Qualitative Assay of Synovial MAGE-1 m-RNA as a New Trend in Diagnosis of Rheumatoid Arthritis

Document Type : Original Article

Authors

1 Medical Biochemistry Department, Faculty of Medicine, Zagazig University

2 Rheumatology & Rehabilitation, Department, Faculty of Medicine, Zagazig University

Abstract

Rheumatoid Arthritis (RA) is the commonest inflammatory joint disease, affecting
nearly 1% of the adult population worldwide. Its diagnosis depends on clinical
symptoms, laboratory investigations and imaging. The emphasis in the management
of this disease is early diagnosis and intervention. Diagnostic specificity of
rheumatoid factor (RF) for RA is poor since it is also found in many other rheumatic
and non-rheumatic diseases. Anticyclic citrullinated peptide (anti-CCP) was reported
to have a high specificity for RA diagnosis, especially in patients with early disease.
However, it was found to have lower sensitivity than RF in RA diagnosis. This study
aimed to evaluate the expression of MAGE-1 mRNA by the synovial fluid cells from
inflamed joints, and the serum levels of anti-CCP as biochemical markers for the
early diagnosis of RA. The study included 30 subjects of both sexes: 10 controls
with traumatic knee joint effusion and 20 rheumatoid arthritis patients. Both
Serum RF and anti-CCP were determined quantitatively by enzyme-linked
immune-sorbent assay (ELISA). The expression of MAGE-1 mRNA by the synovial
fluid cells obtained from the inflamed joints is evaluated by applying reverse
transcription-PCR amplification. MAGE-1 mRNA was detected in synovial fluid cells
of all patients but not in controls. There was significant increase (P < 0.01) of
both serum RF IgM and anti-CCP in rheumatoid patients group when compared to
control one. There was significant positive correlation (r = 0.928; P = < 0.01)
between serum RF IgM and anti-CCP. The specificity of MAGE-I, Anti-CCP and RF
in RA diagnosis was 100%, and the sensitivity of both MAGE-I and Anti-CCP was
100% while that of RF was 85%. Conclusively, the expression results of MAGE-1
transcript in synovial fluid were 100% positive encouraging its utilization as a
biochemical marker for RA diagnosis. The combined use of serum anti-CCP and
MAGE-1 transcript in the synovial fluid cells is recommended for early diagnosis of
RA.

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