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The role of synthetic manufactured peptides containing common citrullinated epitopes in rheumatoid arthritis diagnosis
Clinical Immunology ( IF 8.6 ) Pub Date : 2018-12-10 , DOI: 10.1016/j.clim.2018.12.004
Saeed Darawshe , Abdulla Watad , Nicola L. Bragazzi , Smadar Gertel , Howard Amital

Background

Anti-citrullinated peptide antibodies (ACPA) play an important role in rheumatoid arthritis (RA) diagnosis. In our study, we sought to assess the potential diagnostic value of synthetically manufactured peptides that contain epitopes believed to have a pathogenic role in RA.

Methods

Serum samples from RA patients and healthy controls were obtained. Two synthetic peptides were manufactured containing the common epitopes considered to play a pivotal role in the RA pathogenesis including the antigenic epitopes of filaggrin, beta-fibrinogen, collagen, vimentin and enolase. Three different ELISA kits for citrullinated peptides (namely: CCP3, Cit-ME-Vim and Cit-ME-Eno) were tested and compared. To assess the diagnostic value of the three ELISA tests, for each test the optical densities (OD) were recorded. The statistical power of each test was calculated measuring the area under the curve (AUC) corresponding with each peptide.

Results

Serum levels of ACPA recognized by the commercial CCP3 in RA and healthy controls were 1.31 ± 0.88 optic density units (ODU) and 0.21 ± 0.11 ODU, respectively. Cit-ME-Vim levels were 0.55 ± 0.46 ODU in RA subjects and 0.17 ± 0.182 ODU in healthy controls whereas Cit-ME-Eno was 0.61 ± 0.65 ODU in RA subjects and 0.22 ± 0.20 ODU in healthy controls. AUC results were as follows: CCP3, 0.89 [95%CI 0.75–0.87]; Cit-ME-Vim, 0.76 [95%CI 0.69–0.82]; Cit-ME-Eno, 0.73 [95%CI 0.65–0.79]. Statistical significance for all results was achieved (p < .0001). Sensitivity values for each kit are as follow: CCP3 70.42%; Cit-ME-Vim 63.38%; Cit-ME-Eno 40.85%, and specificity 91% for all tests.

Conclusion

Our study supports the presence of an added value for the Cit-ME-Vim peptides in the diagnosis of RA. Further studies are needed to replicate such findings.



中文翻译:

人工合成的含有瓜氨酸表位的多肽在类风湿关节炎诊断中的作用

背景

抗瓜氨酸肽抗体(ACPA)在类风湿关节炎(RA)诊断中起重要作用。在我们的研究中,我们试图评估包含表位被认为在RA中具有致病作用的表位的合成肽的潜在诊断价值。

方法

从RA患者和健康对照者获得血清样品。制造了两种合成肽,其中包含被认为在RA发病机理中起关键作用的常见表位,包括丝聚蛋白,β-纤维蛋白原,胶原蛋白,波形蛋白和烯醇化酶的抗原表位。测试并比较了三种不同的瓜氨酸肽的ELISA试剂盒(即CCP3,Cit-ME-Vim和Cit-ME-Eno)。为了评估三个ELISA测试的诊断价值,记录每个测试的光密度OD)。计算每个测试的统计功效,以测量对应于每种肽的曲线下面积(AUC)。

结果

RA和健康对照组中商业CCP3识别的ACPA血清水平分别为1.31±0.88光密度单位(ODU)和0.21±0.11 ODU。RA受试者的Cit-ME-Vim水平为0.55±0.46 ODU,健康对照组为0.17±0.182 ODU,而RA受试者的Cit-ME-Eno为0.61±0.65 ODU,健康对照组为0.22±0.20 ODU。AUC结果如下:CCP3,0.89 [95%CI 0.75-0.87];Cit-ME-Vim,0.76 [95%CI 0.69–0.82];Cit-ME-Eno,0.73 [95%CI 0.65-0.79]。所有结果均具有统计学意义(p  <.0001)。每个试剂盒的灵敏度值如下:CCP3 70.42%;Cit-ME-Vim 63.38%;Cit-ME-Eno为40.85%,所有测试的特异性为91%。

结论

我们的研究支持Cit-ME-Vim肽在RA诊断中存在附加价值。复制这些发现还需要进一步的研究。

更新日期:2018-12-10
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