• Khudair Al-bedri Department of Medicine, Consultant Internist and Rheumatologist, College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Zainab A Mahmood Department of Medicine, College of Medicine, University of Basra, Basra, Iraq.
  • Aqeel Hussein Sadeq Department of Rheumatology, Baghdad Teaching Hospital, Rheumatology Unit, Baghdad, Iraq.



Psoriasis, Psoriatic arthritis, Anti-cyclic citrullinated peptide antibodies


Objective: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis, a large number of patients with PsA that has persistent inflammation may develop progressive joint damage and disability and have reduced life expectancy. This study aims to determine the associations of anti-cyclic citrullinated peptide (CCP) antibodies in adult patients with psoriasis and PsA.

Methods: A case–control study was conducted at Baghdad teaching hospital, Units of Rheumatology and Dermatology, during the period from December 2016 to April 2017 including three groups; 40 patients with psoriasis, 40 patients with PsA fulfilling the CASPAR classification criteria, and 40 healthy control persons.

Results: Two patients with psoriasis (5%) and 10 patients with PsA (25%) were seropositive for anti-CCP antibodies (ACPA). Healthy controls were negative for anti-CCPA. Regarding ACPA positivity, a significant difference was found between those three studied groups (p<0.001) and there was a significant difference between positive and negative ACPA in PsA patients regarding disease activity score (p=0.044).

Conclusion: Positive ACPA were found more significant with PsA than in patients with psoriasis as well as associated with higher disease activity.


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Chimenti MS, Ballanti E, Perricone C, Cipriani P, Giacomelli R, Perricone R, et al. Immunomodulation in psoriatic arthritis: Focus on cellular and molecular pathways. Autoimmun Rev 2013;12:599-606.

Gladman DD, Stafford-Brady F, Chang CH, Lewandowski K, Russell ML. Longitudinal study of clinical and radiological progression in psoriatic arthritis. J Rheumatol 1990;17:809-12.

Nerkar D, Mukherjee A, Mehta BK, Banerjee S. Metabolic syndrome associated complications. Int J Pharm Pharm Sci 2015;7:22-5.

Syngle A, Verma I, Kaur S, Syngle T. Interleukin-17inhibition with secukinumab improves sudomotor dysfunction in psoriatic arthritis. Int J Pharm Pharm Sci 2018;10:169.

Kleinert S, Feuchtenberger M, Kneitz C, Tony HP. Psoriatic arthritis: Clinical spectrum and diagnostic procedures. Clin Dermatol 2007;25:519-23.

Ralston SH, McInnes IB. Rheumatology and bone disease. In: Walker BR, Colledge NR, Ralston SH, Penman ID, editors. Davidsons Principles & Practice of Medicine. 22nd ed. London: Chrchill Livingstone; 2014. p. 1108.

Schellekens GA, Visser H, de Jong BA, van den Hoogen FH, Hazes JM, Breedveld FC, et al. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 2000;43:155-63.

Schellekens GA, de Jong BA, van den Hoogen FH, van de Putte LB, van Venrooij WJ. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. J Clin Invest 1998;101:273-81.

Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, et al. Classification criteria for psoriatic arthritis: Development of new criteria from a large international study. Arthritis Rheum 2006;54:2665-73.

Alitaha D, Smolen JS. Evaluation and outcomes of patients with rheumatoid arthritis. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, editors. Rheumatology. 4th ed. Philadelphia, USA: Mosby Elsevier; 2011. p. 945-53.

Prevoo ML, Van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty -eight joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. ArthritisRheum 1995;38:44-8.

Alenius GM, Berglin E, Rantapää Dahlqvist S. Antibodies against cyclic citrullinated peptide (CCP) in psoriatic patients with or without joint inflammation. Ann Rheum Dis 2006;65:398-400.

Abdel Fattah NS, Hassan HE, Galal ZA, El Okda el SE. Assessment of anti-cyclic citrullinated peptide in psoriatic arthritis. BMC Res Notes 2009;2:44.

Candia L, Marquez J, Gonzalez C, Santos AM, Londoño J, Valle R, et al. Low frequency of anticyclic citrullinated peptide antibodies in psoriatic arthritis but not in cutaneous psoriasis. J Clin Rheumatol 2006;12:226-9.

Bogliolo L, Alpini C, Caporali R, Scirè CA, Moratti R, Montecucco C, et al. Antibodies to cyclic citrullinated peptides in psoriatic arthritis. J Rheumatol 2005;32:511-5.

Inanc N, Dalkilic E, Kamali S, Kasapoglu-Günal E, Elbir Y, Direskeneli H, et al. Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 2007;26:17-23.

Vander Cruyssen B, Hoffman IE, Zmierczak H, Van den Berghe M, Kruithof E, De Rycke L, et al. Anti-citrullinated peptide antibodies may occur in patients with psoriatic arthritis. Ann Rheum Dis 2005;64:1145-9.

Korendowych E, Owen P, Ravindran J, Carmichael C, McHugh N. The clinical and genetic associations of anti-cyclic citrullinated peptide antibodies in psoriatic arthritis. Rheumatology (Oxford) 2005;44:1056-60.

Shibata S, Tada Y, Komine M, Hattori N, Osame S, Kanda N, et al. Anti-cyclic citrullinated peptide antibodies and IL-23p19 in psoriatic arthritis. J Dermatol Sci 2009;53:34-9.

Popescu C, Zofotă S, Bojincă V, Ionescu R. Anti-cyclic citrullinated peptide antibodies in psoriatic arthritis–cross-sectional study and literature review. J Med Life 2013;6:376-82.

Behrens F, Koehm M, Thaçi D, Gnann H, Greger G, Maria Wittig B, et al. Anti-citrullinated protein antibodies are linked to erosive disease in an observational study of patients with psoriatic arthritis. Rheumatology (Oxford) 2016;55:1791-5.

Perez-Alamino R, Garcia-Valladares I, Cuchacovich R, Iglesias-Gamarra A, Espinoza LR. Are anti-CCP antibodies in psoriatic arthritis patients a biomarker of erosive disease? Rheumatol Int 2014;34:1211-6.

Maejima H, Aki R, Watarai A, Shirai K, Hamada Y, Katsuoka K, et al. Antibodies against cyclic citrullinated peptide in Japanese psoriatic arthritis patients. J Dermatol 2010;37:339-45.



How to Cite

Al-bedri, K., Z. A. Mahmood, and A. Hussein Sadeq. “ASSOCIATION OF ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY IN A SAMPLE OF ADULT PATIENTS WITH PSORIASIS AND PSORIATIC ARTHROPATHY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 11, Nov. 2018, pp. 385-8, doi:10.22159/ajpcr.2018.v11i11.28577.



Original Article(s)