Anti-cyclic citrullinated peptide antibodies in children with Juvenile Idiopathic Arthritis
Keywords:
Juvenile idiopathic arthritis, Anti-CCP antibodies, PolyarticularAbstract
Aim: The purpose of present study was to access the prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in children with Juvenile Idiopathic Arthritis (JIA), and to investigate the clinical significance and diagnostic value of the anti-CCP antibodies in correlation with age, sex & activity.
Methods: This case-control study was performed on 50 patients with JIA in addition to 40 sex and age-matched children as a control group. The participants were recruited from rheumatology Outpatient Clinic of Cairo University Specialized Pediatric Hospital. Patients were subjected to full history taking, clinical examination, routine laboratory investigations and x-rays on involved joints. Both patients and controls underwent assay of anti-CCP antibodies by AxSYM Anti-CCP IgG Microparticle Enzyme Immunoassay (MEIA) which is a semi-quantitative determination of the IgG class of autoantibodies specific to cyclic citrullinated peptide (CCP) in patients' serum or plasma. Data were analyzed using Mann-Whitney U test, ANOVA, and independent-samples t-test by SPSS version 15.
Results: Anti-CCP positivity was identified amongst patients with JIA, particularly those JIA patients experiencing RF positive polyarticular disease onset. Above all, it is important that anti-CCP positivity and bone erosions, degree of joint damage, and ESR levels were significantly correlated.
Conclusion: Anti-CCP could be utilized as a valuable marker in the polyarticular form of JIA to direct early, and could be aggressive therapeutic intervention.
References
Saraux A, Berthelot JM, Chalès G, Le Henaff C, Mary JY, Thorel JB, et al. Value of laboratory tests in
early prediction rheumatoid arthritis. Arthritis Rheum. 2002; 47(2): 155-65. PMID: 11954009.
Kwok JS, Hui KH, Lee TL, Wong W, Lau YL, Wong RW, et al. Anti-cyclic citrullinated peptide:
diagnostic and prognostic values in juvenile idiopathic arthritis and rheumatoid arthritis in a Chinese
population. Scand J Rheumatol. 2005; 34(5): 359-366. doi: 10.1080/03009740510026634. PMID:
Dewint P, Hoffman IE, Rogge S, Joos R, Union A, Dehoorne J, et al. Effect of age on prevalence of
anticitrullinated protein/peptide antibodies in polyarticular juvenile idiopathic arthritis. Rheumatology
(Oxford). 2006; 45(2): 204-8. doi: 10.1093/rheumatology/kei133. PMID: 16188943.
Ferucci ED, Majka DS, Parrish LA, Moroldo MB, Ryan M, Passo M, et al. Antibodies against cyclic
citrullinated peptide are associated with HLA-DR4 in simplex and multiplex polyarticular-onset juvenile
rheumatoid arthritis. Arthritis Rheum. 2005; 52(1): 239-46. doi: 10.1002/art.20773. PMID: 15641089.
van Gaalen FA, Linn-Rasker SP, van Venrooij WJ, de Jong BA, Breedveld FC, Verweij CL, et al.
Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with
undifferentiated arthritis-A prospective cohort study. Arthritis Rheum. 2004; 50(3): 709-15. doi:
1002/art.20044. PMID: 15022309.
Low JM, Chauhan AK, Kietz DA, Daud U, Pepmueller PH, Moore TL. Determination of anti-cyclic
citrullinated peptide antibodies in the sera of patients with juvenile idiopathic arthritis. J Rheumatol. 2004;
(9): 1829-33. PMID: 15338508.
Lipińska J, Smolewska E, Brózik H, Stańczyk J. Anti-CCP antibodies in children with Juvenile Idiopathic
Arthritis (JIA)—diagnostic and clinical significance. Central-European Journal of Immunology. 2008;
(1): 19-23.
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 Rheumatoid arthritis
classification criteria: an American College of Rheumatology/European League Against Rheumatism
collaborative initiative. Arthritis Rheum. 2010; 62(9): 2569-81. doi: 10.1002/art.27584. PMID: 20872595.
Van Venrooij WJ, Hazes JM, Visser H. Anticitrullinated protein/peptide antibody and its role in the
diagnosis and prognosis of early rheumatoid arthritis. Neth J Med. 2002; 60(10): 383-8. PMID: 12607587.
Syed RH, Gilliam BE, Moore TL. Rheumatoid factors and anticyclic citrul-linated peptide antibodies in
pediatric rheumatology. Curr Rheumatol Rep. 2008; 10(2): 156-63. doi: 10.1007/s11926-008-0027-4.
PMID: 18460272.
Moroldo MB, Chaudhari M, Shear E, Thompson SD, Glass DN, Giannini EH. Juvenile rheumatoid arthritis
affected sibpairs: extent of clinical phenotype concordance. Arthritis Rheum. 2004; 50(6): 1928-34. doi:
1002/art.20292. PMID: 15188369.
Morbach H, Dannecker H, Kerkau T, Girschick HJ. Prevalence of antibodies against mutated citrullinated
vimentin and cyclic citrullinated peptide in children with juvenile idiopathic arthritis. Clin Exp Rheumatol.
; 28(5): 800. PMID: 20822716.
Brunner J, Sitzmann FC. The diagnostic value of anti-cyclic citrullinated pep-tide (CCP) antibodies in
children with Juvenile Idiopathic Arthritis. Clin Exp Rheumatol. 2006; 24(4): 449-51. PMID: 16956438.
Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007; 369(9563): 767-78. doi: 10.1016/S0140- 6736(07)60363-8.
Lee DM, Schur PH. Clinical utility of the anti-CCP assay in patients with rheumatic diseases. Ann Rheum
Dis. 2003; 62(9): 870-4. doi: 10.1136/ard.62.9.870. PMID: 12922961, PMCID: PMC175466.
Duffy CM. Measurement of health status, functional status, and quality of life in children with juvenile
idiopathic arthritis: clinical science for the pediatrician. Pediatr Clin North Am. 2005; 52(2): 359-72. doi:
1016/j.pcl.2005.01.009. PMID: 15820372.
Martini A, Lovell DJ. Juvenile idiopathic arthritis: state of the art and future perspectives. Ann Rheum Dis.
; 69(7): 1260-3. doi: 10.1136/ard.2010.133033. PMID: 20525835.
Omar A, Abo-Elyoun I, Hussein H, Nabih M, Atwa H, Gad S, et al. Anti-cyclic citrullinated peptide (anti- CCP) antibody in juvenile idiopathic arthritis (JIA): Correlations with disease activity and severity of joint
damage (a multicenter trial). Joint Bone Spine. 2013; 80(1): 38-43. doi: 10.1016/j.jbspin.2012.03.008.
PMID: 22575064.
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International League of
Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton.
J Rheumatol. 2004; 31(2): 390-2. PMID: 14760812.
Ellis JA, Munro JE, Ponsonby AL. Possible environmental determinants of juvenile idiopathic arthritis.
Rheumatology (Oxford). 2010; 49(3): 411-25. doi: 10.1093/rheumatology/kep383. PMID: 19965974.
Wang SJ, Yang YH, Lin YT, Yang CM, Chiang BL. Attained adult height in juvenile rheumatoid arthritis
with or without corticosteroid treatment. Clin Rheumatol. 2002; 21(5): 363-8. doi:
1007/s100670200098. PMID: 12223982.
Umławska W, Prusek-Dudkiewicz A. Short stature of children suffering from certain chronic diseases.
Pediatr Endocrinol Diabetes Metab. 2007; 13(3): 135-8. PMID: 17880821.
Simon D, Fernando C, Czernichow P, Prieur AM. Linear growth and final height in patients with systemic
juvenile idiopathic arthritis treated with longterm glucocorticoids. J Rheumatol. 2002; 29(6): 1296-300.
PMID: 12064849.
Alfredo M, Teruzzi B, Cimaz R, Gerloni V. Relationship between delayed menarche and bone
mineralization in patients affected by juvenile idiopathic arthritis (JIA). J Clin Dens. 2006; 9(2): 241. doi:
1016/j.jocd.2006.04.066.
Quartier P. Current treatments for juvenile idiopathic arthritis. Joint Bone Spine. 2010; 77(6): 511-6. doi:
1016/j.jbspin.2010.09.002. PMID: 20961790.
van Rossum M, van Soesbergen R, de Kort S, ten Cate R, Zwinderman AH, de Jong B, et al. Anti-cyclic
citrullinated peptide (anti-CCP) antibodies in children with juvenile idiopathic arthritis. J Rheumatol. 2003;
(4): 825-8. PMID: 12672206.
Gupta R, Thabah MM, Vaidya B, Gupta S, Lodha R, Kabra SK. Anti-cyclic citrullinated peptide antibodies
in juvenile idiopathic arthritis. Indian J Pediatr. 2010; 77(1): 41-4. doi: 10.1007/s12098-010-0006-4. PMID:
Skare TS, Nisihara RM, Silva RM, Munhoz da Silva DJ, Gameiro Silva MB, Utiyama SR. Anti-cyclic
citrullinated Peptide anti-bodies in adult patients with juvenile idiopathic arthritis. J Clin Rheumatol. 2011;
(8): 421-3. doi: 10.1097/RHU.0b013e31823a4d0a. PMID: 22089992.
Habib HM, Mosaad YM, Youssef HM. Anti-cyclic citrullinated peptide antibodies in patients with juvenile
idiopathic arthritis. Immunol Invest. 2008; 37(8): 849-57. doi: 10.1080/08820130802438057. PMID:
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