Diagnostic Value Of Anticitruline Antibody Assay In Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is the most frequent of human systemic autoimmune diseases. It is characterized by the formation of an inflammatory and invasive tissues in synovial membranes, the rheumatoid pannus, capable of eroding adjacent cartilage and bone subsequently leading to Joint destruction (Boini and Guillemin, 2001).

Despite decades of study and the development of series of • classification criteria, the diagnosis of RA remains empirical and imprecise, particularly early in the course of disease (Lee and Schur,

2003). Because early initiation of (Disease modifying anti-rheumatic drugs) can significantly improve long term outcomes for patients with RA. So, there is considerable motivation to accurately diagnose RA early in the course of the disease (O'Dell, 2002).

Currently, most clinical specialists rely on a combination of clinical acumen derived from accumulated experience and objective laboratory and radiological studies to make a diagnosis, to predict disease course, and to guide treatment (Mothonen et at., 2002).

Serological studies form a cornerstone of laboratory based patient assessment. The presence of "Rheumatoid factor" (RF) was identified in patients with RA over 50 years ago (Weinblatt and Schur, 1980).

RF are antibodies directed to the constant regwn of immunoglobulins of the IgG subclass, and their presence 1s determined by agglutination assays, nephlometry, or ELISA-based test, (Smolen, 1996).