Effect of Anti-Cyclic Citrullinated Peptide and HLA-DRB1 Subtypes on Clinical Disease Activity Index in Rheumatoid Arthritis PatientsCorrespondence Address :
Dr. Zahra Mobedi,
Faculty, Department of Rheumatology, Shahr-e-Kord University of Medical Sciences, Shahr-e-Kord, Iran.
Introduction: Rheumatoid arthritis (RA) is a crippling disease with a global prevalence of approximately 0.5%-1% in adults. Genetic, environmental and immunologic factors contribute importantly to pathogenesis of RA. American College of Rheumatology (ACR) assists in early diagnosis of the disease.
Aim: The aim of this study was to investigate the effects of HLADRB1 gene and anti-Cyclic Citrullinated Peptide (CCP) antibody on Clinical Disease Activity Index (CDAI) and to determine the frequency of HLA-DRB1 alleles in the patients with RA.
Materials and Methods: In this descriptive-analytical study, 64 patients with RA referring rheumatology clinic of Hajar Hospital, Shahr-e-Kord, Iran were enrolled based on ACR criteria (1987) by convenience sampling. All patients were examined to assess primary CDAI and referred to laboratory for serologic tests [Rheumatoid Factor (RF) and anti-CCP]. After the patients’ DNA was extracted, HLA-DRB1 was determined per single specific primer-polymerase chain reaction by inno-train kits. The patients were re-examined six months later.
Results: The most prevalent type of HLA-DRB1 in the studied patients was 04. In patients with HLA-DRB1 (04), HLA-DRB1 (01), and HLA-DRB1 (15), CDAI decreased pronouncedly after six months, but in other patients it did not (p<0.05). Of the patients, 81.3% had high titers of anti-CCP, but no association between anti-CCP and CDAI was found.
Conclusion: RA could be a multifactorial disease. The patients with HLA-DRB1 (04), HLA-DRB1 (01) and HLA-DRB1 (15) showed a good response to routine treatments. The patients with HLADRB1 (04) are likely to have no decrease in secondary CDAI. High titers of anti-CCP in patients may indicate the severity of RA in the studied region and perhaps environmental, genetic and unknown or idiopathic factors are aetiologically crucial.
Human leukocyte antigen, Rheumatic diseases, Rheumatoid Factor
Akbar Soleimani, Zahra Mobedi, Maryam Al-e-rasul, Abolghasem Sharifi, Abdolrahim Kazemi Vardanjani. EFFECT OF ANTI-CYCLIC CITRULLINATED
PEPTIDE AND HLA-DRB1 SUBTYPES
ON CLINICAL DISEASE ACTIVITY INDEX IN
RHEUMATOID ARTHRITIS PATIENTS. Journal of Clinical and Diagnostic Research [serial online] 2017 March [cited: 2017 May 25 ]; 11:OC09-OC12. Available from
Date of Submission: Jan 20, 2014
Date of Peer Review: Jul 17, 2014
Date of Acceptance: Aug 26, 2015
Date of Publishing: Mar 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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