A new pattern of citrullinated peptides improves the sensitivity for diagnosing rheumatoid arthritis

瓜氨酸 类风湿性关节炎 医学 氨基酸 关节炎 瓜氨酸化 化学 内科学 生物化学 精氨酸
作者
Zhiwei Ru,Hongbin Zhang,Xiaoyan Huang,Jianrong Lou,Jun Liao,Zhu Chen,Xiang Yang
出处
期刊:Clinical Biochemistry [Elsevier BV]
卷期号:105-106: 87-93 被引量:1
标识
DOI:10.1016/j.clinbiochem.2022.04.002
摘要

Anti-citrullinated protein antibody (ACPA) is found almost exclusively in patients with rheumatoid arthritis (RA). Commercial cyclic citrullinated peptide (CCP) assays that target ACPAs yield specificities as high as 95% for RA diagnoses, but their sensitivities only reach 50-70%. To improve the sensitivity of the CCP assay, a new pattern of citrullinated peptide was identified and named the MCSM (multiple citrulline-similar motif).The MCSM comprised a citrulline core surrounded by citrulline-similar amino acids. A series of peptides with or without the MCSM was synthesized to evaluate the function of the citrulline core and citrulline-similar amino acids. These peptides were used in the enzyme-linked immunosorbent assay to compare samples from 94 RA patients, 117 non-RA patients and 116 healthy subjects. Additionally, the MCSM assay was compared with a commercial CCP assay.When the cutoff value was set at 0.274, the sensitivity and specificity of the MCSM assay were 79.6% and 96.6%, respectively. When one citrulline was substituted in the citrulline core, the sensitivity of the assay decreased from 79.6% to 61%. If all three citrulline-similar amino acids were substituted in the backbone, the sensitivity of the MCSM assay decreased from 79.6% to 58.5%. The coincidence rate of the MCSM assay to the commercial CCP assay was 97.6%.The citrulline core and citrulline-similar amino acids are crucial components of the MCSM pattern. This new MCSM assay could be used to diagnose RA.
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