تقييم دور التركيز المصلي لمستويات الأجسام المضادة للبروتين المكربن و14-3-3أيتا والفوسفات ثنائي الخصوصية الحادي عشر في تشخيص ومتابعة شدة المرض لدى مرضى التهاب المفاصل الرثوي

Evaluation the Role of Serum Levels of anti-Carbamylated Protein, anti-14-3-3η Protein, and Dual Specificity Phosphatase 11 antibodies in Diagnosis and Severity among Patients with Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that mostly affects joints and surrounding tissues (bones, cartilage, and synovial tissues) and symmetrically affects the small joints of the hands and feet. All patients of rheumatoid arthritis must be satisfied six of the ten American College of Rheumatology 2010 criteria, with the recommended laboratory assays being rheumatoid factor and anti-citrullinated peptide antibody.
The study objective is to evaluate the role of carbamylated protein antibody, 14-3-3eta protein antibody, and dual specificity phosphatase 11 antibodies in diagnosis and in assessment the disease severity among rheumatoid arthritis patients both (seropositive and seronegative) patients.
The current study is case-control study conducted in Iraq/Kerbala government/Imam Al-Hassan Al-Mujtaba hospital-rheumatology unit during the period from October 2022 to April 2023, the study included 270 subjects divided into two main groups: 180 rheumatoid arthritis cases and 90 healthy controls, and then cases divided into: 90 seropositive and 90 seronegative according to the presence or absence rheumatoid factor and anti-citrullinated peptide antibody. The mean age and sex of the study groups were matched. After that, all the study participants completed questionnaires, and then venous blood samples were drawn and divided into a sodium citrate tube for the Westergren method erythrocyte sedimentation rate test and a gel tube for serum sample separation. Those were stored at -20 °C in four small Eppendorf tubes for serological assays that included a C-reactive protein test and a rheumatoid factor test by Nephelometry, an anti-citrullinated peptide antibody, a carbamylated protein antibody, the 14-3-3eta protein antibody, and a dual specificity phosphatase 11 antibody that was done by the Enzyme Linked Immune Sorbent Assay. The statistical analysis was done using statistical package for the social sciences version 26.
The current study results showed highly statistically significant difference at P.value less than (0.01) for rheumatoid arthritis patients when compared to healthy control regarding to erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-citrullinated peptide antibody, and the current study markers. The current study markers anti-carbamylated protein antibody, anti-14-3-3eta and anti-dual specificity phosphatase 11 antibody were statistically significant difference in seronegative group than in seropositive at P.value less than (0.05), and in patients with regular treatment than irregulars at P.value less than (0.05), when compared with routine tests rheumatoid factor and anti-citrullinated peptide antibody which were highly statistically significant difference in the seropositive group at P.value less than (0.01), and in patients with irregular treatment at P.value less than (0.01). The current study markers associated significantly with mild to moderate disease activity score28 at P.value less than (0.05), when compared with routine tests which associated significantly with severe disease activity score28 at P.value less than (0.05). The current study markers have positive statistically significant correlation among them at P.value less than (0.05), except anti-dual specificity phosphatase 11 antibodies have negative statistically significant correlation with disease duration and disease activity score28 at P.value less than (0.05).
The study suggests that anti-carbamylated protein, anti-14-3-3eta , and anti-dual specificity phosphatase 11 antibodies can be used as diagnostic markers, particularly in seronegative rheumatoid arthritis patients, as they are associated with mild to moderate disease activity and regular treatment compared to routine tests, this making them useful prognostic markers.