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Diagnostic and prognostic value of anti-CarP antibodies in a sample of Egyptian rheumatoid arthritis patients

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Abstract

Introduction

Detection of autoantibodies in sera of rheumatoid arthritis (RA) patients has an important role in diagnosis and management strategies. Recently, another type of autoantibodies has been detected with activity against carbamylated proteins (anti-CarP) which may play an important role in the diagnosis of RA. The aim of this study was to raise knowledge about the diagnostic and prognostic value of anti-CarP antibodies in RA.

Materials and methods

Seventy RA patients and thirty-four controls were included in this study. DAS28 was used to evaluate disease activity. Joint erosions were assessed by Larsen score using plain X-ray of involved joints of hands and feet. Serum samples were analyzed for anti-CarP antibody titer using the ELISA technique.

Results

Out of 70 patients, 35.7% were positive for anti-CarP and only 5.88% of controls had high titer above the cut-off value. A total of 24.29% of the patients were RF-negative and 30% were ACPA-negative. Five patients (29.41%) of the negative RF group were positive for anti-CarP. Four patients (19%) of the ACPA-negative group were positive for anti-CarP, and three patients (4.28%) of the total number of patients were triple negative and seventeen (24.28%) were triple positive. There was a significant correlation between anti-CarP titer and both DAS28 and Larsen scores only in the positive anti-CarP group. In addition, there was a strong association between anti-CarP antibody titer and joint erosions at both baseline and after 1-year follow-up.

Conclusion

Presence of the anti-CarP antibodies in sera of RA patients may have a prognostic value as it correlates with the disease activity and joint erosions; moreover, it may have a diagnostic value in rheumatoid arthritis especially in RF- and ACPA-negative patients.

Key Points

• This study was carried out to raise our knowledge about the importance of anti-CarP antibodies in predicting the prognosis of RA.

• This study was carried out to assess the correlation between anti-CarP antibodies, disease activity, and joint erosions.

• This study was carried out to state the extent to which we can rely on the anti-CarP antibodies as a biomarker for prediction of RA.

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Acknowledgments

The authors acknowledge all the effort exerted by members of the radiology department in their assistance and support in the radiological part of this study.

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Authors and Affiliations

  1. Department of Rheumatology and Rehabilitation, Faculty of Medicine, Sohag University, Sohag, Egypt

    Sahar A. Elsayed, Mohamed A. Esmail & Randa M. Ali

  2. Department of Biochemistry, Faculty of Pharmacy, Assiut Branch Al-Azhar University, Asyut, Egypt

    Omar M. Mohafez

Authors
  1. Sahar A. Elsayed
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  2. Mohamed A. Esmail
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  3. Randa M. Ali
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  4. Omar M. Mohafez
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Contributions

This study was conceptualized and designed by SAE, MAI, RMA, and OMM. Patients were selected and diagnosed by SAE, MAI, and RMA. Data sheets were written by RMA. Lab assessments were done by OMM. All authors interpreted the data and discussed the results, and the manuscript was written and revised by SAE.

Corresponding author

Correspondence to Sahar A. Elsayed.

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Informed consents were collected from all patients and ethical permission was obtained from the ethical committee of Sohag University.

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Elsayed, S.A., Esmail, M.A., Ali, R.M. et al. Diagnostic and prognostic value of anti-CarP antibodies in a sample of Egyptian rheumatoid arthritis patients. Clin Rheumatol 38, 2683–2689 (2019). https://doi.org/10.1007/s10067-019-04616-z

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  • DOI: https://doi.org/10.1007/s10067-019-04616-z

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