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Background: 1-Assess the correlation between Anti-cyclic citralliuated peptide (anti-CCP2) antibodies concentration with some clinical and laboratory parameters of rheumatoid arthritis (RA): 2-Evaluate the differences in the clinical and serological parameters between antiCCP and anti-CCP patients and Rheumatoid factor (RF and RF) patients. 3-Assess the relationship between smoking history and the detection of anti-CCP2 and RF auto antibodies. Subject and Methods: This is a case-control study carried out on 55 patients with established RA attending the Rheumatology ward of Ibn-Sina Teaching Hospital in Nineveh Governorate during the period from 1 November 2010 to the 1 June 2011 and 35 apparently healthy individuals as a control. Anti-CCP2 antibodies were measured using enzyme linked immunosorbent assay (ELISA).The RF was tested by latex agglutination and ELISA. C-reactive protein (CRP) was measured by Latex agglutination test. Patients' demographic data, disease activity and duration and erythrocyte sedimentation rate (ESR) were also recorded Results: Anti-CCP2 antibodies were found significantly associated with RF, total swollen joints (TSJ) and total tender joints (TTJ) counts (p <0.05) while the correlation with ESR, CRP, disease activity score 28 (DAS28) and disease duration was not significant (p>0.05). In RA patients with smoking history and joints deformity, anti-CCP2antibodies was more often detected. The same results were obtained for RF seropositivity. It was also found that the differences between RF and RF groups were comparable to those between anti-CCP2 and anti-CCP groups except for ESR and CRP. Conclusions: The study suggests that the seropositivity of RF is inflammation driven, whereas, the appearance of anti-CCP antibodies might suggests pathophysiological properties and a possible contribution to on-going immune activation Duhok Med J 2018; 12 (1): 41-54

EVALUATION OF ANTI-CCP ANTIBODIES AND RHEUMATOID FACTOR FOR THE LABORATORY DIAGNOSIS OF RHEUMATOID ARTHRITIS