Prevalence, Sensitivity and Specificity of Antibodies Against Carbamylated Proteins in a Monocentric Cohort of Patients with Rheumatoid Arthritis and Other Autoimmune Rheumatic Diseases

Overview

Journal Arthritis Res Ther

Publisher Biomed Central

Specialty Rheumatology

Date 2016 Nov 27

PMID 27887639

Citations 27

Authors

Arbi Pecani

Cristiano Alessandri

Francesca Romana Spinelli

Roberta Priori

Valeria Riccieri

Manuela Di Franco

Fulvia Ceccarelli

Tania Colasanti

Monica Pendolino

Riccardo Mancini

Simona Truglia

Cristiana Barbati

Marta Vomero

Danilo Sabatinelli

Francesca Morello

Guido Valesini

Fabrizio Conti

Affiliations

Soon will be listed here.

Abstract

Background: Antibodies against carbamylated proteins (anti-CarP) have been recently identified in the sera of patients with rheumatoid arthritis (RA). The objective of the study was to evaluate the prevalence, sensitivity and specificity of anti-CarP compared to anti-citrullinated peptide antibodies (ACPA) and rheumatoid factor (RF), replicating the existing data in a large cohort of Italian patients with RA and extending the evaluation to other autoimmune rheumatic diseases (AIRDs).

Methods: Serum samples (n = 607) from 309 patients with RA, 200 disease controls and 98 normal healthy subjects (NHS) were evaluated. Anti-CarP were detected using carbamylated fetal calf serum as the antigen. ACPAs were detected using second-generation ELISA and IgM RF was assessed as part of routine analysis.

Results: Anti-CarP antibodies were detected in 117 patients with RA (34.4%), ACPA in 190 patients (61.4%) and RF in 202 patients (65.3%). Two (2.04%) of the NHS were positive for anti-CarP, one NHS (1.02%) was positive for ACPA and three NHS were positive for RF (3.06%). Among disease controls, anti-CarP antibodies were detected in 33 patients (16.5%), ACPA in 29 patients (14.5%) and RF in 64 patients (32%). In particular, 16.8% of patients with systemic lupus erythematosus and 31.1% of patients with Sjögren syndrome were positive for anti-CarP. The sensitivity of anti-CarP, ACPA and RF was 46.8%, 61.8% and 64.4%, respectively and specificity was 91.95%, 89.93% and 76.51%, respectively.

Conclusions: The present study extends the knowledge of anti-CarP antibodies, confirming previous data on the diagnostic accuracy of anti-CarP in RA in a large cohort of Italian patients. Anti-CarP antibodies demonstrated relatively low sensitivity and slightly higher specificity compared to ACPA and RF. Even if predominantly present in RA, anti-CarP was detected in a variable percentage of patients with other autoimmune rheumatic diseases and their generation could be attributed to the inflammatory status; the clinical relevance of anti-CarP antibodies in these latter patients should be further determined.

Citing Articles

[Application value of anti-carbamylated protein antibody in the diagnosis of rheumatoid arthritis].

Li Z, Luo C, Wu L, Wu X, Meng X, Chen X Beijing Da Xue Xue Bao Yi Xue Ban. 2024; 56(4):729-734.

PMID: 39041572 PMC: 11284480.

Anti-Carbamylated Protein Antibodies in ACPA-Negative and ACPA-Positive Patients with Rheumatoid Arthritis.

Dibrov D, Avdeeva A, Diatroptov M, Nasonov E Dokl Biochem Biophys. 2024; 517(1):235-242.

PMID: 39002007 DOI: 10.1134/S1607672924700960.

The peculiar features, diversity and impact of citrulline-reactive autoantibodies.

Raposo B, Klareskog L, Robinson W, Malmstrom V, Gronwall C Nat Rev Rheumatol. 2024; 20(7):399-416.

PMID: 38858604 DOI: 10.1038/s41584-024-01124-6.

Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers.

Lee Y, Hong S, Lee G, Shin S, Hong J, Chung S Sci Rep. 2024; 14(1):4316.

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Wu K, Serhan O, Faucher A, Tran S Biomolecules. 2024; 14(1).

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