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The Role of Anti-Cyclic Citrullinated Peptide Antibody From Joint to Brain



Meamar R1 ; Maracy M2 ; Ghasemi M3 ; Salesi M4
Authors
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Authors Affiliations
  1. 1. Department of Pharmacology, School of Medical Sciences, Islamic Azad University, Najafabad Branch, Isfahan, Iran
  2. 2. Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Isfahan Neurosciences Research Center AND Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2014

Abstract

Background: Anti-cyclic citrullinated peptide (CCP) antibodies are highly specific and predictive for rheumatoid arthritis (RA). Recently, existence of anti-CCP in several other inflammatory conditions from psoriatic arthritis to neurodegenerative disorder like Alzheimer's disease (AD) has been reported. We compared the level of anti-CCP titer between the patients with mild cognitive impairment (MCI) and Alzheimer's disease; then, we compared it between the patients with mild rheumatoid arthritis and Alzheimer's disease. Methods: In this cross-sectional study, 40 patients with rheumatoid arthritis, 29 patients with Alzheimer's disease, 30 patients with mild cognitive impairment and 30 healthy controls were enrolled. Anti-CCP titer was measured by solid phase enzyme immunoassay kit. Statistical analysis was performed using one-way analysis of variance and post-hoc Tukey tests. Findings: Level of anti-CCP titer (mean ± SD) was higher significantly in patients with Alzheimer's disease (13.6 ± 1.6) was higher than healthy subjects (4.2 ± 1.1) and patients with mild cognitive impairment (4.8 ± 1.3) (P = 0.0100 for both). Anti-CCP serum level in 32.1% of patients with Alzheimer's disease and 95.5% of patients with mild rheumatoid arthritis was higher than normal range. In addition, the antibody level was significantly higher in patients with rheumatoid arthritis (54.7 ± 4.8) compared to patients with Alzheimer's disease (P = 0.0001). Conclusion: We obviously observed differences in Anti-CCP titer between patients with Alzheimer's disease and those with mild rheumatoid arthritis. It was expected since anti-CCP has a high specificity for rheumatoid arthritis and become positive in early stages of disease with a high predictive value. However, we found that in early stages of cognitive impairment, we could not use this biomarker as a diagnostic test but during disease progression, a significant difference was observed between patients with mild cognitive impairment and those with Alzheimer's disease. It needs more studies to confirm the role of anti-CCP antibody production in patients with Alzheimer's disease.