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Rheumatology Advance Access originally published online on March 20, 2008
Rheumatology 2008 47(5):656-659; doi:10.1093/rheumatology/ken092
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Sensitivity and specificity of autoantibodies binding to citrullinated carboxyterminal telopeptides of types I and II collagens in an early arthritis series

M.-K. Koivula1,2, E. Savolainen3, O. Kaipiainen-Seppänen4, H. Kautiainen5, R. Luosujärvi6, M. Hakala7,8 and J. Risteli1

1Department of Clinical Chemistry, University of Oulu, Oulu, 2Turku University Central Hospital, Turku, 3Kuopio Municipal Hospital, Kuopio, 4Department of Medicine, Kuopio University Hospital, Kuopio, 5MedCare Foundation, Äänekoski, 6Department of Medicine, Helsinki University Central Hospital, Helsinki, 7Rheumatism Foundation Hospital, Heinola and 8Department of Musculoskeletal Medicine and Rehabilitation, Medical School, University of Tampere, Tampere, Finland.

Correspondence to: J. Risteli, Department of Clinical Chemistry, P.O.Box 5000, FI-90014 University of Oulu, Oulu, Finland. E-mail: juha.risteli{at}oulu.fi


  Abstract

Objective. To assess the specificity and sensitivity of autoantibodies binding to citrullinated carboxyterminal telopeptides of types I and II collagens in an early arthritis series.

Methods. A cohort of 146 patients from the Kuopio 2000 Arthritis Survey having RA, AS, PsA, ReA, uSpA or undifferentiated arthritis were studied. Autoantibodies binding citrullinated types I and II carboxytelopeptides were measured in two different inhibition ELISA assays. Sera from 135 adult persons were used as controls.

Results. In RA, the sensitivities were 0.83 with long type I telopeptide and 0.78 with long type II telopeptide and the respective specificities were 0.94 and 0.93, while the corresponding values in other inflammatory joint diseases were much lower. The likelihood ratio in RA increased with longer peptides from 4.20 to 14.06 for type I telopeptide and from 2.74 to 11.67 for type II telopeptide.

Conclusion. The antibody assay using long telopeptide from type I collagen was the most specific and sensitive method in every diagnostic category, although in the arthritides other than RA, binding was much less abundant and possibly citrulline-independent.

KEY WORDS: Anti-CCP antibodies, Autoantibodies, Citrullination, Early arthritis, RA, SpA, Telopeptide, Type I collagen, Type II collagen

Submitted 30 August 2007; revised version accepted 6 February 2008.
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