Diagnostic Value and Clinical Significance
Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease of unknown etiology, characterized by chronic polyarthritis. RA is diagnosed primarily according to clinical manifestations, and serologic support is restricted to the determination of rheumatoid factor (RF). However, its diagnostic specificity for RA is poor since RF is also found in many other rheumatic and nonrheumatic diseases and even in a noticeable proportion of normal healthy subjects, particularly in ageing individuals.
The other most specific autoantibody system for RA is the family of auto antibodies directed to cit-rulline-containing proteins, including antiperinuclear factor (APF), antikeratin antibodies (AKA), antifilag-grin antibodies (AFA) and anti-Sa. Recently, a new serological test, the anticyclic citrullinated peptide (anti-CCP) was developed. Anti-CCP was reported to have a high specificity for the diagnosis of RA, especially in patients with early disease. It was also found that there is an association between anti-CCP and the disease severity in early RA.
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At all stages of RA, disease activity has a crucial role in disability. Both cross sectional and prospective studies showed strong correlations between RF and disease activity parameters. However, there is little information about the prevalence and the association of anti-CCP with the disease activity parameters in patients with advanced RA. The present investigation was undertaken to determine the prevalence of anti-CCP in patients with advanced RA and to compare it with those in age-matched control subjects. We also investigated the relation between anti-CCP and some clinical and laboratory variables of the disease.