Article Text

AB0227 Anti Citrullinated Protein Antibody (ACPA) in Relation to Serum Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) and Disease Activity in Rheumatoid Arthritis
  1. A.F. Elbelasy1,
  2. H. Korayem2,
  3. I. Khalil1,
  4. M. Elsawy2
  1. 1Rheumatology
  2. 2Alexandria University, alexandria, Egypt


Background Bone destruction in rheumatoid arthritis (RA) remains a main concern in the clinical practice where the destructed joints may lead to impaired normal functional activity of patients.

Antibodies against citrullinated proteins (ACPA) and high levels of Receptor activator of nuclear factor kappa-B ligand (RANKL) have been linked to altered bone metabolism in RA including more osteoclastic activity predicting more severe course of RA and more joints erosion.

Objectives To investigate ACPA in RA patients in relation to serum RANKL and disease activity in Rheumatoid arthritis.

Methods Sera of 40 patients diagnosed as RA according to EULAR/ACR 2010 divided into two equal groups of 20 ACPA positive and 20 ACPA negative patient's group where RANKL was measured by enzyme linked immunosorbant assays (ELISA) and Results were correlated with disease activity using DAS28-CRP score.

Results RANKL concentration was significantly higher in ACPA positive RA patients as compared to ACPA negative RA patients and Higher RANKL concentration was associated with higher disease activity measured using the DAS-CRP 28.

Conclusions ACPA positive RA patients are associated with increased levels of RANKL and high disease activity in relation to ACPA negative patients.


  1. Hensvold, Aase Haj, Joshua, Vijay, Saevarsdottir, Saedis, Larkin, Michaela, Israelsson, Lena, Qureshi, Ferhan, et al; Autoantibodies To Citrullinated Proteins Associate With Bone Destruction Marker and Are Modulated By First Anti Rheumatic Treatment In Early Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2013;65 Suppl 10:1327 DOI: 10.1002/art.2013.65.issue-s10.

  2. Syversen SW, Gaarder PI, Goll GL, Ødegård S, Haavardsholm EA, Mowinckel P, et al. High anti-CCP levels and an algorithm of four variables predict radiographic progression in patients with rheumatoid arthritis: results from a 10-year longitudinal study. Ann Rheum Dis 2007.

  3. Aletaha D, Neogi T, Silman AJ, et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010;69:1580-8.

  4. Geusens, P. P., Landewé, R. B. M., Garnero, P., et al. The ratio of circulating osteoprotegerin to RANKL in early rheumatoid arthritis predicts later joint destruction. Arthritis & Rheumatism, 54: 1772–1777. doi: 10.1002/art.21896.

Acknowledgements I would like to thank my professors supervising my research for their support during every step working through this research and my father prof of rheumatology for his support in the medical field and his encouargment.

Disclosure of Interest None declared

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.