Second Generation Automated Anti-CCP Test Better Predicts the Clinical Diagnosis of Rheumatoid Arthritis
Second Generation Automated Anti-CCP Test Better Predicts the Clinical Diagnosis of Rheumatoid Arthritis
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DOI：
10.1007/s10875-011-9610-y
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发表时间：
2012-02
影响因子：
9.1
通讯作者：
M. Elrefaei;Kristie Boose;Martha McGee;T. Tarrant;F. Lin;J. Fine;J. Schmitz
中科院分区：
文献类型：
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作者：
M. Elrefaei;Kristie Boose;Martha McGee;T. Tarrant;F. Lin;J. Fine;J. Schmitz
类风湿关节炎(RA)是最常见的系统性自身免疫性疾病之一。与血清类风湿因子相比，抗环瓜氨酸肽(CCP)抗体的存在在区分RA患者方面更好，也与显著更多的疾病活动性相关。在这项研究中，我们评估了两种新的自动化第二代检测方法，以检测提交给临床免疫学实验室进行抗CCP抗体检测的226份血清样本中抗CCP抗体的存在。我们将使用免疫CAP 250(Phadia)和建筑2000SR(雅培实验室)仪器获得的这些样本的CCP抗体结果与我们目前使用的CCP抗体第三代手动ELISA(Inova Diagnostics)进行了比较。154个样本在三次检测中均为阴性，52个样本为阳性。18个样本的自动检测结果为阴性，而人工酶联免疫吸附试验为弱/中度阳性，总体符合率为79%。当我们将不一致的检测结果与患者诊断进行比较时，我们观察到新的自动化检测与手动ELISA法相比与临床RA诊断有更好的相关性。这两种新的抗CCP抗体检测方法具有自动化的优点，对RA的诊断可能比目前的人工ELISA法具有更好的阳性预测价值。
Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases. The presence of antibodies to cyclic citrullinated peptide (CCP) is better at discriminating RA patients and is also associated with significantly more disease activity compared to serum rheumatoid factor. In this study, we assessed two new automated second generation tests to detect the presence of anti-CCP antibodies in 226 serum samples submitted to the Clinical Immunology Laboratory for anti-CCP antibody testing. We compared CCP antibody results on these samples obtained using the ImmunoCAP 250 (Phadia) and the Architecti2000SR (Abbott Laboratories) instruments to our currently used CCP IgG third generation manual ELISA (Inova Diagnostics). One hundred and fifty-four samples were negative while 52 were positive by all three tests. Eighteen samples were negative by the automated tests but weakly/moderately positive by manual ELISA yielding an overall concordance of 79%. When we compared the discordant test results to patient diagnosis, we observed a better correlation with clinical RA diagnosis for the new automated tests compared to the manual ELISA. These two new anti-CCP antibody tests have the benefit of automation and may have better positive predictive value for the diagnosis of RA than our current manual ELISA.