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Highly Accessed Review

Autoantibody systems in rheumatoid arthritis: specificity, sensitivity and diagnostic value

Martinus AM van Boekel1*, Erik R Vossenaar1, Frank HJ van den Hoogen2 and Walther J van Venrooij1

Author Affiliations

1 Department of Biochemistry, University of Nijmegen, Nijmegen, The Netherlands

2 Department of Rheumatology, UMC St Radboud, Nijmegen, The Netherlands

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Arthritis Res 2002, 4:87-93  doi:10.1186/ar395

Published: 6 November 2001

Abstract

The diagnosis of rheumatoid arthritis (RA) is primarily based on clinical symptoms, so it is often difficult to diagnose RA in very early stages of the disease. A disease-specific autoantibody that could be used as a serological marker would therefore be very useful. Most autoimmune diseases are characterized by a polyclonal B-cell response targeting multiple autoantigens. These immune responses are often not specific for a single disease. In this review, the most important autoantibody/autoantigen systems associated with RA are described and their utility as a diagnostic and prognostic tool, including their specificity, sensitivity and practical application, is discussed. We conclude that, at present, the antibody response directed to citrullinated antigens has the most valuable diagnostic and prognostic potential for RA.

Keywords:
autoantibodies; autoimmunity; citrulline; rheumatoid arthritis