A pilot study to investigate the prevalence of anti-citrullinated peptide antibodies in paired serum and synovial fluid samples in patients with Rheumatoid Arthritis.
Read, Susan Linda
Cardiff Metropolitan University
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Rheumatoid Arthritis (RA) affects approximately 1% of the population. Current diagnosis relies on the interpretation of the clinical condition, with the addition of the somewhat non-specific serological test for Rheumatoid Factor (RF). Although not included in current diagnostic criteria, antibodies against citrullinated proteins (CP) are considered to be specific and predictive markers for RA, although the pathologic relevance of these antibodies remains unclear. The aims of this study are: to undertake paired assessment of serum and joint fluid from appropriate patients with early RA, in an effort to establish whether such patients have the capacity for local production of antibodies to citrullinated protein (anti-CP antibodies); whether a gradient between local and systemic production of such autoantibodies exists in such patients, and whether the testing of synovial fluid for Rheumatoid Factor (RF) and/or anti-CP antibodies has any clinical utility. Despite evidence for the local production of RF and anti-CP antibodies within the synovial compartment, the initial findings suggest that the testing of synovial fluid offers no advantages over the testing of serum, especially considering the relative difficulty of obtaining synovial samples, and of establishing a normal range. Any existing gradient of autoantibody production between serum and synovial fluid may well occur so early on in the disease process as to render it useless for diagnostic purposes. This pilot study was, however, limited to only eighteen patients. Further study, over a longer period, involving a larger group and a more rigorously designed study, encompassing various other arthritis-type conditions as well as comparisons with long-standing RA should yield more useful information.
MSc Biomedical Science
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