Significance of antibodies of IgG, IgA and IgM subtypes antibodies against cyclic citrullinated peptide in early rheumatoid arthritis
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.issn.1007-7480.2013.01.002
   		
        
        	
        		- VernacularTitle:IgG IgA和IgM亚型抗环瓜氨酸肽抗体在早期类风湿关节炎中的检测及意义
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Yingjian ZHANG
			        		
			        		;
		        		
		        		
		        		
			        		Jinxia ZHAO
			        		
			        		;
		        		
		        		
		        		
			        		Lin SUN
			        		
			        		;
		        		
		        		
		        		
			        		Changhong LI
			        		
			        		;
		        		
		        		
		        		
			        		Guiye LI
			        		
			        		;
		        		
		        		
		        		
			        		Xiangyuan LIU
			        		
			        		;
		        		
		        		
		        		
			        		Zhanguo LI
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Arthritis,rheumatoid;
			        		
			        		
			        		
				        		Immunoglobulin G;
			        		
			        		
			        		
				        		Immunoglobulin A;
			        		
			        		
			        		
				        		Immunoglobulin M;
			        		
			        		
			        		
				        		Anti-cyclic citrullinated peptide
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Rheumatology
	            		
	            		 2013;(1):5-9
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Objective To evaluate the prevalence and clinical values of anti-cyclic citrullinated peptide (anti-CCP) antibodies of IgG,IgA and IgM subtypes in individuals with early rheumatoid arthritis (RA).Methods IgG,IgA and IgM subtypes of anti-CCP antibodies were measured in the sera of 87 RA patients with disease duration shorter than 2 years,61 patients with other rheumatic diseases and 49 healthy subjects.We analyzed the diagnostic value of IgG,IgA and IgM subtypes of anti-CCP antibodies and their relationship with disease duration,DAS28,ESR,CRP,and rheumatoid factor (RF).Chi-square test,t test and Spearman's correlation analysis were used for statistical analysis.Results ① The diagnostic sensitivity of IgG,and IgA subtype for early RA was 75.9% and 67.8% respectively,which was higher than IgM subtype (14%,P<0.01 each).The specificity of IgG,IgA and IgM subtype was 96.4%,91.8% and 93.6% respectively.② IgG and IgA subtypes were correlated with CRP (r=0.278,P=0.01; r=0.217,P=0.047) and RF (r=0.430,P=0.000; r=0.271,P=0.012),while IgM subtype was positively correlated with disease duration (r=0.279,P=0.014).③ Patients who had IgG-and IgA subtype had a shorter disease course (3.3±2.3) than those patients who had IgA-and IgG+ (9.5±8.4) and who had IgG+ and IgA+ (8.2±7.0) (P<0.05).④ IgA subtype was positive in 19.0% of the IgG negative patients.When combining IgG,and antibodies of IgA subtypes together,the sensitivity and specificity was 63.2% and 100%,while the sensitivity and specificity was 80.5% and 85.2% when either one was positive.Conclusion Both the IgG,and IgA subtypes of anti-CCP antibodies have a good sensitivity for early RA.They are related to disease activity.Measuring IgA subtype of anti-CCP antibody in RA patients with negative IgG subtype may help to identify early RA.IgA subtype of anti-CCP antibody may play a role in very early RA.