Recognizing rheumatoid arthritis: oncoprotein survivin opens new possibilities: a population-based case-control study

Area of Science:

• Immunology
• Rheumatology
• Biomarker Research

Background:

• Survivin, a known cancer biomarker, is implicated in non-cancer pathologies like rheumatoid arthritis (RA).
• Elevated survivin levels in blood and synovial fluid correlate with joint damage and poor treatment response in RA patients.
• The Malaysian epidemiological investigation of rheumatoid arthritis (MyEIRA) study provides a cohort for investigating RA biomarkers.

Purpose of the Study:

• To evaluate the diagnostic value of blood survivin measurements for rheumatoid arthritis (RA).
• To assess the association of survivin levels with RA risk, considering ACPA and HLA-DRB1 SE alleles.

Main Methods:

• Enzyme-linked immunosorbent assay (ELISA) was used to measure survivin levels in 1233 RA patients and 1566 healthy controls.
• Antibodies against cyclic citrullinated peptides (ACPA) were detected by ELISA.
• HLA-DRB1 shared epitope (SE) alleles were identified using polymerase chain reaction (PCR).

Main Results:

• High survivin levels were found in 50.7% of RA cases versus 5.4% of controls, indicating high specificity.
• Survivin was associated with increased RA risk, particularly in patients lacking SE alleles and ACPA (OR=5.40).
• Combined analysis of survivin, SE, and ACPA significantly elevated RA risk (OR=16.21) compared to survivin-negative individuals with SE and ACPA.

Conclusions:

• Blood survivin detection offers a straightforward method to enhance RA diagnosis.
• Survivin measurement improves the predictability of RA, especially in conjunction with ACPA and SE allele status.
• This study highlights survivin's potential as a valuable biomarker in RA diagnostics within the Malaysian population.