The Association of Anti-Cyclic Citrullinated Peptide Positivity with Extra-Articular Manifestations in Patients with Rheumatoid Arthritis
DOI:
https://doi.org/10.70749/ijbr.v3i7.2015Keywords:
Rheumatoid arthritis, Anti-CCP antibodies, Extra-articular manifestations, Disease activity, SeropositivityAbstract
Background: Rheumatoid arthritis (RA) is a chronic, auto-immune disorder that is accompanied by long-term joint illness and systemic redification, which refers to additional-articular manifestations (ExRA). Anti-cyclic citrullinated peptide (anti-CCP) antibodies are RA specific and linked to disease activity. This study attempted to assess the role of anti-CCP positivity as related to ExRA in patients with RA. Methods: Non-probability consecutive sampling was utilized to recruit 91 RA patients within the Department of Medicine, BKMC, Swabi, in the form of a cross-sectional study. Demographic, clinical, and serological data were obtained, as well as an anti-CCP level and RA Disease Activity Score-28 (DAS-28). Clinical examination and imaging were used to confirm the presence of ExRA. Results: There was a mean age of 45.3 (12.4) years; 71.4 percent were females. ExRA existed in 9.9 percent of patients, rheumatoid nodules (4.4 percent) being in the lead. Eighty one point three percent of participants were found to be anti-CCP positive. Of those having ExRA, 88.9 percent were anti-CCP positive; the relationship was not significant (p = 0.391). There was a substantial relationship between high DAS-28 scores (>5.1) and the ExRA presence (p = 0.032). Conclusion: ExRA was often associated with the presence of Anti-CCP antibodies in the RA patients but the association was not statistically significant. ExRA was significantly associated with higher disease activity. Such results increase the necessity of strict observation of disease activity to mark patients predisposed to system complications.
Downloads
References
1. Padyukov, L. (2022, January). Genetics of rheumatoid arthritis. In Seminars in immunopathology (Vol. 44, No. 1, pp. 47-62). Berlin/Heidelberg: Springer Berlin Heidelberg.
https://doi.org/10.1007/s00281-022-00912-0
2. Ding, Q., Hu, W., Wang, R., Yang, Q., Zhu, M., Li, M., ... & Zhu, Y. Z. (2023). Signaling pathways in rheumatoid arthritis: implications for targeted therapy. Signal transduction and targeted therapy, 8(1), 68.
https://doi.org/10.1038/s41392-023-01331-9
3. Korkmaz C, Us T, Kaşifoğlu T, Akgün Y. Anti-cyclic citrullinated peptide (CCP) antibodies in patients with long-standing rheumatoid arthritis and their relationship with extra-articular manifestations. Clin Biochem. 2006;39(10):961–5.
https://doi.org/10.1016/j.clinbiochem.2006.06.004
4. Naqvi A, Hassali M, Aftab M, Naqvi S, Zehra F, Ahmad R, et al. Development of Evidence-Based Disease Education Literature for Pakistani Rheumatoid Arthritis Patients. Diseases. 2017;5(4):27.
https://doi.org/10.3390/diseases5040027
5. Naqvi A, Hassali, Aftab M. Epidemiology of rheumatoid arthritis, clinical aspects and socio-economic determinants in Pakistani patients: A systematic review and meta-analysis. J Pak Med Assoc. 2019;69(3):389-98.
6. Ashiq, K., Ashiq, S., Mobashar, A., Abid, F., Yasmeen, A., Shehzadi, N., ... & Hussain, K. (2023). An updated review on rheumatoid arthritis (RA): epidemiology, pathophysiology, diagnosis, and the current approaches for its treatment. Sudan Journal of Medical Sciences, 18(4), 539-551.
https://doi.org/10.18502/sjms.v18i4.14742
7. Greiner A, Plischke H, Kellner H, Gruber R. Association of anti-cyclic citrullinated peptide antibodies, anti-citrullin antibodies, and IgM and IgA rheumatoid factors with serological parameters of disease activity in rheumatoid arthritis. Ann N Y Acad Sci. 2005;1050:295–303.
https://doi.org/10.1196/annals.1313.031
8. Motta, F., Bizzaro, N., Giavarina, D., Franceschini, F., Infantino, M., Palterer, B., ... & Selmi, C. (2023). Rheumatoid factor isotypes in rheumatoid arthritis diagnosis and prognosis: a systematic review and meta-analysis. RMD open, 9(3), e002817.
https://doi.org/10.1136/rmdopen-2022-002817
9. Steiner, G., Verschueren, P., Van Hoovels, L., Studenic, P., & Bossuyt, X. (2024). Classification of rheumatoid arthritis: is it time to revise the criteria?. Rmd Open, 10(2), e003851.
https://doi.org/10.1136/rmdopen-2023-003851
10. Serdaroğlu M, Çakırbay H, Değer O, Cengiz S, Kul S. The association of anti-CCP antibodies with disease activity in rheumatoid arthritis. Rheumatology international. 2008;28:965-70.
https://doi.org/10.1007/s00296-008-0570-3
11. Salinas, M., Blasco, Á., Flores, E., Minguez, M., & Leiva-Salinas, C. (2024). Double positivity for rheumatoid factor and anti-CCP autoantibodies: improving referral from primary care of patients suspected of having rheumatoid arthritis. Primary Health Care Research & Development, 25, e6.
https://doi.org/10.1017/s1463423623000695
12. Prete M, Racanelli V, Digiglio L, Vacca A, Dammacco F, Perosa F. Extra-articular manifestations of rheumatoid arthritis: An update. Autoimmunity Reviews. 2011 ;11(2):123–31.
https://doi.org/10.1016/j.autrev.2011.09.001
13. Gonzalez-Lopez L, Rocha-Muñoz AD, Ponce-Guarneros M, Flores-Chavez A, Salazar-Paramo M, Nava A, et al. Anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) relation with extra-articular manifestations in rheumatoid arthritis. J Immunol Res. 2014;2014:536050.
https://doi.org/10.1155/2014/536050
14. Díaz Cuña C, Consani S, Rostan S, Fernández L, Moreira E, Sanmartí R. Rheumatoid arthritis: extra articular manifestations and comorbidities. Rev Colomb Reumatol. 2022;29(3):196–204.
https://doi.org/10.1016/j.rcreue.2021.03.003
15. Arleevskaya, M. I., Novikov, A. A., Valeeva, A. R., Korovina, M. O., Serdiuk, I. L., Popov, V. A., ... & Renaudineau, Y. (2024). At Early Rheumatoid Arthritis Stage, the Infectious Spectrum Is Driven by Non-Familial Factors and Anti-CCP Immunization. Journal of Clinical Medicine, 13(10), 2796.
https://doi.org/10.3390/jcm13102796
16. Taylor P, Gartemann J, Hsieh J, Creeden J. A Systematic Review of Serum Biomarkers Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor as Tests for Rheumatoid Arthritis. Autoimmune Diseases. 2011;2011:e815038.
https://doi.org/10.4061/2011/815038
17. Gerli R, Bartoloni Bocci E, Sherer Y, Vaudo G, Moscatelli S, Shoenfeld Y. Association of anti-cyclic citrullinated peptide antibodies with subclinical atherosclerosis in patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(5):724–5.
https://doi.org/10.1136/ard.2007.073718
18. Rahali, F. Z., Tarmidi, M., Hazime, R., & Admou, B. (2023). Clinical significance of anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis: Literature review. SN Comprehensive Clinical Medicine, 5(1), 272.
https://doi.org/10.1007/s42399-023-01613-x
19. Alexiou I, Germenis A, Koutroumpas A, Kontogianni A, Theodoridou K, Sakkas LI. Anti-cyclic citrullinated peptide-2 (CCP2) autoantibodies and extra-articular manifestations in Greek patients with rheumatoid arthritis. Clinic Rheumatol. 2008;27:511-3.
https://doi.org/10.1007/s10067-007-0800-1
20. Mitroi A, Ionescu AM. Extra-Articular Manifestations in Rheumatoid Arthritis - Predictors of Osteoporosis. Acta Medica Transilvanica. 2021;26(4):50–2.
https://doi.org/10.2478/amtsb-2021-0073
21. Moshayedi, S., Tasorian, B., & Almasi-Hashiani, A. (2022). The prevalence of osteoporosis in rheumatoid arthritis patient: a systematic review and meta-analysis. Scientific reports, 12(1), 15844.
https://doi.org/10.1038/s41598-022-20016-x
22. Sulaiman FN, Wong KK, Ahmad WA, Ghazali WS. Anti-cyclic citrullinated peptide antibody is highly associated with rheumatoid factor and radiological defects in rheumatoid arthritis patients. Medicine. 2019;98(12):945-50.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
