Correlation of hs-CRP Levels with Anti-CCP And Rheumatoid Factor Among Clinically Suspected Rheumatoid Arthritis Cases

A Predictor for Early Inflammation?

Authors

  • Bineeta Kashyap Associate Professor, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.
  • Nisha Goyal Senior Resident, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.
  • Krishna Singha Post Graduate Student, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.
  • Mohd Tajuddin Senior Resident, Department of Microbiology, Delhi State Cancer Institute, Delhi
  • N P Singh Director Professor and Head, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.
  • Rajnish Avasthi Professor & Head, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

DOI:

https://doi.org/10.21276/apalm.2651

Keywords:

hs-CRP, anti-CCP, RF, RA

Abstract

Objective: Despite the wide availability of markers to diagnose the established disease of RA, there is lack of evidence for the suitability of any of these established biomarkers for diagnosing the disease at an early stage of its pathogenesis. Hs-CRP has the potential to be useful as a predictor of early inflammation in clinically suspected RA cases.

Methods: 80 patients (40: anti-CCP positive; 40: anti-CCP negative) irrespective of their age and gender were enrolled. RF status and hs-CRP levels were determined in these patients. Correlation of hs-CRP levels with anti-CCP was done.

Results: Mean anti-CCP levels among RF positive and negative cases were 410 U/ml and 62.4 U/ml respectively. Among both the groups of anti-CCP positive and negative patients, majority had hs-CRP levels between 50-60 mg/l. Hs-CRP levels were more than 6 mg/l in majority of the suspected arthritis cases irrespective of the anti-CCP or RF status. Mean hs-CRP levels were 50.8 and 43.6 mg/l among anti-CCP positive and negative cases respectively by unpaired t-test. There was no correlation between serum anti-CCP and hs-CRP levels among both anti-CCP negative and positive cases.

Conclusions:  Hs-CRP when used alone or in combination with other established markers, can aid in the early diagnosis, prediction of course of disease and assessment of response to treatment in RA cases.

Author Biographies

Nisha Goyal, Senior Resident, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

Senior Resident, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

Krishna Singha, Post Graduate Student, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

  1. Post Graduate Student, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi

Mohd Tajuddin, Senior Resident, Department of Microbiology, Delhi State Cancer Institute, Delhi

  1. Senior Resident, Department of Microbiology, Delhi State Cancer Institute, Delhi

N P Singh, Director Professor and Head, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

Director Professor and Head, Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

Rajnish Avasthi, Professor & Head, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

  1. Professor & Head, Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi.

References

1 Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010;376(9746):1094-1108.
2 Carmona L, Cross M, Williams B, Lassere M, March L. Rheumatoid arthritis. Best Pract Res ClinRheumatol. 2010;24:733-745.
3 Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008;59:1690-1697.
4. Boyer JF, Gourraud PA, Cantagrel A, Davignon JL, Constantin A. Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine. 2011;78:179-183.
5.Handa R, Rao UR, Lewis JF, Rambhad G, Shiff S, Ghia CJ. Literature review of rheumatoid arthritis in India.Int J Rheum Dis. 2016;19:440-451.
6. Waaler E. On the occurrence of a factor in human serum activating the specific agglutination of sheep red corpuscles. ActaPatholMicrobiol Scand. 1940; 17:172–188.
7. Bla¨ss S, Engel JM, Burmester GR. The immunologic homunculus in rheumatoid arthritis. Arthritis Rheum. 1999; 42:2499–2506.
8. Slaughter L, Carson DA, Jensen FC, Holbrook TL, Vaughan JH. In vitro effects of Epstein-Barr virus on peripheral blood mononuclear cells from patients with rheumatoid arthritis and normal subjects. J Exp Med. 1978;148:1429–1434.
9. Izui S, Eisenberg RA, Dixon FJ. IgM rheumatoid factors in mice injected with bacterial lipopolysaccharides. J Immunol. 1979; 122:2096–2102.
10. Brown PB, Nardella FA, Mannik M. Human complement activation by self-associated IgG rheumatoid factors. Arthritis Rheum. 1982; 25:1101–1107.
11. Tighe H, Chen PP, Tucker R, Kipps TJ, Roudier J, Jirik FR, et al. Function of B cells expressing a human immunoglobulin M rheumatoid factor autoantibody in transgenic mice. J Exp Med. 1993; 177:109–118.
12. Song YW, Kang EH. Autoantibodies in rheumatoid arthritis: rheumatoid factors and anticitrullinated protein antibodies. QJM. 2010 Mar;103:139-46.

13. Reparon-Schuijt CC, van Esch WJ, van Kooten C, Schellekens GA, de Jong BA, van Venrooij WJ, et al. Secretion of anti-citrulline-containing peptide antibody by B lymphocytes in rheumatoid arthritis. Arthritis Rheum. 2001;44:41–47.
14. 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 Jun 5;146(11):797-808.
15.Kokkonen H, Johansson M, Innala L, Jidell E, Rantapa¨a¨ - Dahlqvist S. The PTPN22 1858C/T polymorphism is associated with anti-cyclic citrullinated peptide antibody-positive early rheumatoid arthritis in northern Sweden. Arthritis Res Ther 2007; 9:R56.
16. Kashyap B, Tiwari U, Garg A, Kaur IR. Diagnostic utility of anti-CCP antibodies and rheumatoid factor as inflammatory biomarkers in comparison with C-reactive protein and TNF-α in rheumatoid arthritis. Trop J Med Res. 2015;18:5–9.
17. Sharif M, Elson C, Kirwan J. Sensitive C-reactive protein in arthritis. BMJ 2001;322:4-5.
18. Fransen J, Welsing PMJ, De Keijzer RMH, Van Riel PLCM. Development and validation of the DAS28 using CRP. Ann Rheum Dis. 2003;62Suppl 1:10.
19. Dessein PH, Joffe BI, Stanwix AE. High sensitivity C-reactive protein as a disease activity marker in rheumatoid arthritis. J Rheumatol. 2004 Jun;31(6):1095-1097.
20. Shen R, Ren X, Jing R, Shen X, Chen J, JuS,et al. Rheumatoid Factor,Anti-Cyclic Citrullinated Peptide Antibody, C-Reactive Protein, and ErythrocyteSedimentation Rate for the Clinical Diagnosis of Rheumatoid Arthritis. Lab Med.2015;46:226-229.
21. Serdaroğlu M, Cakirbay H, Değer O, Cengiz S, Kul S. The association of anti‑CCP antibodies with disease activity in rheumatoid arthritis. Rheumatol Int. 2008;28:965‑970.
22. Ridker PM, Cushman M, Stempfer MJ, et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973-979.

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Published

01-10-2019

How to Cite

1.
Kashyap B, Goyal N, Singha K, Tajuddin M, Singh NP, Avasthi R. Correlation of hs-CRP Levels with Anti-CCP And Rheumatoid Factor Among Clinically Suspected Rheumatoid Arthritis Cases: A Predictor for Early Inflammation?. Ann of Pathol and Lab Med [Internet]. 2019 Oct. 1 [cited 2024 Nov. 23];6(9):A481-486. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/2651

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