Related Experiment Video
Updated: Jun 25, 2025
Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
The development of anticyclic citrullinated peptide (anti-CCP) antibody following severe COVID-19
Seyed Askar Roghani1,2,3, Mohammad Dastbaz1, Ramin Lotfi4,5
1Immunology Department, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Insights
COVID-19 patients show increased autoantibodies linked to autoimmune diseases. Anticyclic citrullinated peptide antibodies were notably higher in severe COVID-19 cases.
Area of Science:
- Immunology
- Rheumatology
- Infectious Diseases
Background:
- Dysregulated immune responses are characteristic of severe COVID-19.
- Autoantibodies (AABs) associated with systemic autoimmune rheumatic diseases (SARDs) may play a role in COVID-19 pathogenesis.
Purpose of the Study:
- To investigate the prevalence of SARDs-associated AABs in hospitalized COVID-19 patients.
- To compare AAB occurrence across different COVID-19 severity levels (moderate, severe, critical).
Main Methods:
- Serum samples from 176 COVID-19 patients (90 moderate, 50 severe, 36 critical) and 176 healthy controls were analyzed.
- Assays included antinuclear antibodies (ANAs), anti-dsDNA, c-ANCA, p-ANCA, antiphospholipid antibodies (aPLs), and anti-CCP using ELISA.
- Statistical comparisons were made between patient groups and controls.
Main Results:
- COVID-19 patients exhibited significantly higher rates of ANAs, anti-dsDNA, anti-CCP, c-ANCA, and p-ANCA compared to healthy controls (p < .0001 for most).
- Anticyclic citrullinated peptide (anti-CCP) positivity was significantly elevated in severe COVID-19 patients compared to those with moderate disease (p < .01).
Conclusions:
- Findings support the hypothesis that COVID-19 can trigger the development of autoantibodies related to SARDs.
- This study is the first large-scale investigation to report the occurrence of anti-CCP in severe COVID-19.
Objectives:
The dysregulated immune response is one of the cardinal features of severe coronavirus disease 2019 (COVID-19). This study was conducted to clarify the occurrence of autoantibodies (AABs) associated with systemic autoimmune rheumatic diseases (SARDs) in hospitalized patients with a moderate, severe, and critical form of COVID-19.
Methods:
The serum samples obtained from 176 hospitalized COVID-19 patients were investigated in this study, including patients with moderate (N = 90), severe (N = 50), and critical (N = 36) forms of COVID-19. Also, the serum samples collected from healthy subjects before the COVID-19 pandemic were used as controls (N = 176). The antinuclear antibodies (ANAs), antidouble-stranded DNA (anti-dsDNA), cytoplasmic-anti neutrophil cytoplasmic antibody (c-ANCA), perinuclear ANCA (p-ANCA), antiphospholipid antibodies (aPLs), and anticyclic citrullinated peptide (anti-CCP) occurrence was evaluated using a solid-phase enzyme-linked immunosorbent assay (ELISA).
Results:
The results showed that the occurrence of ANAs, anti-dsDNA, anti-CCP, c-ANCA, and p-ANCA was significantly higher in the COVID-19 patients compared to serum obtained from healthy subjects (p < .0001, p < .0001, p < .0001, p < .05, and p < .001, respectively). The positive number of anti-CCP tests increased significantly in severe COVID-19 compared to the moderate group (p < .01).
Conclusion:
Our study further supports the development of autoantibodies related to systemic autoimmune rheumatologic diseases. To the best of our knowledge, this is the first study with a large sample size that reported the occurrence of anti-CCP in a severe form of COVID-19.
