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Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Diagnostic accuracy of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis
O Kasapçopur1, S Altun, M Aslan
1Department of Paediatric Rheumatology, Cerrahpaşa Medical School, Istanbul, Turkey. ozgurcopur@e-kolay.net.
Insights
Anti-cyclic citrullinated peptide antibodies (anti-CCP) are rarely positive in juvenile idiopathic arthritis (JIA), unlike rheumatoid arthritis (RA). Anti-CCP positivity in JIA may indicate rheumatoid factor positivity or erosive disease.
Area of Science:
- Immunology
- Rheumatology
- Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) is a heterogeneous autoimmune disease affecting children.
- Anti-cyclic citrullinated peptide antibodies (anti-CCP) are established biomarkers for rheumatoid arthritis (RA).
- The role of anti-CCP in JIA requires further elucidation.
Purpose of the Study:
- To investigate the correlation between serum anti-CCP antibody levels and JIA subtypes.
- To determine the association of anti-CCP positivity with an erosive disease course in JIA.
- To compare anti-CCP prevalence in JIA with that in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and healthy controls.
Main Methods:
- Serum anti-CCP antibody levels were measured using ELISA in 122 children with JIA.
- JIA patients were analyzed for subtypes, rheumatoid factor (RF) status, and presence of erosive joint disease.
- Comparative analysis included 19 children with SLE, 27 with RA, and 15 healthy children.
Main Results:
- Anti-CCP antibodies were positive in only three girls with seropositive polyarticular JIA and erosive disease.
- All children with JIA evaluated during active disease or remission, patients with SLE, and healthy children tested negative for anti-CCP.
- A high positivity rate (70%) for anti-CCP antibodies was observed in adult patients with RA.
Conclusions:
- Anti-CCP positivity is infrequent in juvenile idiopathic arthritis (JIA) compared to adult rheumatoid arthritis (RA).
- Anti-CCP antibodies may be detected in JIA patients with rheumatoid factor (RF) positivity or erosive joint disease.
- These findings suggest a limited role for anti-CCP as a diagnostic marker in JIA, but potential utility in identifying specific subgroups.
Objective:
To correlate serum anti-cyclic citrullinated peptide antibodies (anti-CCP) levels with juvenile idiopathic arthritis (JIA) subtypes and with an erosive disease course.
Methods:
The study group comprised 122 children with JIA; 16 were evaluated during both active disease and remission. Nineteen children with systemic lupus erythematosus (SLE), 27 with rheumatoid arthritis (RA), and 15 healthy children were also included in the study. Twelve children with JIA were rheumatoid factor (RF) positive, and 34 patients had persistent erosive joint disease. Anti-CCP antibody levels were determined by ELISA; values above 5 relative units were regarded as positive.
Results:
Three girls with seropositive polyarticular JIA and erosive joint disease had positive anti-CCP values. Children evaluated during active disease and remission, patients with SLE, and healthy children all had negative anti-CCP antibody levels. However, 19/27 (70%) adult patients with RA had positive anti-CCP antibody values.
Conclusions:
In contrast with RA, anti-CCP positivity is only rarely found in patients with JIA. In patients with RF positivity and/or in patients with erosive joint disease, anti-CCP can be detected.
