الفهرس 
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Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease with symmetrical peripheral polyarthritis, predominantly involving the small joints. It occurs more commonly in women than in men with a 2–3:1 ratio. the most common age group that suffers from RA are those in the 30–50.
The typical manifestations of RA include pain in one or more joints over several weeks to months and morning, which usually improves with exercise.
With the increasing recognition of RA and development of novel treatment strategies, early diagnosis and prompt treatment may result in some patients achieving remission status or low disease activity & reduces the permanent disability which has essential rule in the long term outcome of the disease and its progression.
Early diagnosis and treatment is possible currently with the anti-CCP antibody and RF which are a part of the 2010 ACR/ EULAR classification criteria for RA.
Collagen triple helix repeat containing-1 (CTHRC1) was found strongly associated with the murine proteoglycan-induced arthritis severity and collagen antibody-induced murine arthritis (CAIA).
This study is designed to evaluate levels of CTHRC1 protein in RA patients in order to detect its role as a diagnostic marker and its possible association with disease activity.
We conducted our study on 25 RA patients, and 25 normal healthy individuals served as a control group. The patient and control groups were subjected to full history taking, thorough clinical examination & laboratory investigations.
Serum levels of CTHRC1 was measured in all patients and controls.
The present study revealed that the serum levels of CTHRC1:
1. Significantly higher in patients than control group (highly significant difference of p<0.001 between the two groups) indicating its ability to differentiate rheumatoid arthritis from healthy status as it was found in activated fibroblast-like synoviocytes (FLS) in the inflamed synovium in rheumatoid arthritis and in plasma from patients with RA, but CTHRC1 was found to have low physiological levels in healthy controls.
2. Significantly higher in early disease group than controls & late disease group (P values <0.001) denoting its diagnostic value in rhumatoid arthritis during early disease process and therefore its future possible use as diagnostic biomarker.
3. Cut of point was >29 ng/ml diagnoses RA with sensitivity of 100% and specificity of 88% therefore serum CTHRC1 is a promising biomarker for evaluation of RA patients. It can be used in RA diagnosis with high sensitivity and specificity.
4. Have positive correlation with RF and ACPA which is helpful for the confirmed diagnosis of RA. And because many patients were found falsely negative for RF and ACPA, CTHRC1 could be the future marker of choice to detect patients in this serological gap.
Conclusion:
Patients with RA had elevated levels of serum CTHRC1 compared to controls. A significant high level of CTHRC1 was found in early disease duration patients than controls and late disease duration patients. So, this data stated that addition of CTHRC1 as a serological marker is of great value of diagnosis of RA especially in early disease duration.