Gene/Protein Disease Symptom Drug Enzyme Compound
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To prevent joint destruction, it is important to diagnose RA early and to speculate the prognosis. Several new laboratory tests have been developed for this purpose. In addition to rheumatoid factor (RF), IgG-RF, anti-agalactosyl IgG antibodies (CARF), and matrix metalloproteinase 3 (MMP-3) have become available as diagnostic tests for RA. Among them, anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) have the sensitivity and specificity of 81.0% and 92.4%, respectively, which are superior to other laboratory tests by ROC analysis. Moreover, the specificity of anti-CCP antibodies to diagnose early RA was much higher than that of RF, although the sensitivity of CARF was slightly high compared with that of RF. In contrast, MMP-3 is thought to be an evaluative test for the activity of RA because a significant correlation was found between MMP-3 and CRP, but MMP-3 has a possibility as a prognostic test to know the joint damage of RA. We have shown that the progression of joint damage (Sharp score) was faster in MMP-3-positive patients than negative patients. Anti-CCP antibodies was also reported to associate with the progression of joint damage and may be used also as a prognostic test. We next examined how efficiently was the diagnosis of RA made by combining these laboratory tests. Although anti-CCP antibodies are highly specific to RA, the specificity of RF was not so high but became up to 92% when combined with MMP-3. In order to diagnose RA efficiently, we may firstly examine RF, next MMP-3 if RF is positive, and anti-CCP antibodies if RF is negative.
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PMID:[Topics on immunological tests for rheumatoid arthritis]. 1562

Objective. To make individualised decisions regarding treatment is one of the most important challenges in clinical practise, and identification of sensitive and specific markers of prognosis is an important research question. The main objective of this study was to evaluate relationships between the level of autoantibodies, radiographic changes and laboratory markers of bone, and cartilage destruction. Methods. A total of 114 RA patients were examined. The serum concentration of IgM RF, antibodies to cyclic citrullinated peptide (anti-CCP), modified citrullinated vimentin (anti-MCV), matrix metalloproteinase 3 (MMP-3), and cartilage oligomeric matrix protein (COMP, ng/mL) were measured. The van der Heijde-modified Sharp Score was used to quantify the radiologic changes. Results. Among the patients who were high-positive for anti-MCV, the value of total modified Sharp score (mTSS) (96.5; 66-120) was higher as well as the joint space narrowing (82; 60.5-105.5), and a higher level of MMP-3 was recorded more frequently (56%) in comparison with negative/low-positive patients (57; 31-88, 50; 29-82, 31% resp., P < 0.05). The level of COMP was also higher among patients high-positive for anti-MCV (9.7; 8.1-13.1 and 6.8; 5.4-10.7, resp., P = 0.02). Conclusion. A high positive level of anti-MCV as contrasted with anti-CCP and IgM RF is associated with more pronounced destructive changes in the joints.
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PMID:The relationship of antibodies to modified citrullinated vimentin and markers of bone and cartilage destruction in rheumatoid arthritis. 2483 44