Test to predict Rheumatoid Arthritis


Researchers at Oxford University have now come up with a new test that can accurately predict a person’s chances of being diagnosed with rheumatoid arthritis, up to 16 years in advance. This important breakthrough can help people make crucial lifestyle choices and take preventive measures.
How it works
This new test aims to identify a specific immunodominant peptide in addition to the “usual” autoantibodies found in patients with RA. The peptide, an “extracellular protein,” is called citrullinated tenascin-C (cTNC) and is often found in higher levels in the joints of rheumatoid arthritis patients. This led the Oxford scientists to wonder if it was, in fact, the thing that activates autoimmune antibodies in individuals with RA, and the cause of — or a contributor to — a process called citrullination.

During inflammatory RA flares, proteins are altered through citrullination, which is believed to cause the body’s immune system to viciously attack itself.
Lead study researcher, Anja Schwenzer, Ph.D said, “we knew that tenascin-C is found at high levels in the joints of people with RA.” Her team worked to see if this tenascin-C protein could actually be citrullinated, thus serving as a target for the autoantibodies attacking the body during RA flare-ups.
Details of the study
The study looked at more than 2,000 patients. The blood test accurately diagnosed RA in about 50 percent of cases. Unlike some other tests, it also had a low rate of false positives.
“What is particularly exciting is that when we looked at samples taken from people before their arthritis began, we could see these antibodies to cTNC up to 16 years before the disease occurred” said Professor Kim Midwood of the Oxford University Kennedy Institute. “On average, the antibodies could be found 7 years before the disease appeared,”
Hope for preventing arthritis
This discovery may be crucial because most rheumatologists acknowledge the importance of early detection and early treatment in rheumatoid arthritis. The earlier RA is treated, the more effective treatments may be and the less disability and deformity may occur.
This blood test may allow doctors to monitor predisposed patients closely and help them get their disease under control the moment symptoms begin to appear. “Early diagnosis is key, with research showing that there’s often a narrow window of opportunity following the onset of symptoms for effective diagnosis and control of disease through treatment,” says Stephen Simpson, director of research at Arthritis Research UK, the organization that funded the study.
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