Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis

Objective. Assess the level of antibodies to carbamylated proteins (anti-CarP) and analyse the clinical and immunological associations in patients with ACCP-negative and ACCP-positive variants of rheumatoid arthritis.Materials and methods. 150 patients with a reliable diagnosis of rheumatoid arthrit...

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Main Authors: D. A. Dibrov, A. S. Avdeeva, M. E. Diatroptov, E. L. Nasonov
Format: Article
Language:Russian
Published: IMA PRESS LLC 2024-01-01
Series:Научно-практическая ревматология
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Online Access:https://rsp.mediar-press.net/rsp/article/view/3480
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author D. A. Dibrov
A. S. Avdeeva
M. E. Diatroptov
E. L. Nasonov
author_facet D. A. Dibrov
A. S. Avdeeva
M. E. Diatroptov
E. L. Nasonov
author_sort D. A. Dibrov
collection DOAJ
description Objective. Assess the level of antibodies to carbamylated proteins (anti-CarP) and analyse the clinical and immunological associations in patients with ACCP-negative and ACCP-positive variants of rheumatoid arthritis.Materials and methods. 150 patients with a reliable diagnosis of rheumatoid arthritis and 25 patients as healthy controls were included in the study. Depending on ACCP values, two groups of patients were recruited: ACCP-positive (n=75) and ACCP-negative (n=75). RA activity was assessed by the DAS28 (Disease Activity Score 28) index. Determination of antibodies to carbamylated proteins was performed by enzyme-linked immunosorbent assay (BlueGene Biotech, China). Quantitative determination of ACCP in serum was performed by enzyme immunoassay using a commercial reagent kit (AxisShield, UK; upper limit of normal 5.0 U/ml; Orgentec, Germany; upper limit of normal 20.0 U/ml).Results and discussion. Me for anti-CarP in patients with RA was 126.2 [100.83; 157.41] ng/ml and was statistically significantly higher (p<0.001) than healthy controls 88.89 [70.53; 107.75] ng/ml. Among all patients with RA, 50 (33.3%) were anti-Carp positive, 22 (29.3%) were anti-Carp(+) in the ACCP(+) group, 28 (37.3%) in the ACCP(–) group, and 1 (2%) volunteer from healthy controls (p=0.002). In ROC analysis to assess the diagnostic significance of anti-Carp for RA for all patients with RA, the area under the curve was 0.783±0.047 (95% CI: 0.691–0.874; p<0.001), with a cut-off point of 143 ng/ml, specificity 96%, sensitivity 36.7%.In the ACCP(+) RA group, the erosion count was statistically significantly higher (p=0.044) in anti-CarP(+) patients than in anti-CarP(–) patients. A weak direct correlation between anti-CarP and DAS28 was found in the ACCP(–) RA group.Conclusion. We studied the predictive value of anti-CarP as an adjuvant biomarker in ACCP(+) and ACCP(–) subtypes of RA. ACCP(+), anti-CarP(+) patients have a more “erosive” subtype of the disease than ACCP(+), anti-CarP(–) patients. In ACCP(+) patients, anti-CarP helps to identify a more erosive subtype of the disease, and among ACCP(–) patients, it helps to reduce the proportion of seronegative patients. Further studies are needed to determine the optimal standards for the laboratory diagnosis of anti-CarP and to clarify the diagnostic potential of these antibodies as part of the differential diagnosis of arthritis in other rheumatic diseases.
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spelling doaj-art-e8512c7118f94463b9317e905d56afcb2025-08-20T03:37:53ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922024-01-0161675175710.47360/1995-4484-2023-751-7572956Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritisD. A. Dibrov0A. S. Avdeeva1M. E. Diatroptov2E. L. Nasonov3V.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Objective. Assess the level of antibodies to carbamylated proteins (anti-CarP) and analyse the clinical and immunological associations in patients with ACCP-negative and ACCP-positive variants of rheumatoid arthritis.Materials and methods. 150 patients with a reliable diagnosis of rheumatoid arthritis and 25 patients as healthy controls were included in the study. Depending on ACCP values, two groups of patients were recruited: ACCP-positive (n=75) and ACCP-negative (n=75). RA activity was assessed by the DAS28 (Disease Activity Score 28) index. Determination of antibodies to carbamylated proteins was performed by enzyme-linked immunosorbent assay (BlueGene Biotech, China). Quantitative determination of ACCP in serum was performed by enzyme immunoassay using a commercial reagent kit (AxisShield, UK; upper limit of normal 5.0 U/ml; Orgentec, Germany; upper limit of normal 20.0 U/ml).Results and discussion. Me for anti-CarP in patients with RA was 126.2 [100.83; 157.41] ng/ml and was statistically significantly higher (p<0.001) than healthy controls 88.89 [70.53; 107.75] ng/ml. Among all patients with RA, 50 (33.3%) were anti-Carp positive, 22 (29.3%) were anti-Carp(+) in the ACCP(+) group, 28 (37.3%) in the ACCP(–) group, and 1 (2%) volunteer from healthy controls (p=0.002). In ROC analysis to assess the diagnostic significance of anti-Carp for RA for all patients with RA, the area under the curve was 0.783±0.047 (95% CI: 0.691–0.874; p<0.001), with a cut-off point of 143 ng/ml, specificity 96%, sensitivity 36.7%.In the ACCP(+) RA group, the erosion count was statistically significantly higher (p=0.044) in anti-CarP(+) patients than in anti-CarP(–) patients. A weak direct correlation between anti-CarP and DAS28 was found in the ACCP(–) RA group.Conclusion. We studied the predictive value of anti-CarP as an adjuvant biomarker in ACCP(+) and ACCP(–) subtypes of RA. ACCP(+), anti-CarP(+) patients have a more “erosive” subtype of the disease than ACCP(+), anti-CarP(–) patients. In ACCP(+) patients, anti-CarP helps to identify a more erosive subtype of the disease, and among ACCP(–) patients, it helps to reduce the proportion of seronegative patients. Further studies are needed to determine the optimal standards for the laboratory diagnosis of anti-CarP and to clarify the diagnostic potential of these antibodies as part of the differential diagnosis of arthritis in other rheumatic diseases.https://rsp.mediar-press.net/rsp/article/view/3480anti-carbamylated protein antibodiesanti-carprheumatoid arthritisaccp-negative rheumatoid arthritisseronegative rheumatoid arthritis
spellingShingle D. A. Dibrov
A. S. Avdeeva
M. E. Diatroptov
E. L. Nasonov
Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
Научно-практическая ревматология
anti-carbamylated protein antibodies
anti-carp
rheumatoid arthritis
accp-negative rheumatoid arthritis
seronegative rheumatoid arthritis
title Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
title_full Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
title_fullStr Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
title_full_unstemmed Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
title_short Anti-carbamylated protein antibodies in ACCP-negative and ACCP-positive patients with rheumatoid arthritis
title_sort anti carbamylated protein antibodies in accp negative and accp positive patients with rheumatoid arthritis
topic anti-carbamylated protein antibodies
anti-carp
rheumatoid arthritis
accp-negative rheumatoid arthritis
seronegative rheumatoid arthritis
url https://rsp.mediar-press.net/rsp/article/view/3480
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AT elnasonov anticarbamylatedproteinantibodiesinaccpnegativeandaccppositivepatientswithrheumatoidarthritis