Diabetomics Lumella - New Point-of-Care Blood Test Kit for Early Detection of Preeclampsia

Abstract
Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of synovial joints. Anticitrullinated protein autoantibodies are detected by the CCP test in early disease and predict the development of erosive disease as well as extraarticular manifestations. We recently reported that many RA patients have anti-citrullinated albumin (ACA) autoantibodies, which only recognize albumin in its citrullinated form.

Methods: Anti-modified albumin autoantibodies, predominantly ACA, were quantitated using a rapid point-of-care test and the data analyzed by ACA and CCP status for correlations with clinical and laboratory parameters and medication.

Results: In two cohorts of RA patients (n=168), 55% were positive for anti-modified albumin autoantibodies (here referred to as ACA+) while healthy donors (n=37) were negative (p 0.0001). Patients with other rheumatologic diseases were generally negative for ACA with a few exceptions, such as those with RA overlap syndromes. ACA values correlated with titers of rheumatoid factor. The ACA test segregated seronegative RA patients into two distinct categories, while seropositive RA patients with a positive ACA had higher disease activity, more erosions on x-rays, and a higher proportion of TNF inhibitor non-responders and combination therapy than ACA-negative patients.

Conclusions: The ACA test could help identify seronegative RA patients with a citrullination-associated disease similar to seropositive RA (despite a negative CCP test), as well as to recognize seropositive RA patients with a worse prognosis and in need of more aggressive therapy. The rapid point-of-care test could prove useful for screening and in settings where a clinical laboratory is not readily available. 250 words Keywords: Rheumatoid arthritis; Citrullination; Anti-citrullinated protein antibodies; Albumin