oldukça anlamlı bir fark bulundu. (P değeri= 0,0001). DAS-28 ile RF değeri arasında bir fark bulunamadı (p= 0,252). Sigara kullanım durumuna göre; sigara içimi ile Anti-CCP değeri (p = 0,003) ve DAS-28 (p =0,0001) arasında oldukça anlamlı bir fark bulundu. Ancak; sigara içimi ile RF arasında anlamlı bir fark bulunamadı (p=0,15). Sonuç: Eklem iltihabında hastalık aktivitesi ile Anti-CCP değeri arasında oldukça önemli bir fark bulundu ayrıca sigara içen hastalar içmeyenlere nazaran daha yüksek Anti-CCP değerine sahiptiler. Sigara içenlerde ise içmeyenlere gore daha şiddetli ve aktif hastalık aktivitesi gözlendi.

Anahtar Kelimeler

Anti-CCP, DAS-28, Eklem İltihabı, RF

References

Lee DM, Weinblatt ME. Rheumatoid Arthritis. Lancet. 2001;358:903–11.
Pincus T, Callahan LF, Sale WG, Brooks AL, Payne LE, Vaughn WK. Severe functional declines, work disability, and increased mortality in seventy-five Rheumatoid Arthritis patients studied over nine years. Arthritis Rheum. 1984;27:864–72.
Goodson N. Coronary artery disease and Rheumatoid Arthritis. CurrOpinRheumatol. 2002;14:115–20.
Padyukov L, Silva C, Stolt P, Alfredsson L, Klareskog L: A gene–environment interaction between smoking and shared epitope genes in HLA-DR provides a high risk of seropositive Rheumatoid Arthritis. Arthritis Rheum. 2004;50:3085-92.
Linn-Rasker SP, van der Helm-van Mil AHM, van Gaalen FA, Kloppenburg M, De Vries R, le Cessie S, Breedveld FC, Toes REM, Huizinga TWJ: Smoking is a risk factor for Anti-ccp antibodies only in RA patients that carry HLA-DRB1 shared epitope alleles. Ann Rheum Dis. 2005, in press.
Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B: Prediction of radiological outcome in early Rheumatoid Arthritis in clinical practice: role of antibodies to citrullinated peptides (Anti-ccp). Ann Rheum Dis. 2004;63:1090-5.
Hill JA, Southwood S, Sette A, Jevnikar AM, Bell DA, Cairns E: Cutting edge: the conversion of arginine to citrulline allows for a high-affinity peptide interaction with the Rheumatoid Arthritis-associated HLADRB1*0401 MHC class II molecule. J Immunol. 2003;171:538-41.
Berglin E, Padyukov L, Sundin U, Hallmans G, Stenlund H, Van Venrooij WJ, Klareskog L, Dahlqvist SR: A combination of autoantibodies to cyclic citrullinated peptide (CCP) and HLA-DRB1 locus antigens is strongly associated with future onset of Rheumatoid Arthritis. Arthritis Res Ther 2004, 6:R303-R308.
Klareskog L, Stolt P, Lundberg K, et al. A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination. Arthritis Rheum. 2006;54:38–46.
Van Gaalen FA, Linn-Rasker SP, van Venrooij WJ, de Jong BA, Breedveld FC, Verweij CL et al. Autoantibodies to cyclic citrullinated peptides predict progression to Rheumatoid Arthritis in patients with undifferentiated arthritis: a prospective cohort study. Arthritis Rheum. 2004;50:709–15.

Rantapaa-Dahlqvist S, de Jong BA, Berglin E, Hallmans G, Wadell G, Stenlund H et al. Antibodies against cyclic citrullinated peptide and IgA Rheumatoid factor predict the development of Rheumatoid Arthritis. Arthritis Rheum. 2003;48:2741–
Klippel JH, Stone JH, Crofford LJ, White PH. (2008) Primer on the Rheumatic Disease. 13 edition.
Springer Science & Business Media, New York, USA. 2008;16-17:118-9.
Ioan-Facsinay, A. et al. Marked differences in fine specificity and isotype usage of the anti-citrullinated protein antibody in health and disease. Arthritis Rheum. 2008:58:3000–8..
Schuerwegh, A. J. et al. Evidence for a functional role of IgEanticitrullinated protein antibodies in Rheumatoid Arthritis. Proc. Natl Acad. Sci.USA. 2010;107:2586–91.
Kokkonen, H. et al. Antibodies of IgG, IgA and IgMisotypes against cyclic citrullinated peptide precede the development of Rheumatoid Arthritis. Arthritis Res. Ther. 13, R13 (2011).
Fautrel B. et al. Level of Agreement of the 1987 ACR and 2010 ACR/EULAR Rheumatoid Arthritis classification critera: an analysis based on ESPOIR cohort data. Ann Rheum Dis. 2012;71:386-9.
Bas S, Genevay S, Meyer O, Gabay C. Anti-cyclic citrullinated peptide antibodies, IgM and IgA Rheumatoid factors in the diagnosis and prognosis of Rheumatoid Arthritis. Rheumatology Oxford. 2003;42:677-80.
Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B. Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (Anti-ccp). Ann Rheum Dis. 2004;63:1090-5.
Jansen LM, van Schaardenburg D, van der HorstBruinsma I, van der Stadt RJ, de Koning MH, Dijkmans BA. The predictive value of Anti-cyclic citrullinated peptide antibodies in early arthritis. J Rheumatol. 2003;30:1691-5.
Kroot EJ, de Jong BA, van Leeuwen MA, et al. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum. 2000;43:1831-5.
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
Tamai M, Kawakami A, Uetani M, et al. The presence of anti-cyclic citrullinated peptide antibody is associated with magnetic resonance imaging detection of bone marrow oedema in early stage Rheumatoid Arthritis. Ann Rheum Dis. 2006;65:133Vallbracht I, Rieber J, Oppermann M, Forger F, Siebert U, Helmke K. 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. vanGaalen FA, van Aken J, Huizinga TW, et al. Association between HLA class II genes and autoantibodies to cyclic citrullinated peptides (CCPs) influences the severity of Rheumatoid Arthritis. Arthritis Rheum. 2004;50:2113-21.
Ronnelid J, Wick MC, Lampa J, et al. Longitudinal analysis of citrullinated protein/peptide antibodies (Anti-cp) during 5 year follow up in early Rheumatoid Arthritis: Anti-cp status predicts worse disease activity and greater radiological progression. Ann Rheum Dis. 2005;64:1744-9.
Kastbom A, Strandberg G, Lindroos A, Skogh T. Anti-ccp antibody test predicts the disease course during 3 years in early Rheumatoid Arthritis (the Swedish TIRA project). Ann Rheum Dis. 2004;63:1085-9.
Mary Lee PharmD BCPS FCCP editor. Basic Skils in interpreting Laboratory Data. ISBN10:1585281808.4th Edition.
Verstappen SM, Jacobs JW, Bijlsma JW, Heurkens AH, van Booma-Frankfort C, Borg EJ, et al. Five-year followup of Rheumatoid Arthritis patients after early treatment with disease-modifying antirheumatic drugs versus treatment according to the pyramid approach in the first year. Arthritis Rheum. 2003;48:1797–807.
Emery P. Evidence supporting the benefit of early intervention in Rheumatoid Arthritis. J Rheumatol.2002;66:3–8.
Emery P, Marzo H, Proudman S. Management of patients with newly diagnosed Rheumatoid Arthritis. Rheumatology (Oxford). 1999;38:27–31.
Papadopoulos I , Kastimbri P, Katsaraki A, Temekonidis T, Georgiadis A, Drosos A. Clinical course and outcome of early Rheumatoid Arthritis. Rheumatol Int. 2001;20:205–10.
Rau R , Herborn G, Menninger H, Sangha O. Radiographic outcome after three years of patients with early erosive Rheumatoid Arthritis treated by intramuscular methotrexate or parenteral gold. Extension of a one year double-blind study in 174 patients. Rheumatology (Oxford). 2002;41:196–204.
N. Del Val Del Amo, R. Ibanez Bosch, C. Fito Manteca, R. Gutierrez Polo,E. Loza Cortina. Anticyclic citrullinated peptide antibody in Rheumatoid Arthritis: Relation with disease aggressiveness; Clinical and Experimental Rheumatology. 2006;24:281-6.
MarijaGlasnovic ,Ivica Bo{njak1, AleksandarV~ev, Ivan Soldo , ElizabetaGlasnovic-Horvatic ,Silva Soldo-Butkovic , JasnaPavela and Nikola Micunovic. Anti-Citrullinated Antibodies, Radiological Joint Damages and Their Correlations with Disease Activity Score (DAS-28); Coll. Antropol. 2007;1:345–
Omer Kuru, AyhanBilgici, AsumanBirinci, Hasan Ulusoy, Durupinar. Prognostic value 0f Anti-ccp antibody and Rheumatoid factor in patients with Rheumatoid Arthritis; Bratislleklisty. 2009;110(10).
Kastbom A, Strandberg G, Lindroos A, Skogh T. Anti-ccp antibody test predicts the disease course during 3 years in early Rheumatoid Arthritis (the Swedish TIRA project). Ann Rheum Dis. 2004;63:1085–9
Önder B, Kurtaran A, Kimyon S, Selçuk B, Akyüz M . Association of Anti-ccp positivity with serum ferritin and DAS-28; Rheumatol Int. 2009;30:223-7
MünevverSerdaroflu ,HaoimÇak آrbay , Orhan Defer , SevilCengiz , SibelKul. The association of Anti-ccp antibodies with disease activity in Rheumatoid Arthritis ;Rheumatol Int. 2008;28:965–70.
S P Linn-Rasker, A H M van der Helm-van Mil, F A van Gaalen, M Kloppenburg, R R P de Vries, S le Cessie, F C Breedveld, R E M Toes, T W J Huizinga. Smoking is a risk factor for Anti-ccp antibodies onlyin Rheumatoid Arthritis patients who carry HLA-DRB1 shared epitope alleles; Ann Rheum Dis 2006;65:366– doi: 10.1136/ard.2005.041079
Lee DM, Phillips R, Hagan EM, Chibnik LB, Costenbader KH, Schur PH., Quantifying Anti-cyclic citrullinated peptide titres: clinical utility and association with tobacco exposure in patients with Rheumatoid Arthritis; Ann Rheum Dis. 2009;68:201Ted R. Mikuls, MD, MSPH1, Laura B. Hughes, MD, MSPH2, Andrew O. Westfall, MS2, V. Michael Holers, MD3, Lezlie Parrish, MPH3, Desiree van der Heijde4, Maaltje van Everdingen, MD, PhD4, Graciela S. Alarcón, MD, MPH2, Doyt L. Conn, MD5, Beth Jonas, MD6, Leigh F. Callahan, PhD6, Edwin A. Smith, MD7, Gary Gilkeson, MD7, George Howard, DrPH2, LarryW. Moreland, MD2,*, and S. Louis Bridges Jr., MD, PhD2. Cigarette smoking, disease severity, and autoantibody expression in African Americans with recent-onset Rheumatoid Arthritis;Ann Rheum Dis. 2008;67:1529–34.
Frederick Wolfe . The effect of smoking on clinical, laboratory, and radiographic status in Rheumatoid Arthritis; Rheumatol.2000; 27:569-70.
N.G. Papadopoulos, Y. Alamanos1, P.V. Voulgari, E.K. Epagelis, N. Tsifetaki,A.A. Drosos. Does cigarette smoking influence disease expression, activity and severity in early Rheumatoid Arthritis patients?; Clinical and Experimental Rheumatology. 2005;23:861-86.
V. F. Manfredsdottir, T. Vikingsdottir, T. Jonsson, A. J. Geirsson, O. Kjartansson, M. Heimisdottir, S. L. Sigurdardottir, H. Valdimarssonand A. Vikingsson. The effects of tobacco smoking and Rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritis; Rheumatology. 2006;45:734–40.
Vesperini V, Lukas C, Fautrel B, Le Loet X, Rincheval N, Combe B .Tobacco exposure reduces radiographic progression in early Rheumatoid Arthritis; Arthritis Care and Research. 2013;22:243
YazışmaAdresi / Address for Correspondence: Dr.Hawar Ali Ehsan Kaka Khan Sulaimaniya Medical School IRAQ E-mail: haekkam@gmail.com G eliştarihi/Received on : 02.04.2014
Kabul tarihi/Accepted on: 09.04.2014

Details

Primary Language

Turkish

Subjects

-

Journal Section

-

Authors

Raouf Rahim Merza This is me

Dana Mohammed Tofiq This is me

Najlaa Naser Radhi This is me

Hawar Ali Ehsan Kaka Khan This is me

Publication Date

July 22, 2014

Submission Date

July 22, 2014

Acceptance Date

-

Published in Issue

Year 2014 Volume: 39 Number: 4

DOI

https://doi.org/10.17826/cutf.92036

IZ

https://izlik.org/JA87AG27WT

MLA

Merza, Raouf Rahim, et al. “Romatoid Artritte Hastalık Aktivitesi Ile Anti-CCP İlişkisi”. Cukurova Medical Journal, vol. 39, no. 4, Dec. 2014, doi:10.17826/cutf.92036.

This journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The Association of Anti-CCP and Disease Activity in Rheumatoid Arthritis

Abstract

Keywords

Romatoid Artritte Hastalık Aktivitesi ile Anti-CCP İlişkisi

Öz

Anahtar Kelimeler

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite