Diagnostic Utility of Anti-cyclic Citrullinated Peptide Antibodies for Rheumatoid Arthritis in Patients with Active Lung Tuberculosis

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2008 Nov 13

PMID 19002544

Citations 7

Authors

Shunsuke Mori

Hiromichi Naito

Sumire Ohtani

Tohru Yamanaka

Mineharu Sugimoto

Affiliations

Soon will be listed here.

Abstract

This study was intended to evaluate the utility of anti-cyclic citrullinated peptide antibodies (second generation, anti-CCP2) as a diagnostic marker for rheumatoid arthritis (RA) in patients with active tuberculosis. Among 89 patients with active tuberculosis, anti-CCP2 was detected in six (6.7%), and three of these (3.4%) were strongly positive for anti-CCP2. The positive rate of anti-CCP2 in patients with newly diagnosed RA was 82.1% (87 of 106 cases), while the rate in healthy control subjects was 0.4% (one of 237 individuals). The mean level of anti-CCP2 among the RA group was 159.3 U/ml, which was significantly higher than both that among the tuberculosis group (15.4 U/ml) and that among the healthy controls (0.7 U/ml). IgM rheumatoid factor (RF) was detected in 16 patients from the tuberculosis group (18.0%) with a mean serum level of 18.6 IU/ml and in 77 patients of the RA group (72.6%) with a mean level of 164.0 IU/ml. Only two cases in the tuberculosis group were positive for both anti-CCP2 and IgM RF. These observations show that measurement of anti-CCP2 seems to be a reliable serological tool for identifying early RA in patients with active tuberculosis.

Citing Articles

Mortality and Predictive Factors for Death Following the Diagnosis of Interstitial Lung Disease in Patients with Rheumatoid Arthritis: A Retrospective, Long-Term Follow-Up Study.

Mori S, Sakai F, Hasegawa M, Nakamura K, Sugahara K J Clin Med. 2025; 14(4).

PMID: 40004909 PMC: 11855988. DOI: 10.3390/jcm14041380.

Aberrant immunity in the oral cavity-a link with rheumatoid arthritis?.

Malcolm J, Culshaw S Front Oral Health. 2024; 5:1430886.

PMID: 38948089 PMC: 11211539. DOI: 10.3389/froh.2024.1430886.

Poncet's Disease in the Preclinical Phase of Rheumatoid Arthritis.

Nyo M, Ally M, Van Duuren E, Arendse R Case Rep Rheumatol. 2018; 2018:3571247.

PMID: 29854537 PMC: 5964554. DOI: 10.1155/2018/3571247.

Antibodies to citrullinated peptides in tuberculosis.

Lima I, Oliveira R, Atta A, Marchi S, Barbosa L, Reis E Clin Rheumatol. 2013; 32(5):685-7.

PMID: 23344687 DOI: 10.1007/s10067-013-2173-y.

A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis.

Taylor P, Gartemann J, Hsieh J, Creeden J Autoimmune Dis. 2011; 2011:815038.

PMID: 21915375 PMC: 3170888. DOI: 10.4061/2011/815038.

References

Cha S, Choi C, Han T, Kang C, Kang C, Bae S . Association of anti-cyclic citrullinated peptide antibody levels with PADI4 haplotypes in early rheumatoid arthritis and with shared epitope alleles in very late rheumatoid arthritis. Arthritis Rheum. 2007; 56(5):1454-63. DOI: 10.1002/art.22570. View

Schellekens G, Visser H, de Jong B, van den Hoogen F, Hazes J, Breedveld F . The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum. 2000; 43(1):155-63. DOI: 10.1002/1529-0131(200001)43:1<155::AID-ANR20>3.0.CO;2-3. View

Lee D, Schur P . Clinical utility of the anti-CCP assay in patients with rheumatic diseases. Ann Rheum Dis. 2003; 62(9):870-4. PMC: 1754666. DOI: 10.1136/ard.62.9.870. View

Guedes-Barbosa L, Mangueira C, Scheinberg M . Anticitrulline peptide antibodies (CCP3) in leprosy sera: a negative association. Clin Rheumatol. 2007; 27(4):515-6. DOI: 10.1007/s10067-007-0810-z. View

Suzuki A, Yamada R, Chang X, Tokuhiro S, Sawada T, Suzuki M . Functional haplotypes of PADI4, encoding citrullinating enzyme peptidylarginine deiminase 4, are associated with rheumatoid arthritis. Nat Genet. 2003; 34(4):395-402. DOI: 10.1038/ng1206. View

Huizinga T, Amos C, van der Helm-van Mil A, Chen W, van Gaalen F, Jawaheer D . Refining the complex rheumatoid arthritis phenotype based on specificity of the HLA-DRB1 shared epitope for antibodies to citrullinated proteins. Arthritis Rheum. 2005; 52(11):3433-8. DOI: 10.1002/art.21385. View

Carmona L, Hernandez-Garcia C, Vadillo C, Pato E, Balsa A, Gonzalez-Alvaro I . Increased risk of tuberculosis in patients with rheumatoid arthritis. J Rheumatol. 2003; 30(7):1436-9. View

Avouac J, Gossec L, Dougados M . Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis. 2006; 65(7):845-51. PMC: 1798205. DOI: 10.1136/ard.2006.051391. View

Hoppe B, Haupl T, Gruber R, Kiesewetter H, Burmester G, Salama A . Detailed analysis of the variability of peptidylarginine deiminase type 4 in German patients with rheumatoid arthritis: a case-control study. Arthritis Res Ther. 2006; 8(2):R34. PMC: 1526594. DOI: 10.1186/ar1889. View

10.

Elkayam O, Segal R, Lidgi M, Caspi D . Positive anti-cyclic citrullinated proteins and rheumatoid factor during active lung tuberculosis. Ann Rheum Dis. 2005; 65(8):1110-2. PMC: 1798246. DOI: 10.1136/ard.2005.045229. View

11.

Vossenaar E, Nijenhuis S, Helsen M, van der Heijden A, Senshu T, van den Berg W . Citrullination of synovial proteins in murine models of rheumatoid arthritis. Arthritis Rheum. 2003; 48(9):2489-500. DOI: 10.1002/art.11229. View

12.

Berglin E, Johansson T, Sundin U, Jidell E, Wadell G, Hallmans G . Radiological outcome in rheumatoid arthritis is predicted by presence of antibodies against cyclic citrullinated peptide before and at disease onset, and by IgA-RF at disease onset. Ann Rheum Dis. 2005; 65(4):453-8. PMC: 1798112. DOI: 10.1136/ard.2005.041376. View

13.

Greiner A, Plischke H, Kellner H, Gruber R . Association of anti-cyclic citrullinated peptide antibodies, anti-citrullin antibodies, and IgM and IgA rheumatoid factors with serological parameters of disease activity in rheumatoid arthritis. Ann N Y Acad Sci. 2005; 1050:295-303. DOI: 10.1196/annals.1313.031. View

14.

Malaviya A, Kotwal P . Arthritis associated with tuberculosis. Best Pract Res Clin Rheumatol. 2003; 17(2):319-43. DOI: 10.1016/s1521-6942(02)00126-2. View

15.

Yamada T, Nakajima A, Inoue E, Tanaka E, Hara M, Tomatsu T . Increased risk of tuberculosis in patients with rheumatoid arthritis in Japan. Ann Rheum Dis. 2006; 65(12):1661-3. PMC: 1798455. DOI: 10.1136/ard.2005.047274. View

16.

van Gaalen F, Linn-Rasker S, van Venrooij W, de Jong B, Breedveld F, Verweij C . Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: a prospective cohort study. Arthritis Rheum. 2004; 50(3):709-15. DOI: 10.1002/art.20044. View

17.

Irigoyen P, Lee A, Wener M, Li W, Kern M, Batliwalla F . Regulation of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis: contrasting effects of HLA-DR3 and the shared epitope alleles. Arthritis Rheum. 2005; 52(12):3813-8. DOI: 10.1002/art.21419. View

18.

Vossenaar E, Smeets T, Kraan M, Raats J, van Venrooij W, Tak P . The presence of citrullinated proteins is not specific for rheumatoid synovial tissue. Arthritis Rheum. 2004; 50(11):3485-94. DOI: 10.1002/art.20584. View

19.

Caponi L, Petit-Teixeira E, Sebbag M, Bongiorni F, Moscato S, Pratesi F . A family based study shows no association between rheumatoid arthritis and the PADI4 gene in a white French population. Ann Rheum Dis. 2004; 64(4):587-93. PMC: 1755438. DOI: 10.1136/ard.2004.026831. View

20.

Fernandez-Suarez A, Reneses S, Wichmann I, Criado R, Nunez A . Efficacy of three ELISA measurements of anti-cyclic citrullinated peptide antibodies in the early diagnosis of rheumatoid arthritis. Clin Chem Lab Med. 2005; 43(11):1234-9. DOI: 10.1515/CCLM.2005.214. View