Evaluation of Rheumatoid Factor, Anti - Cyclic citrullinated peptide, Erythrocyte Sedimentation Rate, and Cell Reactive Protein in diagnosis of Rheumatoid

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease that causes synovial inflammation, which leads to joint erosion. A group of factors contribute to the occurrence of the disease, including ecological and hereditary features, which can lead to the disease's progress. This study investigated the association between rheumatoid disease and various biomarkers, including RF, anti-CCP, ESR, and CRP. The study aimed to determine the ability of these biomarkers to diagnose rheumatoid disease. Materials and Methods: 100 samples were collected from patients suspected of having rheumatoid arthritis from Al-Sadr Medical City in Najaf/Iraq, the samples were diagnosed by the consultant and the arthritis unit in the abovementioned hospitals from August 2023 to February 2024. Then 50 samples were collected from healthy people as a control group. five ml of intravenous blood was drawn from both patients and controls, and the sera were separated by centrifugation, kept at −20°C, and tested. RF was detected by agglutination of RF latex strips (Solarbio/China), ESR, and CRP. Antibodies to CCP were measured by (ELISA) kit from Genius/USA protocol. Results: The results showed that rheumatoid arthritis was significantly associated with age and gender.  patients 24(24%) had a family history of genetic factors. while 76 (76%) were affected by other non-genetic factors. In this study, there is a highly significant difference (P<0.01) And the chi-square was 75. When comparing the RF group with the control group, the RF gave a positive result (84%), while 16 (16%) gave a negative result for the RF, compared with the control. The negative results for the RF were 45 (90%) and 5 (10%) gave positive results.  a significant difference (P<0.01) and a chi-square of 122 when comparing between the anti-CCP group and the control group. Anti-CCP gave 93 (93%) positive results for RA compared to the control, 50 (100%) gave negative results (RF, Anti-ccp), (ESR, CRP) also significantly increased in RA. the sensitivity results showed that 84% of tested cases indicated positive results for RF. RF is found in cases of rheumatoid arthritis with a sensitivity of 84%. On the other hand, the specificity result indicates that 90% of healthy controls tested negative for RF. Therefore, RF may be a good indicator for monitoring RA, where positive findings are more prevalent. The susceptibility result indicates that all cases tested showed positive results for ANTI-CCP. ANTI-CCP is present in RA cases with a sensitivity of 93%. It is noteworthy that the specificity is also 100%, indicating that no positive results for ANTI-CCP were found in the healthy control group tested. Therefore, ANTI-CCP is a highly sensitive and specific indicator of RA. Conclusion: The research exposed a notable association between rheumatoid disease and age as well as gender. The occurrence of Anti-CCP demonstrated higher diagnostic accuracy for rheumatoid disease compared to RF alone, as indicated by their sensitivity and specificity. Moreover, ESR and CRP levels were meaningfully raised in individuals with rheumatoid disease, further supporting their role as dependable markers for measuring disease activity. These findings significantly contribute to our understanding of the analytic and prognostic value of these biomarkers in rheumatoid disease.