open access

Vol 2, No 4 (2017)
Review article
Published online: 2018-03-30
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Laboratory diagnostics and pathogenesis of rheumatoid arthritis — the past and the present

Magdalena Kuligowska-Prusińska1, Grazyna Odrowąż-Sypniewska1
·
Medical Research Journal 2017;2(4):128-134.
Affiliations
  1. Department of Laboratory Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, C. Sklodowskiej 9, 85-094 Bydgoszcz, Poland

open access

Vol 2, No 4 (2017)
REVIEW ARTICLES
Published online: 2018-03-30

Abstract

Rheumatoid arthritis (RA) is one of the most common systemic connective tissue diseases of autoimmune origin and is characterised by chronic inflammation of joints. The aetiology of this disease has not been fully understood yet. A crucial role in the development of RA is played by multiple genetic (shared epi-tope, HLA-DR genes, family predisposition) and environmental factors (smoking, female-specific factors, bacteria, viruses and mucosal inflammation, periodontal and lung diseases). The purpose of this article is to review the latest data on the pathogenesis of this disease and biomarkers used in the diagnostics of RA. RA is associated with the production of autoantibodies, among which rheumatoid factor (RF) and anti-citrullinated protein (anti-CCP) antibodies are included in the new classification criteria of RA. So far, anti-CCP is the best marker of RA; its high sensitivity and specificity have been helpful in diagnostics and monitoring disease activity and the development of more aggressive disease, as well as the pharmacological treatment used. Recently, anti-carbamylated (anti-carP) antibodies and calprotectin have been described in RA, which also appears to be promising in the diagnostics of this disease.

Abstract

Rheumatoid arthritis (RA) is one of the most common systemic connective tissue diseases of autoimmune origin and is characterised by chronic inflammation of joints. The aetiology of this disease has not been fully understood yet. A crucial role in the development of RA is played by multiple genetic (shared epi-tope, HLA-DR genes, family predisposition) and environmental factors (smoking, female-specific factors, bacteria, viruses and mucosal inflammation, periodontal and lung diseases). The purpose of this article is to review the latest data on the pathogenesis of this disease and biomarkers used in the diagnostics of RA. RA is associated with the production of autoantibodies, among which rheumatoid factor (RF) and anti-citrullinated protein (anti-CCP) antibodies are included in the new classification criteria of RA. So far, anti-CCP is the best marker of RA; its high sensitivity and specificity have been helpful in diagnostics and monitoring disease activity and the development of more aggressive disease, as well as the pharmacological treatment used. Recently, anti-carbamylated (anti-carP) antibodies and calprotectin have been described in RA, which also appears to be promising in the diagnostics of this disease.

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Keywords

rheumatoid arthritis, rheumatoid factor, antibodies, calprotectin, classification criteria

About this article
Title

Laboratory diagnostics and pathogenesis of rheumatoid arthritis — the past and the present

Journal

Medical Research Journal

Issue

Vol 2, No 4 (2017)

Article type

Review article

Pages

128-134

Published online

2018-03-30

Page views

1443

Article views/downloads

1012

DOI

10.5603/MRJ.2017.0017

Bibliographic record

Medical Research Journal 2017;2(4):128-134.

Keywords

rheumatoid arthritis
rheumatoid factor
antibodies
calprotectin
classification criteria

Authors

Magdalena Kuligowska-Prusińska
Grazyna Odrowąż-Sypniewska

References (30)
  1. Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016; 388(10055): 2023–2038.
  2. Shafrin J, Tebeka MG, Price K, et al. The Economic Burden of ACPA-Positive Status Among Patients with Rheumatoid Arthritis. J Manag Care Spec Pharm. 2018; 24(1): 4–11.
  3. Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis. Autoimmune Dis. 2011; 2011: 815038.
  4. Deane K, Demoruelle M, Kelmenson L, et al. Genetic and environmental risk factors for rheumatoid arthritis. Best Practice & Research Clinical Rheumatology. 2017; 31(1): 3–18.
  5. Roszyk E, Puszczewicz M. Role of human microbiome and selected bacterial infections in the pathogenesis of rheumatoid arthritis. Reumatologia. 2017; 55(5): 242–250.
  6. Hedström AK, Stawiarz L, Klareskog L, et al. Smoking and susceptibility to rheumatoid arthritis in a Swedish population-based case-control study. Eur J Epidemiol. 2018 [Epub ahead of print].
  7. Joshua V, Chatzidionisyou K, Catrina AI. Role of the lung in individuals at risk of rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017; 31(1): 31–41.
  8. Farid SSh, Azizi G, Mirshafiey A. Anti-citrullinated protein antibodies and their clinical utility in rheumatoid arthritis. Int J Rheum Dis. 2013; 16(4): 379–386.
  9. Falkenburg WJJ, van Schaardenburg D. Evolution of autoantibody responses in individuals at risk of rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017; 31(1): 42–52.
  10. Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria. Arthritis Rheum. 2010; 62: 2569–2581.
  11. Matuszewska A, Madej M, Wiland P. Markery immunologiczne reumatoidalnego zapalenia stawów. Postepy Hig Med Dosw (online. 2016; 70: 251–257.
  12. Gavrilă BI, Ciofu C, Stoica V. Biomarkers in Rheumatoid Arthritis, what is new? J Med Life. 2016; 9(2): 144–148.
  13. Schett G. The role of ACPAs in at-risk individuals: Early targeting of the bone and joints. Best Pract Res Clin Rheumatol. 2017; 31(1): 53–58.
  14. van der Linden MPM, van der Woude D, Ioan-Facsinay A, et al. Value of anti-modified citrullinated vimentin and third-generation anti-cyclic citrullinated peptide compared with second-generation anti-cyclic citrullinated peptide and rheumatoid factor in predicting disease outcome in undifferentiated arthritis and rheumatoid arthritis. Arthritis Rheum. 2009; 60(8): 2232–2241.
  15. Brzustewicz E, Henc I, Daca A, et al. Autoantibodies, C-reactive protein, erythrocyte sedimentation rate and serum cytokine profiling in monitoring of early treatment. Cent Eur J Immunol. 2017; 42(3): 259–268.
  16. van Oosterhout M, Bajema I, Levarht EWN, et al. Differences in synovial tissue infiltrates between anti-cyclic citrullinated peptide-positive rheumatoid arthritis and anti-cyclic citrullinated peptide-negative rheumatoid arthritis. Arthritis Rheum. 2008; 58(1): 53–60.
  17. Šenolt L, Grassi W, Szodoray P. Laboratory biomarkers or imaging in the diagnostics of rheumatoid arthritis? BMC Med. 2014; 12: 49.
  18. Shi J, van de Stadt LA, Levarht EW, et al. Anti-carbamylated protein antibodies are present in arthralgia patients and predict the development of rheumatoid arthritis. Arthritis Rheum. 2013; 65(4): 911–915.
  19. Jiang X, Trouw LA, van Wesemael TJ, et al. Anti-CarP antibodies in two large cohorts of patients with rheumatoid arthritis and their relationship to genetic risk factors, cigarette smoking and other autoantibodies. Ann Rheum Dis. 2014; 73(10): 1761–1768.
  20. Yee A, Webb T, Seaman A, et al. Anti-CarP antibodies as promising marker to measure joint damage and disease activity in patients with rheumatoid arthritis. Immunol Res. 2015; 61(1-2): 24–30.
  21. Bax M, Huizinga TWJ, Toes REM. The pathogenic potential of autoreactive antibodies in rheumatoid arthritis. Semin Immunopathol. 2014; 36(3): 313–325.
  22. Shi J, van Veelen PA, Mahler M, et al. Carbamylation and antibodies against carbamylated proteins in autoimmunity and other pathologies. Autoimmun Rev. 2014; 13(3): 225–230.
  23. Kumar S, Pangtey G, Gupta R, et al. Assessment of anti-CarP antibodies, disease activity and quality of life in rheumatoid arthritis patients on conventional and biological disease-modifying antirheumatic drugs. Reumatologia. 2017; 55(1): 4–9.
  24. Jonsson MK, Sundlisæter NP, Nordal HH, et al. Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis. Ann Rheum Dis. 2017; 76(12): 2031–2037.
  25. Elnady B, Soliman A, Shaker RM, et al. Potential role of calprotectin as a monitoring biomarker for clinical and sonographic activity and treatment outcome in recent-onset rheumatoid arthritis. Egyptian Rheumatology and Rehabilitation. 2016; 43(3): 143.
  26. Mansour HE, Abdullrhman MA, Mobasher SA, et al. Serum Calprotectin in Rheumatoid Arthritis: A Promising Diagnostic Marker, How Far Is It Related to Activity and Sonographic Findings? Journal of Medical Ultrasound. 2017; 25(1): 40–46.
  27. Hurnakova J, Hulejova H, Zavada J, et al. Serum Calprotectin Discriminates Subclinical Disease Activity from Ultrasound-Defined Remission in Patients with Rheumatoid Arthritis in Clinical Remission. PLoS One. 2016; 11(11): e0165498.
  28. Kopeć-Mędrek M, Widuchowska M, Kucharz EJ. Calprotectin in rheumatic diseases: a review. Reumatologia. 2016; 54(6): 306–309.
  29. Kang KY, Woo JW, Park SH. S100A8/A9 as a biomarker for synovial inflammation and joint damage in patients with rheumatoid arthritis. Korean J Intern Med. 2014; 29(1): 12–19.
  30. Šenolt L. Calprotectin (a S100 protein) as a sensitive biomarker for rheumatoid arthritis: new perspectives for an old finding. International Journal of Clinical Rheumatology. 2012; 7(2): 127–129.

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