Summary:
Introduction: Due to the high specificity and strong association with erosive course of the disease,
anti-CCP antibodies have recently been suggested as a new diagnostic criterion for rheumatoid
arthritis. Positivity of these antibodies before the first clinical manifestation of RA supports the idea
of the role of anti-CCP in the pathogenesis of the disease. Aim: to evaluate specificity of anti-CCP
antibodies in synovial fluid from patients with rheumatoid arthritis in comparison with activeoste
oarthritis of the knee. To evaluate putative correlation between synovial fluid and serum anti-CCP
antibodies, activity and functional status of the disease. Patients and methods: Anti-CCP antibodies
were measured in serum and synovial fluid from 46 patients with rheumatoid arthritis and 41
patients with osteoarthritis of the knee using commercially available ELISA kit. Results: Good correlation
(ρ=0.87, p<0.01) of the mean level of anti-CCP antibodies in serum and synovial fluid was
found in patients with rheumatoid arthritis. No significant correlation between the level of anti-CCP,
duration of the disease, functional status and activity of rheumatoid arthritis was found. Frequency
of positive anti-CCP antibodies was significantly higher in patients with rheumatoid arthritis in contrast
to patients with osteoarthritis of the knee (34.8 % vs. 0%, p<0.001). Conclusions: We found a high
specificity of positive anti-CCP antibodies in serum and synovial fluid from patients with rheumatoid
arthritis in contrast to patients with osteoarthritis. Serum levels of anti-CCP antibodies correlated
with synovial fluid levels. Although the role of citrullinated peptides in the pathogenesis of
rheumatoid arthritis is not known so far, the presence of antibodies against those proteins seems to
be promising diagnostic tool. Moreover, current results of other authors support the idea of potential
value for evaluation of anti-CCP antibodies as prognostic marker.
Key words:
rheumatoid arthritis, osteoarthritis of the knee, anti-CCP antibodies, synovial fluid
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