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

Abstract

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.

Diagnostic value of anti‐citrullinated α‐enolase peptide 1 antibody in patients with rheumatoid arthritis: A systematic review and meta‐analysis

“…[15][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33][34][35]37,38 Most of the studies used ELISAs to detect the anti-CEP 1 antibody by commercial ELISA kits or a self-established ELISA method. [15][16][17]19,22,24,25,28,29,[31][32][33][35][36][37][38] Two types of CEP-1 peptide sequences were used as coating antigens in the self-established ELISA methods: one was a CKIHA(cit)EIFDS(cit)GNPTVEC (cyclic) with C-terminal and N-terminal cysteines to facilitate cyclization in 6 included studies, 25,31,33,35,37,38 and another was a KIHA(cit)EIFDS(cit) GNPTVE without cysteine in 4 of the studies. 24,28,29,32 Detailed...…”

Tobacco-Derived Lipopolysaccharide, Not Microbial Translocation, as a Potential Contributor to the Pathogenesis of Rheumatoid Arthritis

“…In this context, it is noteworthy that bacterial LPS is known to initiate inflammatory mechanisms that cause protein citrullination [13], an event intimately linked to the immunopathogenesis of RA. In this context, autoantibodies to citrullinated proteins/peptides are not only diagnostic for RA but are also indicative of severe erosive disease [14–16]. Importantly, bacterial products are also present in cured tobacco [17–19], with smoking now well recognised as being a major risk factor for RA [20].…”