A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India

Anindya Das; Chimanjita Phukan; Chitralekha Baruah

doi:doi:10.11648/j.iji.20160405.11

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A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India

Anindya Das, Chimanjita Phukan, Chitralekha Baruah

Published in International Journal of Immunology (Volume 4, Issue 5)

Received: 15 October 2016 Accepted: 31 October 2016 Published: 23 November 2016

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Abstract

Objective: Rheumatoid arthritis (RA) is a polyarticular and systemic chronic inflammatory autoimmune disease, occurring throughout the world. The aim of the present study is to observe the role of anti-CCP antibody and Rheumatoid Factor (RF) assay in diagnosing patients of rheumatoid arthritis in north-eastern part of India, in the state of Assam and also to evaluate the individual and combined sensitivity and specificity of anti-CCP antibody and RF assay in diagnosing RA. Methods: A total of 88 cases presenting with history of polyarthritis were included in the study of which the study group comprised of 57 clinically diagnosed cases of rheumatoid arthritis and control group comprised of 31 patients of non-RA rheumatic diseases having joint pain. Individual sensitivity and specificity of the above tests, and also the combined specificity of the two tests and also the three tests were calculated and the results of the tests were compared with each other to examine the correlation between them. Results: Sensitivity of anti-CCP ELISA, RF IgM ELISA and RF Latex test was 91.23%, 75.44% and 40.35% with specificity of 70.97%, 67.74% and 90.32% respectively. If the three tests are combined then the combined specificity of the three tests is 99.59%. One important observation was that out of 9 anti-CCP positive cases in the control group(n = 31) 5 cases were weakly positive (titer 6.25 – 20 U/ml), considering cut-off value 6.25 U/ml as mentioned by the kit.If these weakly positive cases in the control group are considered as negative, then specificity of anti-CCP ELISA increases from 70.97% to 87.1% which is more acceptable. Conclusion: From this study it is observed that anti-CCP antibodies are highly sensitive and specific for diagnosing RA. If this test is combined with RF IgM ELISA and Latex test then combined specificity can be increased more than 99%. However, weakly positive titers of anti-CCP antibodies are more prevalent in other non-RA rheumatic diseases in North-Eastern part of India.

Published in	International Journal of Immunology (Volume 4, Issue 5)
DOI	10.11648/j.iji.20160405.11
Page(s)	27-34
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anti-CCP Antibody, Rheumatoid Factor, Latex Agglutination Test, Combined Specificity, Resultant Sensitivity, Enzyme Linked Immunosorbent Assay (ELISA), Cut-Off Value

References

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Anindya Das, Chimanjita Phukan, Chitralekha Baruah. (2016). A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. International Journal of Immunology, 4(5), 27-34. https://doi.org/10.11648/j.iji.20160405.11

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Anindya Das; Chimanjita Phukan; Chitralekha Baruah. A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. Int. J. Immunol. 2016, 4(5), 27-34. doi: 10.11648/j.iji.20160405.11

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AMA Style

Anindya Das, Chimanjita Phukan, Chitralekha Baruah. A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. Int J Immunol. 2016;4(5):27-34. doi: 10.11648/j.iji.20160405.11

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@article{10.11648/j.iji.20160405.11,
  author = {Anindya Das and Chimanjita Phukan and Chitralekha Baruah},
  title = {A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India},
  journal = {International Journal of Immunology},
  volume = {4},
  number = {5},
  pages = {27-34},
  doi = {10.11648/j.iji.20160405.11},
  url = {https://doi.org/10.11648/j.iji.20160405.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20160405.11},
  abstract = {Objective: Rheumatoid arthritis (RA) is a polyarticular and systemic chronic inflammatory autoimmune disease, occurring throughout the world. The aim of the present study is to observe the role of anti-CCP antibody and Rheumatoid Factor (RF) assay in diagnosing patients of rheumatoid arthritis in north-eastern part of India, in the state of Assam and also to evaluate the individual and combined sensitivity and specificity of anti-CCP antibody and RF assay in diagnosing RA. Methods: A total of 88 cases presenting with history of polyarthritis were included in the study of which the study group comprised of 57 clinically diagnosed cases of rheumatoid arthritis and control group comprised of 31 patients of non-RA rheumatic diseases having joint pain. Individual sensitivity and specificity of the above tests, and also the combined specificity of the two tests and also the three tests were calculated and the results of the tests were compared with each other to examine the correlation between them. Results: Sensitivity of anti-CCP ELISA, RF IgM ELISA and RF Latex test was 91.23%, 75.44% and 40.35% with specificity of 70.97%, 67.74% and 90.32% respectively. If the three tests are combined then the combined specificity of the three tests is 99.59%. One important observation was that out of 9 anti-CCP positive cases in the control group(n = 31) 5 cases were weakly positive (titer 6.25 – 20 U/ml), considering cut-off value 6.25 U/ml as mentioned by the kit.If these weakly positive cases in the control group are considered as negative, then specificity of anti-CCP ELISA increases from 70.97% to 87.1% which is more acceptable. Conclusion: From this study it is observed that anti-CCP antibodies are highly sensitive and specific for diagnosing RA. If this test is combined with RF IgM ELISA and Latex test then combined specificity can be increased more than 99%. However, weakly positive titers of anti-CCP antibodies are more prevalent in other non-RA rheumatic diseases in North-Eastern part of India.},
 year = {2016}
}

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TY  - JOUR
T1  - A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India
AU  - Anindya Das
AU  - Chimanjita Phukan
AU  - Chitralekha Baruah
Y1  - 2016/11/23
PY  - 2016
N1  - https://doi.org/10.11648/j.iji.20160405.11
DO  - 10.11648/j.iji.20160405.11
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 27
EP  - 34
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20160405.11
AB  - Objective: Rheumatoid arthritis (RA) is a polyarticular and systemic chronic inflammatory autoimmune disease, occurring throughout the world. The aim of the present study is to observe the role of anti-CCP antibody and Rheumatoid Factor (RF) assay in diagnosing patients of rheumatoid arthritis in north-eastern part of India, in the state of Assam and also to evaluate the individual and combined sensitivity and specificity of anti-CCP antibody and RF assay in diagnosing RA. Methods: A total of 88 cases presenting with history of polyarthritis were included in the study of which the study group comprised of 57 clinically diagnosed cases of rheumatoid arthritis and control group comprised of 31 patients of non-RA rheumatic diseases having joint pain. Individual sensitivity and specificity of the above tests, and also the combined specificity of the two tests and also the three tests were calculated and the results of the tests were compared with each other to examine the correlation between them. Results: Sensitivity of anti-CCP ELISA, RF IgM ELISA and RF Latex test was 91.23%, 75.44% and 40.35% with specificity of 70.97%, 67.74% and 90.32% respectively. If the three tests are combined then the combined specificity of the three tests is 99.59%. One important observation was that out of 9 anti-CCP positive cases in the control group(n = 31) 5 cases were weakly positive (titer 6.25 – 20 U/ml), considering cut-off value 6.25 U/ml as mentioned by the kit.If these weakly positive cases in the control group are considered as negative, then specificity of anti-CCP ELISA increases from 70.97% to 87.1% which is more acceptable. Conclusion: From this study it is observed that anti-CCP antibodies are highly sensitive and specific for diagnosing RA. If this test is combined with RF IgM ELISA and Latex test then combined specificity can be increased more than 99%. However, weakly positive titers of anti-CCP antibodies are more prevalent in other non-RA rheumatic diseases in North-Eastern part of India.
VL  - 4
IS  - 5
ER  -

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Author Information

Anindya Das

Department of Microbiology, Gauhati Medical College and Hospital, Guwahati, India
Chimanjita Phukan

Department of Microbiology, Gauhati Medical College and Hospital, Guwahati, India
Chitralekha Baruah

Department of Medicine, Gauhati Medical College and Hospital, Guwahati, India

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Anindya Das, Chimanjita Phukan, Chitralekha Baruah. (2016). A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. International Journal of Immunology, 4(5), 27-34. https://doi.org/10.11648/j.iji.20160405.11

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Anindya Das; Chimanjita Phukan; Chitralekha Baruah. A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. Int. J. Immunol. 2016, 4(5), 27-34. doi: 10.11648/j.iji.20160405.11

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AMA Style

Anindya Das, Chimanjita Phukan, Chitralekha Baruah. A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India. Int J Immunol. 2016;4(5):27-34. doi: 10.11648/j.iji.20160405.11

Copy | Download

@article{10.11648/j.iji.20160405.11,
  author = {Anindya Das and Chimanjita Phukan and Chitralekha Baruah},
  title = {A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India},
  journal = {International Journal of Immunology},
  volume = {4},
  number = {5},
  pages = {27-34},
  doi = {10.11648/j.iji.20160405.11},
  url = {https://doi.org/10.11648/j.iji.20160405.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20160405.11},
  abstract = {Objective: Rheumatoid arthritis (RA) is a polyarticular and systemic chronic inflammatory autoimmune disease, occurring throughout the world. The aim of the present study is to observe the role of anti-CCP antibody and Rheumatoid Factor (RF) assay in diagnosing patients of rheumatoid arthritis in north-eastern part of India, in the state of Assam and also to evaluate the individual and combined sensitivity and specificity of anti-CCP antibody and RF assay in diagnosing RA. Methods: A total of 88 cases presenting with history of polyarthritis were included in the study of which the study group comprised of 57 clinically diagnosed cases of rheumatoid arthritis and control group comprised of 31 patients of non-RA rheumatic diseases having joint pain. Individual sensitivity and specificity of the above tests, and also the combined specificity of the two tests and also the three tests were calculated and the results of the tests were compared with each other to examine the correlation between them. Results: Sensitivity of anti-CCP ELISA, RF IgM ELISA and RF Latex test was 91.23%, 75.44% and 40.35% with specificity of 70.97%, 67.74% and 90.32% respectively. If the three tests are combined then the combined specificity of the three tests is 99.59%. One important observation was that out of 9 anti-CCP positive cases in the control group(n = 31) 5 cases were weakly positive (titer 6.25 – 20 U/ml), considering cut-off value 6.25 U/ml as mentioned by the kit.If these weakly positive cases in the control group are considered as negative, then specificity of anti-CCP ELISA increases from 70.97% to 87.1% which is more acceptable. Conclusion: From this study it is observed that anti-CCP antibodies are highly sensitive and specific for diagnosing RA. If this test is combined with RF IgM ELISA and Latex test then combined specificity can be increased more than 99%. However, weakly positive titers of anti-CCP antibodies are more prevalent in other non-RA rheumatic diseases in North-Eastern part of India.},
 year = {2016}
}

Copy | Download

TY  - JOUR
T1  - A Study on the Importance of Anti Cyclic Cytrullinated Peptide Antibodies (Anti-CCP) and Rheumatoid Factor (RF) Assay in Detection of Patients with Rheumatoid Arthritis in North Eastern Part of India
AU  - Anindya Das
AU  - Chimanjita Phukan
AU  - Chitralekha Baruah
Y1  - 2016/11/23
PY  - 2016
N1  - https://doi.org/10.11648/j.iji.20160405.11
DO  - 10.11648/j.iji.20160405.11
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 27
EP  - 34
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20160405.11
AB  - Objective: Rheumatoid arthritis (RA) is a polyarticular and systemic chronic inflammatory autoimmune disease, occurring throughout the world. The aim of the present study is to observe the role of anti-CCP antibody and Rheumatoid Factor (RF) assay in diagnosing patients of rheumatoid arthritis in north-eastern part of India, in the state of Assam and also to evaluate the individual and combined sensitivity and specificity of anti-CCP antibody and RF assay in diagnosing RA. Methods: A total of 88 cases presenting with history of polyarthritis were included in the study of which the study group comprised of 57 clinically diagnosed cases of rheumatoid arthritis and control group comprised of 31 patients of non-RA rheumatic diseases having joint pain. Individual sensitivity and specificity of the above tests, and also the combined specificity of the two tests and also the three tests were calculated and the results of the tests were compared with each other to examine the correlation between them. Results: Sensitivity of anti-CCP ELISA, RF IgM ELISA and RF Latex test was 91.23%, 75.44% and 40.35% with specificity of 70.97%, 67.74% and 90.32% respectively. If the three tests are combined then the combined specificity of the three tests is 99.59%. One important observation was that out of 9 anti-CCP positive cases in the control group(n = 31) 5 cases were weakly positive (titer 6.25 – 20 U/ml), considering cut-off value 6.25 U/ml as mentioned by the kit.If these weakly positive cases in the control group are considered as negative, then specificity of anti-CCP ELISA increases from 70.97% to 87.1% which is more acceptable. Conclusion: From this study it is observed that anti-CCP antibodies are highly sensitive and specific for diagnosing RA. If this test is combined with RF IgM ELISA and Latex test then combined specificity can be increased more than 99%. However, weakly positive titers of anti-CCP antibodies are more prevalent in other non-RA rheumatic diseases in North-Eastern part of India.
VL  - 4
IS  - 5
ER  -

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