Clinical analysis of blood markers and imaging for diagnosis and prognosis of rheumatoid arthritis

2020 ◽  
Author(s):  
Desheng Yang ◽  
Haini Li ◽  
Shengxia Zhang ◽  
Guifeng Yang ◽  
Song Liu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Characteristic Curve ◽  
Joint Damage ◽  
Diagnostic Value ◽  
Clinical Analysis ◽  
Radiological Outcome ◽  
Diagnostic Efficacy ◽  
Diagnosis And Prognosis ◽  
Imaging Result ◽  
Radiological Damage

Abstract Background The purpose of this study is to explore the combined diagnostic value of anti-cyclic citrullinated peptide antibody (A-CCP), rheumatoid factor (RF) and imaging result in early rheumatoid arthritis, and the role of A-CCP and RF in prediction for radiological outcomes. Methods 101 patients with rheumatoid arthritis and 97 control individuals were detect their A-CCP, RF and radiological joint changes, the diagnostic efficacy of the respective indicators and the combined indicators was analyzed by logistic regression model. Results Our results showed that values of A-CCP and RF were significantly higher in the RA group than in the normal group. Receiver operating characteristic curve results show that the sensitivity of RF is higher than A-CCP and radiological outcome, and specificity of CCP is higher than RA and radiological outcome, and the diagnostic ability of combination of RF, A-CCP and radiological outcome is the strongest. Furthermore, RF and A-CCP had high significant OR for radiological joint damage and progression. Conclusions Our study indicated that the combined diagnosis of RF and A-CCP with radiological outcome can improve the diagnostic efficacy of RA, and RF and A-CCP are independent predictors of radiological damage and progression.

scholarly journals Peptides Bearing Multiple Post-Translational Modifications as Antigenic Targets for Severe Rheumatoid Arthritis Patients

2021 ◽  
Vol 22 (24) ◽  
pp. 13290
Author(s):  
Cristina García-Moreno ◽  
María J. Gómara ◽  
Raúl Castellanos-Moreira ◽  
Raimon Sanmartí ◽  
Isabel Haro
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Serum Antibody ◽  
Joint Damage ◽  
Erosive Disease ◽  
Post Translational Modifications ◽  
Diagnosis And Prognosis ◽  
Modified Peptides ◽  
Chimeric Peptides

Rheumatoid arthritis (RA) is characterized by the presence of autoantibodies that are of paramount importance for the diagnosis and prognosis of the disease and have been implicated in its pathogenesis. Proteins resulting from post-translational modifications (PTMs) are capable of triggering autoimmune responses important for the development of RA. In this work, we investigate serum antibody reactivity in patients with an established RA against a panel of chimeric peptides derived from fibrin and filaggrin proteins and bearing from one to three PTMs (citrullination, carbamylation and acetylation) by home-designed ELISA tests (anti-AMPA autoantibodies). The role of anti-AMPAs as biomarkers linked to the presence of a more severe RA phenotype (erosive disease with radiological structural damage) and to the presence of interstitial lung disease (ILD), a severe extra-articular manifestation in RA patients entailing a high mortality, was also analyzed. In general, the association with the clinical phenotype of RA was confirmed with the different autoantibodies, and especially for IgA and IgM isotypes. The prevalence of severe joint damage was only statistically significant for the IgG isotype when working with the peptide bearing three PTMs. Furthermore, the median titers were significantly higher in patients with RA-ILD, a finding not observed for the IgG isotype when working with the single- and double-modified peptides.

Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

2021 ◽  
pp. jim-2021-001785
Author(s):  
Rasha A Elkholy ◽  
Reham L Younis ◽  
Alzahraa A Allam ◽  
Rasha Youssef Hagag ◽  
Muhammad Tarek Abdel Ghafar
Keyword(s):  
Diabetic Nephropathy ◽  
Early Detection ◽  
Characteristic Curve ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Efficacy ◽  
Significant Difference ◽  
Patients With Diabetes

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.

Diagnostic Value of Multi-Parameter MRI in Sub-Stage of T3 Rectal Cancer

2020 ◽  
Vol 10 (11) ◽  
pp. 2768-2772
Author(s):  
Lei Xu ◽  
Rui Shao ◽  
Honglei Li ◽  
Liang Wang
Keyword(s):  
Rectal Cancer ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Youden Index ◽  
Time Signal ◽  
Diagnostic Efficiency ◽  
Diagnostic Efficacy ◽  
Diffusion Limited ◽  
Morphological Index ◽  
T3 Rectal Cancer

The paper aims to explore the diagnostic value of multi-parameter MRI in sub-stage of T3 rectal cancer. According to the results of clear pathological evaluation, 52 patients were divided into T3I and T3II groups according to the maximum mesorectum depth of tumor infiltration. The χ2 test was used to compare the differences of the overall morphology index, morphological index of the extramural strips, type of time-signal intensity curve (TIC), and the location index of DWI diffusion-limited distribution between the two groups. The independent sample t was used to test and compare the differences in semi-quantitative parameters of DCE between the two lesion groups. The pathological results were used as the dependent variables, the indicators mentioned above with statistical differences were used as the independent variables, and a Logistic regression model was established to construct joint parameters and evaluate its diagnostic efficacy. The differences in the circumferential diameter of lesions and morphological index of extramural strips (p < 0.01), and DWI diffusion restricted distribution index (p < 0.01) of the two groups were statistically significant. The difference in the DCE semiquantitative parameter early enhancement ratio (EER) (p < 0.01) between the two groups. The maximum Youden index of a newly-constructed parameter diagnosis combination: circumferential diameter of lesions + extramural strips + distribution locations of limited diffusion on DWI + EER was 0.73, the area under receiver operating characteristic curve(ROC) was 0.887 and the diagnostic sensitivity and specificity were 85.24% and 87.34%. By making full use of multi-parameter information, combined with morphological index of extramural strips, circumferential diameter of lesions, EER and distribution locations of the diffusion-limited of DWI as evaluation indexes, it can provide a high diagnostic efficiency for the sub-stage of T3 rectal cancer.

scholarly journals Pre-analytical and analytical confounders of serum calprotectin as a biomarker in rheumatoid arthritis

2019 ◽  
Vol 58 (1) ◽  
pp. 40-49
Author(s):  
Lieve Van Hoovels ◽  
Bert Vander Cruyssen ◽  
Laura Bogaert ◽  
Stefanie Van den Bremt ◽  
Xavier Bossuyt
Keyword(s):  
Rheumatoid Arthritis ◽  
Infectious Disease ◽  
Disease Activity ◽  
Clinical Performance ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Healthy Controls ◽  
Reactive Protein ◽  
Diagnosis And Prognosis ◽  
Edta Plasma

Abstract Background There is a need for additional biomarkers to assist in the diagnosis and prognosis of rheumatoid arthritis (RA). The aim of our study was to evaluate the (pre-analytical, analytical and clinical) performance of serum calprotectin as a marker of inflammation in RA. Methods The study population included 463 rheumatologic patients (including 111 RA patients and 352 controls) who for the first time consulted a rheumatologist, 20 healthy controls and 27 patients with an infectious disease. Calprotectin was measured (using four different assays) in serum or in serum and EDTA plasma (healthy controls and infectious disease group). For rheumatologic patients, results for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were available. Results Results for blood calprotectin were assay- and matrix-dependent, with higher values found in serum than in plasma. Serum calprotectin was higher in RA patients than in rheumatologic diseased controls and in healthy controls. Serum calprotectin was lower in RA patients than in patients with an infectious disease. Serum calprotectin was associated with disease activity (DAS score). The area under the curve (AUC) to discriminate RA from controls was 0.756 for CRP, 0.714 for ESR and 0.726–0.783 for calprotectin. Conclusions Our data document that calprotectin measurement is assay- and matrix-dependent. Serum calprotectin is associated with disease activity. Additional (prospective) studies are warranted to further evaluate the prognostic and diagnostic value of blood calprotectin measurements.

Interleukin-34 in the Serum and Synovial Fluid of Rheumatoid Arthritis Patients: Relation to Disease Activity and Radiographic Damage

2018 ◽  
Vol 58 (01) ◽  
pp. 65-70 ◽  
Author(s):  
Zahraa Selim ◽  
Sonya Rashad ◽  
Marwa Abdelaziz ◽  
Shaimaa Salah ◽  
Doaa Fouad ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Synovial Fluid ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Joint Damage ◽  
Bone Destruction ◽  
Radiographic Damage ◽  
Healthy Control ◽  
Radiological Damage ◽  
Arthritic Joints

Abstract Background Interleukin 34 (IL-34) is a recently discovered proinflammatory cytokine that can promote inflammation and osteoclastogenesis in arthritic joints. In this study, we tried to assess the serum and synovial fluid (SF) levels of IL-34 in rheumatoid arthritis (RA) patients, and to determine its relationship with disease activity and radiographic damage. Patients and methods ELISA was used to evaluate IL-34 levels in the serum of RA patients (n=50), osteoarthritis (OA) patients (n=28), and healthy control subjects (n=20) and in SF isolated from RA and OA patients. Disease activity in RA patients was assessed using the disease activity score-28 (DAS 28). The extent of radiographic joint damage, narrowing, and erosions was assessed. Results Serum IL-34 level was significantly elevated in RA patients compared to that in OA patients and healthy controls (P<0.0001). Synovial IL-34 level was also significantly elevated in RA patients compared to that in OA patients (P=0.0004). Serum and synovial IL-34 levels were significantly higher in cases that were rheumatoid factor (RF) positive (n=28) compared to the levels in RF-negative RA cases (n=22) (P=0.03 and P=0.04, respectively). Serum and synovial IL-34 levels were positively correlated with RF (r=0.43, P=0.02 and r=0.39, P=0.03, respectively), and with the extent of radiological damage (SENS) (P=0.0002 and P<0.0001, respectively). However, no significant correlation between IL-34 levels and disease activity was found. Conclusion IL-34 appears to play a key role in the pathogenesis of RA and contribute to bone destruction, making it a potential therapeutic target in the management armamentarium of the disease.

scholarly journals The Value of Different Single or Combined Indexes of the Captopril Challenge Test in the Diagnosis of Primary Aldosteronism

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiao Xiang ◽  
Tao Chen ◽  
Kai Yu ◽  
Yuanmei Li ◽  
Qianrui Li ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Characteristic Curve ◽  
Challenge Test ◽  
Influence Factors ◽  
Binary Logistic Regression ◽  
Plasma Renin ◽  
Diagnostic Value ◽  
Diagnostic Efficacy ◽  
Plasma Aldosterone Concentration ◽  
Logistic Regression Models

ObjectiveThe result interpretation of the captopril challenge test (CCT) for the diagnosis of primary aldosteronism (PA) is not standardized. Superiorities of different indexes in the CCT have not been fully investigated. We aimed to comprehensively evaluate the value and influence factors of different CCT-associated indexes in the diagnosis of PA.MethodsWe enrolled 312, 85, 179 and 97 patients in the groups of PA, essential hypertension (EH), unilateral PA (UPA) and bilateral PA (BPA), respectively. For each single index investigated, we computed diagnostic estimates including the area under the receiver operating characteristic curve (AUC). We performed pre-specified subgroup analyses to explore influence factors. We assessed the diagnostic value of combined indexes in binary logistic regression models.ResultsPost-CCT aldosterone to renin ratio (ARR) (AUC = 0.8771) and plasma aldosterone concentration (PAC) (AUC = 0.8769) showed high value in distinguishing PA from EH, and their combination (AUC = 0.937) was even superior to either alone. The diagnostic efficacy was moderately high for post-CCT aldosterone to angiotensin II ratio (AA2R) (AUC = 0.834) or plasma renin activity (PRA) (AUC = 0.795) but low for the suppression percentage of PAC (AUC = 0.679). Post-CCT PAC had a significantly higher AUC in the UPA than BPA subgroup (AUC = 0.914 vs 0.827, P&lt;0.05).ConclusionWe can take post-CCT ARR and PAC altogether into account to distinguish PA from EH, while caution should be taken to interpret CCT results with the suppression percentage of PAC. Post-CCT PAC may perform better to identify the unilateral than bilateral form of PA.

scholarly journals Clinical Biomarkers and Pathogenic-Related Cytokines in Rheumatoid Arthritis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaoyin Niu ◽  
Guangjie Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Joint Damage ◽  
Unknown Etiology ◽  
Disease Development ◽  
Diagnosis And Prognosis ◽  
Clinical Biomarkers ◽  
Relieve Pain ◽  
Novel Biomarkers ◽  
Made In

Rheumatoid arthritis (RA) is a common autoimmune disease with unknown etiology and pathogenesis. Although major therapeutic advances have been made in recent years, there is no cure for the disease. Current medications mainly reduce inflammation in order to relieve pain and slow joint damage, but many have potentially serious side effects. Therefore, to find specific biomarkers will benefit both RA patients to find relief from the disease and physicians to monitor the disease development. A number of biomarkers have been discovered and used clinically, and others are still under investigation. The autoantibodies, which are widely used in diagnosis and prognosis, novel biomarkers, which reflect clinical disease activity, and newly found biomarkers and pathogenic-related cytokines are discussed in this review.

scholarly journals FRI0571 THE DIAGNOSTIC VALUE OF KL-6 IN RHEUMATOID ARTHRITIS ASSOCIATED WITH INTERSTITIAL LUNG DISEASE IN XINJIANG OF CHINA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 887.2-888
Author(s):  
G. Chen ◽  
L. Wu
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Disease ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Connective Tissue Diseases ◽  
Diagnostic Value ◽  
Operating Characteristic Curve ◽  
Xinjiang Of China

Background:Rheumatoid arthritis (RA) is a systemic inflammatory disease.Many researchers have observed that extra articular organs were highly involved in RA patients.The most common extra-articular manifestations were pulmonary involvement.Serum levels of KL-6 have been reported to be elevated in various ILD such as idiopathic pulmonary fibrosis, collagen vascular disease associated interstitial pneumonias, and other interstitial lung disorders.However, little is known regarding the usefulness of this biomarker in connective tissue diseases related interstitial lung diseases(CTD-ILD). Especially,the diagnostic value of KL-6 in interstitial lung disease associated with rheumatoid arthritis(RA-ILD) still has a dispute.Objectives:To assess the diagnosis of the serum Krebs von den Lungen-6(KL-6) for RA-ILD patients in Xinjiang of China.Methods:This retrospective study included 184 patients with RA in who visited the department of rheumatology and immunology of People’s Hospital of Xinjiang Uygur Autonomous Region between January, 2015 and December, 2019.The patients were divided into RA-ILD group(n=95) and RA group(n=89) according to the presence of ILD. Serum KL-6 concentration (U/mL) was measured using the chemiluminescent enzyme immunoassay kit.Results:The mean age(p < 0.001) and median value of CCP (p = 0.006) were significantly higher in the RA-ILD group.RA-ILD group had elevated serum KL-6 levels compared to RA group [447(281, 687)U/ml vs 195(151.5,265.5)U/ml](p < 0.001)(figure 1).According to the Receiver Operating Characteristic Curve (ROC) analysis, the area under the curve was of 0.879 and the optimal cut-off value of serum KL-6 to discriminate the presence of ILD was 277 U/ml, with sensitivity of 77.9%, specificity of 79.8%(figure 2).Figure 1.Comparison of serum KL-6 concentrations in RA-ILD group and RA group.Figure 2.Receiver-operating characteristic curve(ROC) of KL-6 for the diagnosis of RA-ILDConclusion:The present study confirms that KL-6 is a biological marker which is associated with RA-ILD. Furthermore, Patients with RA who are older and have a higher value of CCP are more likely to develop ILD.References:[1] Anaya JM, Diethelm L, Ortiz LA et al (1995) Pulmonary involvement in rheumatoid arthritis. Semin Arthritis Rheum 24:242–254[2] Bonella F, Costabel U (2014) Biomarkers in connective tissue disease-associated interstitial lung disease. Semin Respir Crit Care Med 35:181–200[3] Doishita S, Inokuma S, Asashima H et al (2011) Serum KL-6 level as an indicator of active or inactive interstitial pneumonitis associated with connective tissue diseases. Intern Med 50: 2889–2892Disclosure of Interests:None declared

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