Is there an association between Anti-Citrullinated Peptide Antibodies and the Severity of Rheumatoid Arthritis Parameters in Algerian Patients?

  • siheme OUALI Department of Biology, Djillali Liabes University of Sidi bel Abbes, Laboratory of Molecular Microbiology, Proteomics and Health, Algeria
  • Khalida ZEMRI Department of Biology, Djillali Liabes University of Sidi bel Abbes, Algeria
  • Ferial SELLAM National Research Center of Biotechnology. CRBT
  • Noria HARIR Department of Biology, Djillali Liabes University of Sidi bel Abbes, Laboratory of Molecular Microbiology, Proteomics and Health, Algeria
  • Zahira BENIASSA Department of Biology, Djillali Liabes University of Sidi bel Abbes, Algeria
  • Sid Tadj HEBRI Department of internal medicine, CHU Sidi BelAbbes,Algeria
  • Ouassini BENSABER Department of functional rehabilitation, CHU Sidi Bel Abbes, Algeria
  • Douniazad ELMEHADJI Department of Biology, Djillali Liabes University of Sidi bel Abbes, Algeria
  • Zouaoui NADJI Department of internal medicine, CHU Sidi BelAbbes,Algeria
  • Karima KAROUBI Department of internal medicine, EPH Benisaf- AinTemouchent, Algeria

Abstract

Objectives: The aim of this study was to demonstrate the relationships between anti-citrullinated peptide/protein antibodies status and clinical characteristics, disease severity, radiological damages and laboratory assessment in Algerian patients with Rheumatoid arthritis, as well as their importance like a predictive factor for the diagnosis of Rheumatoid arthritis (RA).


Methods: 281 patients diagnosed with RA according to ACR 1987 criteria in the  internal medicine and Functional Rehabilitation departments (the University Hospital of Sidi Bel Abbes) were enrolled in the study based on medical records including age, gender, disease duration, disease activity score (DAS28), joint damages, laboratory tests and treatment. All data were processed and analyzed via SPSS 22.0.


Results: 86.5% of patients were females with a mean age and disease duration of respectively 52.665±12.3477, 4.19±4.050.  Patients with Anti-CCP positive (79.7%) presented a high disease activity (p<0.0001), a long disease duration (p=0.016) and a erosion damages (p<0.0001). we did not found any significant relation between gender, hands damages and CRP..A logistic regression showed that the presence of Anti-CCP was associated with Erosion, disease activity, age and RF presence.


Conclusion: There was a strong relation between Anti-CCP antibodies status and the development of RA in Algerian patients. It could be considered as a useful predictor of disease severity.


 

Keywords: Rheumatoid Arthritis, Algerian Patients, Anti-Citrullinated Peptide/Protein Antibodies, Disease activity, Erosion, Severity

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References

1. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis & Rheumatism, 2002; 46(2):328‑46.
2. Tobón GJ, Youinou P, Saraux A. The environment, geo-epidemiology, and autoimmune disease: Rheumatoid arthritis. Journal of Autoimmunity, 2010; 35(1):10‑4.
3. Avouac J. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Annals of the Rheumatic Diseases, 2005; 65(7):845‑51.
4. Alamanos Y, Voulgari PV, Drosos AA. Incidence and Prevalence of Rheumatoid Arthritis, Based on the 1987 American College of Rheumatology Criteria: A Systematic Review. Seminars in Arthritis and Rheumatism, 2006; 36(3):182‑8.
5. Slimani S, Ladjouze-Rezig A. Prevalence of rheumatoid arthritis in an urban population of Algeria: a prospective study. Rheumatology, 2014; 53(3):571‑3.
6. Kirwan JR, Quilty B. Prognostic criteria in rheumatoid arthritis: can we predict which patients will require specific anti-rheumatoid treatment? Clin Exp Rheumatol, 1997; 15 Suppl 17:S15-25.
7. Haugeberg G, Bøyesen P, Helgetveit K, Prøven A. Clinical and Radiographic Outcomes in Patients Diagnosed with Early Rheumatoid Arthritis in the First Years of the Biologic Treatment Era: A 10-year Prospective Observational Study. J Rheumatol, 2015; 42(12):2279‑87.
8. Nishimura K, Sugiyama D, Kogata Y, Tsuji G, Nakazawa T, Kawano S, et al. Meta-analysis: Diagnostic Accuracy of Anti–Cyclic Citrullinated Peptide Antibody and Rheumatoid Factor for Rheumatoid Arthritis. Ann Intern Med, 2007; 146(11):797.
9. Svärd A, Kastbom A, Reckner-Olsson Å, Skogh T. Presence and utility of IgA-class antibodies to cyclic citrullinated peptides in early rheumatoid arthritis: the Swedish TIRA project. Arthritis Res Ther, 2008; 10(4):R75.
10. van Venrooij WJ, Zendman AJW, Pruijn GJM. Autoantibodies to citrullinated antigens in (early) rheumatoid arthritis. Autoimmunity Reviews, 2006; 6(1):37‑41.
11. van Gaalen FA, Linn-Rasker SP, van Venrooij WJ, de Jong BA, Breedveld FC, Verweij CL, et al. Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: A prospective cohort study. Arthritis & Rheumatism, 2004; 50(3):709‑15.
12. Rantapää-Dahlqvist S, de Jong BAW, Berglin E, Hallmans G, Wadell G, Stenlund H, et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis: Anti-CCP Antibody and IgA-RF Predict RA. Arthritis & Rheumatism, 2003; 48(10):2741‑9.
13. Im CH, Kang EH, Ryu HJ, Lee JH, Lee EY, Lee YJ, et al. Anti-cyclic citrullinated peptide antibody is associated with radiographic erosion in rheumatoid arthritis independently of shared epitope status. Rheumatol Int, 2009; 29(3):251‑6.
14. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum, 2010; 62(9):2569‑81.
15. Saraux A, Berthelot JM, Chalès G, Le Henaff C, Thorel JB, Hoang S, et al. Ability of the American College of Rheumatology 1987 criteria to predict rheumatoid arthritis in patients with early arthritis and classification of these patients two years later. Arthritis Rheum, 2001; 44(11):2485‑91.
16. Prevoo MLL, Van’T Hof MA, Kuper HH, Van Leeuwen MA, Van De Putte LBA, Van Riel PLCM. Modified disease activity scores that include twenty-eight-joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis: MODIFIED DISEASE ACTIVITY SCORE. Arthritis & Rheumatism, 1995; 38(1):44‑8.
17. Cheng T-T, Yu S-F, Su F-M, Chen Y-C, Su BY-J, Chiu W-C, et al. Anti-CCP-positive patients with RA have a higher 10-year probability of fracture evaluated by FRAX®: a registry study of RA with osteoporosis/fracture. Arthritis Research & Therapy, 2018; 20(1):16.
18. Barra L, Bykerk V, Pope JE, Haraoui BP, Hitchon CA, Thorne JC, et al. Anticitrullinated protein antibodies and rheumatoid factor fluctuate in early inflammatory arthritis and do not predict clinical outcomes. J Rheumatol, 2013; 40(8):1259‑67.
19. Arnab B, Biswadip G, Arindam P, Shyamash M, Anirban G, Rajan P. Anti-CCP antibody in patients with established rheumatoid arthritis: Does it predict adverse cardiovascular profile? J Cardiovasc Dis Res, 2013;4(2):102‑6.
20. Orsolini G, Caimmi C, Viapiana O, Idolazzi L, Fracassi E, Gatti D, et al. Titer-Dependent Effect of Anti-Citrullinated Protein Antibodies On Systemic Bone Mass in Rheumatoid Arthritis Patients. Calcif Tissue Int, 2017; 101(1):17‑23.
21. Slimani S, Abbas A, Ben Ammar A, Kebaili D, Ali EH, Rahal F, et al. Characteristics of rheumatoid arthritis in Algeria: a multicenter study. Rheumatol Int, 2014; 34(9):1235‑9.
22. Forslind K, Ahlmén M, Eberhardt K, Hafström I, Svensson B, BARFOT Study Group. Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis, 2004; 63(9):1090‑5.
23. Ghozlani I, Mounach A, Ghazi M, Kherrab A, Niamane R, El Maghraoui A. Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis. The Egyptian Rheumatologist, 2018; 40(2):73‑8.
24. Kim HH, Kim J, Park S-H, Kim S-K, Kim O-D, Choe J-Y. Correlation of anti-cyclic citrullinated antibody with hand joint erosion score in rheumatoid arthritis patients. Korean J Intern Med, 2010; 25(2):201‑6.
25. Mb H, S M, N K, H M, F F, A R, et al. Anticyclic citrullinated peptide antibody and rheumatoid factor in south Tunisian patients with rheumatoid arthritis: association with disease activity and severity. J Clin Lab Anal, 2013; 28(1):21‑6.
26. Syversen SW, Gaarder PI, Goll GL, Ødegård S, Haavardsholm EA, Mowinckel P, et al. High anti-cyclic citrullinated peptide levels and an algorithm of four variables predict radiographic progression in patients with rheumatoid arthritis: results from a 10-year longitudinal study. Ann Rheum Dis, 2008; 67(2):212‑7.
27. Serdaroğlu M, Çakırbay H, Değer O, Cengiz S, Kul S. The association of anti-CCP antibodies with disease activity in rheumatoid arthritis. Rheumatol Int, 2008; 28(10):965‑70.
28. Bodur H, Ataman S, Akbulut L, Evcik D, Kavuncu V, Kaya T, et al. Characteristics and medical management of patients with rheumatoid arthritis and ankylosing spondylitis. Clin Rheumatol, 2008; 27(9):1119‑25.
29. Önder B, Kurtaran A, Kimyon S, Selçuk B, Akyüz M. Association of anti-CCP positivity with serum ferritin and DAS-28. Rheumatol Int, 2009; 30(2):223‑7.
30. Vanichapuntu M, Phuekfon P, Suwannalai P, Verasertniyom O, Nantiruj K, Janwityanujit S. Are anti-citrulline autoantibodies better serum markers for rheumatoid arthritis than rheumatoid factor in Thai population? Rheumatol Int, 2010; 30(6):755‑9.
31. Alexiou I, Germenis A, Ziogas A, Theodoridou K, Sakkas LI. Diagnostic value of anti-cyclic citrullinated peptide antibodies in Greek patients with rheumatoid arthritis. BMC Musculoskelet Disord, 2007; 8(1):37.
32. Abdel‐Nasser AM, Mahmoud MH, El Mansoury TM, Osman AM. Anti‐CCP2 is an adjunct to, not a surrogate for, rheumatoid factor in the diagnosis of rheumatoid arthritis: diagnostic utility of anti‐CCP2 antibodies in Egyptian patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology, 2008; 37(5):329‑36.
33. Shovman O, Gilburd B, Zandman-Goddard G, Sherer Y, Orbach H, Gerli R, et al. The Diagnostic Utility of Anti-cyclic Citrullinated Peptide Antibodies, Matrix Metalloproteinase-3, Rheumatoid Factor, Erythrocyte Sedimentation Rate, and C-reactive Protein in Patients with Erosive and Non-erosive Rheumatoid Arthritis. Clinical and Developmental Immunology, 2005; 12(3):197‑202.
34. bn Yacoub, Y., Amine, B., Laatiris, A. et al. Rheumatoid factor and antibodies against citrullinated peptides in Moroccan patients with rheumatoid arthritis: association with disease parameters and quality of life. Clin Rheumato, 2012; 31:329–334.
35. González-Febles J, Rodríguez-Lozano B, Sánchez-Piedra C, Garnier-Rodríguez J, Bustabad S, Hernández-González M, et al. Association between periodontitis and anti-citrullinated protein antibodies in rheumatoid arthritis patients: a cross-sectional study. Arthritis Res Ther, 2020; 22(1):27.
36. Linn-Rasker SP. Smoking is a risk factor for anti-CCP antibodies only in rheumatoid arthritis patients who carry HLA-DRB1 shared epitope alleles. Annals of the Rheumatic Diseases, 2006; 65(3):366‑71.
37. Van Doornum S, McColl G, Wicks IP. Accelerated atherosclerosis: An extraarticular feature of rheumatoid arthritis? Arthritis & Rheumatism, 2002; 46(4):862‑73.
38. García de Veas Silva JL, González Rodríguez C, Hernández Cruz B. Asociación del epítopo compartido, el tabaquismo y la interacción entre ambos con la presencia de autoanticuerpos (anti-PCC y FR) en pacientes con artritis reumatoide en un hospital de Sevilla, España. Reumatología Clínica, 2019; 15(5):289‑95.
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OUALI siheme, ZEMRI K, SELLAM F, HARIR N, BENIASSA Z, HEBRI ST, BENSABER O, ELMEHADJI D, NADJI Z, KAROUBI K. Is there an association between Anti-Citrullinated Peptide Antibodies and the Severity of Rheumatoid Arthritis Parameters in Algerian Patients?. JDDT [Internet]. 15Jul.2020 [cited 4Aug.2020];10(4):17-4. Available from: http://jddtonline.info/index.php/jddt/article/view/4201

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