Search For a Biomarker For The Diagnosis And Prognosis of Rheumatoid Arthritis Prasanth G, Sunil Rao Padmaraj, Vijayakumar T & Riju Mathew Abstract Rheumatoid Arthritis (RA) is one of the commonest systemic autoimmune disease. Diagnosis of Rheumatoid Arthritis is based on the detection of Rheumatoid factor (RF) and Anti cyclic citrullinated peptide Antibody (ACCP) .But these markers have limited use in predicting the prognosis of the disease. Hematological and Inflammatory markers are indicators of disease activity .Correlation of the various biomarkers would be beneficial in effective treatment and management of the condition .An attempt is being made to correlate the conventional markers like RF and ACCP with the newer marker Anti Sa Antibody (Anti Sa) and hematological parameters such as Hemoglobin (Hb) , Red cell Distribution Width (RDW) and Erythrocyte Sedimentation Rate (ESR).It was observed that these parameters together serve as better biomarkers for the diagnosis and prognosis of RA. Index terms Rheumatoid Arthritis, Anti Sa Antibody, Anti cyclic citrullinated peptide (ACCP), Rheumatoid factor(RF), Chemiluminescence microparticle Immunoassay (CMIA) ,Immunonephelometry,Red cell distribution width (RDW),Erythrocyte sedimentation rate (ESR),haemoglobin (Hb) ------------------------------------------------xxx----------------------------------------- Introduction Rheumatoid arthritis is one of the commonest autoimmune disorders affecting the joints causing mild inflammation to serious complications. Detection of Rheumatoid factor was considered as the diagnostic tool until the more specific markers like cyclic citrullinated peptide antibodies(ACCP) were discovered 1,2 . ACCP is now considered as one of the very specific marker for RA. But most of these markers has very poor prognostic value and often present in detectable amounts even after appropriate treatment and management 3 . Recently, a new immunological marker Anti Sa was discovered which has very high specificity for RA with relatively low sensitivity when compared to RF & ACCP 4 . There are studies which highlights the prognostic significance of Anti Sa especially in the diagnosis and management of cases of erosive arthritis 5 . Hematological abnormalities especially high ESR and increased levels of inflammatory markers like C Reactive protein (CRP) and fibrinogen is also associated with RA. ———————————————— x Prasanth.G is currently pursuing PhD degree program at Yenepoya University: Email prasanthg4u@gmail.com x Dr Sunil rao Padmaraj is currently,Professor , Research guide & HOD Microbiology at Yenepoya University x Dr Vijayakumar T isProfessor,Research guide &Chief of Basic Medical Sciences at Educare Institute of dental Sciences x Riju Mathew is currently pursuing PhD degree program at Yenepoya University: There are studies indicating a positive correlation between RDW ,ESR & CRP in Rheumatoid Arthritis 6,7 . Anemia is also considered to be factor leading to low haemoglobin concentrations which in turn could affect the red cell distribution width 8 .As none of these markers individually is found useful in diagnosis and prognosis, the present study was undertaken to evaluate the conventional and new biomarkers in Rheumatoid Arthritis patients. Materials and Methods The study was carried out at Educare Institute of Dental Sciences. Twenty clinically proven cases of RA as per American college of Rheumatology (ACR) criteria form the test group. Twenty age and sex matched subjects selected from the siblings and the staff of the hospital form the control group. None of the patients were suffering from any disease other than RA while the control subjects had no chronic or acute illness, autoimmune disease and was not on any medication. Blood samples were collected from all the subjects after obtaining their informed consent and the following investigations were carried out. Haemoglobin & RDW using Sysmex KX 21 analyser,ESR by Westergrens method RF, by Immunonephelometry on Siemens BN Prospec analyzer, Anti CCP on Abbott Architect Chemiluminescence microparticle Immunoassay analyzer and Anti Sa by Euroimmun ELISA. The results were analysed using Minitab & SPSS statistical software. International Journal of Scientific & Engineering Research, Volume 5, Issue 2, February-2014 ISSN 2229-5518 72 IJSER © 2014 http://www.ijser.org IJSER