الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 160 |  |  |
| | | from | 160 | | |
Abstract
Rheumatoid arthritis (RA) is a common autoimmune disease that causes chronic inflammation of the synovium. RA synovitis evokes arthritis symptoms and leads to destruction of cartilage and bone in joints.
Clinical presentation of RA appears between the age of 20 and 40 years old, more commonly in women than in men with a 2–3:1 ratio. the most common age group that suffers from RA are those in the 30–50, at least 50% of these patients are unable to hold down a full-time job, presumably due to the disability that ensues.
If the disease is diagnosed early before significant joint erosion occurs, treatment can prevent irreversible joint damage. However, early diagnosis is difficult for several reasons: joint symptoms and signs are limited, physical findings to suggest synovitis may be absent, and laboratory test results may be seronegative in some patients. Therefor there is desperate need for development of a new biomarker that have predictive capacity for RA.
Early prevention is possible through early diagnosis and treatment. Currently, the anti-CCP antibody and RF are a part of the 2010 ACR/ EULAR classification criteria for RA.
ACPAs are most widely used in daily clinical practice, along with RF which are the antibodies of proteins with citrullination, The second most researched AMPAs following ACPA are anti- Carp Abs They are the antibodies of proteins with carbamylation.
Anti-Carp antibodies seem to be associated with a more severe radiological progression, higher disease activity and significantly more disability over time in patients with RA. The presence of anti-Carp antibodies of patients with arthralgia predicts the development of severe arthritis Therefore; anti-Carp antibodies might be a useful biomarker to identify newly diagnosed RA patients who require early and aggressive clinical intervention.
This study is designed to evaluate levels of anti-Carp antibodies in RA patients in order to detect its role as a diagnostic marker and its possible association with disease activity and severity.
We conducted our study on 30 RA patients, and 30 normal healthy individuals served as a control group. The patient and control groups were subjected to full history taking, thorough clinical examination, laboratory investigations, and plain x-ray of the clinically affected joints.
Serum levels of anti- Carp antibody was measured in all patients and controls using ELISA technique.
The present study revealed that the serum levels of anti-Carp antibody:
• Significantly higher in patients than control group.
• Cut of point was >8ng/ml diagnoses RA with sensitivity of 73.33% and specificity of 100%.
• Significant positive correlation with CRP as biomarkers of activity of RA
• Positive correlation with RF and ACPA as a diagnostic biomarker for RA.
• Higher in patients with more joints damage and erosions as assessed by Larsen radiological score as there was significant correlation between Larsen score and serum Anti-Carp.
In conclusion: patients with RA had elevated levels of serum anti- Carp antibody compared to controls. We also found that serum Anti-Carp has high specificity and relatively low sensitivity which provide agood diagnostic value in RA. We found that serum Anti-Carp concentrations significantly correlated with disease severity scales, laboratory data (CRP) and radiological findings. Anti – Carp antibody measurement may not only serve as a diagnostic biomarker for RA, and has the potential to contribute to the fundamental processes underlying the pathogenesis of RA, but also it may serve as a marker for disease progression and severity. So, our data stated that addition of anti-carbamylated protein antibody as a serological marker is of great value of diagnosis of RA and also prediction of disease severity.