Othman, Maizatul Akmal
(2018)
Evaluation of anti-carbamylated protein antibodies as a potential biomarker in assisting the diagnosis of rheumatoid arthritis and its correlation with disease activity.
Masters thesis, Universiti Sains Malaysia.
Abstract
Rheumatoid arthritis (RA) is an inflammatory rheumatic disease
characterized by the presence of autoantibodies. This study aims to determine the
sensitivity and specificity of anti-carbamylated protein (anti-CarP) antibodies in
rheumatoid arthritis (RA) patients in relation to rheumatoid factor (RF), anti-cyclic
citrullinated peptide (anti-CCP) antibodies, C-reactive protein (CRP) as well as to
determine their association with disease activity score-28 (DAS28) and health
assessment questionnaire (HAQ) score. This study included 105 RA patients (48 RFpositive
and 57 RF-negative patients) conducted at Hospital Universiti Sains
Malaysia (HUSM) from January 2015 until February 2016. Fifty healthy controls
(HCs) were included. CRP, RF, anti-CCP and anti-CarP antibodies were measured.
HAQ was administered to each of the study participants. DAS28 of the 105 RA
patients was measured. The level of anti-CarP antibodies was significantly increased
in the RA patients compared to that in the HCs (p=0.042). The sensitivity and
specificity of anti-CarP antibodies in RA patients were 42% and 78%, respectively.
The presence of anti-CarP antibodies was significantly associated with RF (p=0.019)
and the HAQ results (p=0.010). However, there was no significant association ofanti-CarP antibodies with anti-CCP antibodies and CRP (p=0.564 and p=0.075,
respectively). Furthermore, a significant association between anti-CarP antibodies
with DAS28 was not found (p=0.165). This study provides further evidence that the
level of anti-CarP antibodies is significantly elevated in RA patients. In addition, this
study showed that anti-CarP-positive RA patients more likely to demonstrate
increased disability compared to anti-CarP-negative RA patients. Therefore, anti-
CarP antibodies have a potential to be further develop as a biomarker to aid in the
diagnosis and prognosis of RA.
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