Rheumatoid factors are a class of immunoglobulin’s which have a different type of affinities. Its discovery was made a long time ago but its underlying mechanism is undergoing production, physiologic ability, and pathological factors. Studies have offered description pertaining promotion of agglutination based in sheep red blood cells sensitized by sub agglutinating antibodies. Studies have shown that they are found among patients’ with autoimmune and nonautoimmune conditions. Rheumatoid factors are part of anti- Cyclic citrullinated peptide bodies which are moderately sensitive and marking often improves diagnostic accuracy (Falkenburg, von Richthofen & Rispens, 2019).
The immunoglobulin’s ant bodies against Fc fragments of the immunoglobulin are referred to as rheumatoid factors. With its production found in B cells, they circulate in the blood. Their role is largely unknown. It is estimated that about 60%-80% of persons with rheumatoid factors have the presence of rheumatoid arthritis during their disease course. RF positive results are found in less than 40% of patients with early rheumatoid factors. The rheumatoid factor levels often vary based on disease activity even in cases of drug-induced remissions due to high titration of rheumatoid factor (Anquetil et al., 2015).
Rheumatoid factors are measurable by the use of blood tests routine. Rheumatoid factors are normal proteins within the body immune system. Rheumatoid antibody offers to bind to normal antibodies and is generally referred to as autoantibody. Rheumatoid factors have been historically been measured using assays (Mori, Hirose & Yonemura, 2010).
The clinical benefits of rheumatoid assessment are crucial in the Assesment of rheumatoid factors. This results in approximately 755 of the patients with rheumatoid factors. High rheumatoid factors often indicate poor patient prognosis as compared to patients’ with higher RF who tend to be having more severity of the disease. The consequential occurrence of rheumatoid factors causes inflammatory disease which results in progressive functional limitation, physical disability a premature. Rheumatoid extraction often gets an economic toll in terms of directs costs related to the production of productivity and premature mortality. The therapy has been shown to have slow effects in preventing disability and thus reduced associated costs. The establishment of benefit assessment is crucial in treatment costs (Waritani et al., 2017).
Diagnostic biomarkers have been used to show identification of rheumatoid factor and the identification in the early stages is essential in the prevention of erosion and stop the progression of radiologic changes. Currently, the ACR/ EULAR 2010 is the diagnosis guidelines which are used in the assessment of rheumatoid factors against Cyclic citrullinated proteins. Ventolin protein has been used as citrullinated d reaction dedicated by peptide arginine which has the formation of anti-vimentin antibodies. In order to improve its quality, additional change is often required. Additional change often influences vimentin antigenic, with glycine formation leading to mutated citrullinated vimentin antibodies. This biomarker has been essential in treating and diagnosis rheumatoid arthritis among apoproteins testing positive (Luime et a.,2010).
Biological biomarkers are objective assessments which are used as indicators of normal and pathological assessments on therapies. Among patients with rheumatoid arthritis, it reflects the key rheumatoid factor which is essential in assessing the disease activity. Rheumatoid arthritis allows for variable disease with joint injury and early identification of patients with the disease is likely to benefit from aggressive intervention. The key useful biological markers in the diagnosis for rheumatoid arthritis entail these of rheumatoid factors and antibody assessment. The presence of rheumatoid factors predicts the various functional and radiographic factors.
In the assessment of rheumatoid factor isotypes, the IgA, IgG, and IgM are often investigated with specimen type used being serum. The application of RF assay using the Elisa method has been applied (Aydin, 2015).
ELISA assessment entails the immobilization of the cells of the sample cells which are achieved through direct adsorption which is the specific surface on housing capture antibody. The capture antibody is essential in proving specific target antigen thus leading to the formation of capture antibody.
The RF describes the antibodies in term so of IgG and IgA which is directed towards antigenic determinants which are found in animals. The RF-IgM activity is often detected by agglutination, nephelometry and random assay linked in the immunosorbent essays which ELISA and EIA have used sued as the best techniques to measure rf-IgM activity (He, 2013).
The used diagnostic specificity of 20% and a predictive value of 10% is used to tests for Rheumatoid factor has been shown to be low. The specificity and predictive value can be increased simultaneously by measuring the three isotypes. The principle method being used is the RF3 assay which employs quantitative methods of sandwich through immune assay principle.
The role of rheumatoid factors on the identification of patients is crucial and plays a critical role in disease significance. The use of Rheumatoid factors is essential in identifying the patient state. In order to increase the underlying specificity in Assesment of rheumatoid arthritis, a classification criterion has been used, the anti-cyclic citrullinated protein antibody testing has been added in order to improve specificity. Meat analysis studies have indicated that the use of anti-cyclic citrullinated protein/peptide antibody and rheumatoid factor are similar, however, anti-cyclic citrullinated protein/peptide antibody has more specificity (Rissin et al., 2010).
The rheumatoid factors steps use the ELISA technique in the detection of IgM antibodies. The purified forms of antigen are bound to be formed. The patient serum samples are assessed for the antibody is first diluted and added well. In the presence of the antibody, the serum antigen-antibody forms complexes. After washing off the unbound serum, the addition of horseradish peroxidase-conjugated anti-human IgM is done. The conjugate will form binding on the human antibody which is present (Tylor, 2014).
The immunosorbent essays which ELISA kit is found as a commercial product. It is a strip or full plate ELISA kit. It is essential for analyzing the presence of rheumatoid factor. ELISA kit target analyst in the biological samples. The resultant concentration gradients use the standards kit positive control in detecting a range of various biological research samples which has a rheumatoid factor. The ELISA analytical antibody factor antigens interact and use an HRP calorimeter detection method to detect Rheumatoid factor antigen. The quality control in this approach uses reproducibility in identifying intro essay and interassay (Agarwal, Ressler & Snyder, 2015).
The kit can be undertaken at the point of sale for the patient. Rheumatoid factor is an indirect solid phase enzyme which is used as an enzyme immunoassay for assessment of rheumatoid factors in human serum or plasma. The intended objective of the assay is to assess diagnostic use to ain rheumatoid arthritis. Companion diagnostics offers a test which assesses biomarker thus allowing for classifying patients into the response and no responses.
The future growth of companion diagnostics will be simply on the bases of a thriving ecosystem. Companion diagnostics have been used as an assay. The ELISA assay is often used as a gold standard for assessment of analyte in the blood and other fluids. ELISA measurement is accurate and reproducible upon generation of color and controlled conditions. It employs antibody and chromogenic detection system analogs principle method (Murdock et al., 2013).
ELISA adaptation has been sued on enzyme linked to quantitative analysis. There are enzyme-linked immunosorbent presences of antibody in a variety of samples. Various types of ELISA have been sued to detect proteins, viruses, and drugs. The most common application of ELISA is the use of toxicants. This assay has been sued extensively in analyzing analyte. The procedure entails the addition of antigen which coats on the solid support surface. Thereafter an enzyme is linked to an enzyme which is added to the antibody complex.
ELISA assay is useful in evaluating the presence of antigen in a sample. It is crucial in determining serum antibody concentrations. This assay technology has been used in applications related to the food industry and in the detection of potential allergens in foods produced and also used as a serological blood test for celiac disease. Further it has been used in toxicology as a presumptive screen for certain drugs. It has been widely been used in testing of HIV due to its high sensitivity. In ELISA Assay, dilution of serum is done 400 times and applied on the plate which has HIV antigens, if their presence of antibodies, they can bind to the antigens. A specially prepared antibody is formed which binds and advanced linkage made on the enzyme. The plate will contain the enzyme, The resultant plate enzyme in proportion on the secondary antibody of the plate (Ingegnoli, Castelli & Gualtierotti, 2013).
Since a long time, Enzyme-Linked Immunosorbent Assay is primarily used for the detection of analytes. The ELISA was the first method used in assessing HIV due to its high sensitivity. ELISA is a versatile and effective method which can adapt well with technological advancements. Prior to ELISA introduction, urine swap was used for assessing pregnancy among women through other means. Over the years technology has changed the transformation of technology, there are immense changes which have transpired on the rise of polymerase chain reactions development (Arellano?Garcia et al., 2008).
PCR was used to incubate and assess various reactions, despite these advances in the technology and innovations brought about, ELISA assay has remained the same for many years. Radioimmunoassays are often sensitive methods which use isotopes. the automation part is designed to offer full assays or individual steps such as delicate wash process and reduce the setup time. Numerous variants still provide the versatility and possibilities for future developments and investigations into the assay.
Enzyme-Linked Immunosorbent Assay for RF displays great diagnostic tool due to its highly sensitive methods, various approaches have been used such as proving of the fingerprint to identify of bio-isolators been proposed. ELISA assay still provides an important approach to this. Exciting avenues such as the use of ELISA provide a link between ADCC ELISA and the association of measuring ELISA to measure ADCC (Vashist & Luong, 2018).
The essence of diagnostic biomarkers is essential in medical practice which ensures accurate diagnosis of diseases and conditions. Diagnostic biomarkers are essential in critical for determination for the medical condition facing the patient. There is an increasing appreciation on the use of treatment has been indicative of specific treatments of various markers, for example, those that predict the likelihood of occurrence of other diseases. Path physiologic markers such as preserved ejection can reduce the responding treatments such as predictive biomarker. The genetic markers are often used to distinguish responders and no responders who can respond to different treatments avenues such as those in cancer treatments. Thus diagnostic biomarker identifies the disease and nonrespondents play a critical role in the results of diagnostic classification used biomarkers and predictive markers (Vashist et al., 2016).
The key importance of accurate on diagnosis warrants assessments of the clinical performance of diagnostic biomarkers. Diagnostic biomarkers are essential for testing diseases. The diagnostic markers have been used in combination with prognostic and predictive markers. Prognostic markers are sued to provide information on likely cause of cancer in an untreated individual. In low risks, early disease markers guide patients in identifying patients who need post-surgical chemotherapy. Predictive markers are used to identify patients for specific therapies. They are essential in predicting the likely benefit for the patients. Utility predictive markers are established (Gualtierotti, Ciavarella & Meroni, 2014).
Conclusion
Rheumatoid factors belong to IgM type antibodies which interact with assay antibodies at the FC areas. Often RFs present serum assessment for the patient with rheumatoid arthritis. Assessment of the concentration of serum or plasma has been undertaken using commercial available immune essays. Clinical assessment shaves been used in assessing immunosorbent assays for IgM and IgG rheumatoid factors assessed in a series of assessments. This essay reflected on the application of ELISA assays in the assessment of rheumatoid factor towards assessment of rheumatoid arthritis. In this review, diagnostic biomarkers have been used to identify the antigens. Future applications of the Assays show strong utilization in the future due to its high predictive and sensitivity values it has.
References
Agarwal, A., Ressler, D., & Snyder, G. (2015). The current and future state of companion diagnostics. Pharmacogenomics and personalized medicine, 8, 99.
Anquetil, F., Clavel, C., Offer, G., Serre, G., & Sebbag, M. (2015). IgM and IgA rheumatoid factors purified from rheumatoid arthritis sera boost the Fc receptor–and complement-dependent effector functions of the disease-specific anti–citrullinated protein autoantibodies. The Journal of Immunology, 194(8), 3664-3674.
Arellano?Garcia, M. E., Hu, S., Wang, J., Henson, B., Zhou, H., Chia, D., & Wong, D. T. (2008). Multiplexed immunobead?based assay for detection of oral cancer protein biomarkers in saliva. Oral diseases, 14(8), 705-712.
Aydin, S. (2015). A short history, principles, and types of ELISA, and our laboratory experience with peptide/protein analyses using ELISA. Peptides, 72, 4-15.
Falkenburg, W. J., von Richthofen, H. J., & Rispens, T. (2019, February). On the origin of rheumatoid factors: insights from analyses of variable region sequences. In Seminars in arthritis and rheumatism (Vol. 48, No. 4, pp. 603-610). WB Saunders.
Gualtierotti, R., Ciavarella, T., & Meroni, P. L. (2014). Rheumatoid Factors. In Autoantibodies (pp. 751-760). Elsevier.
He, J. (2013). Practical guide to ELISA development. In The Immunoassay Handbook (pp. 381-393). Elsevier.
Ingegnoli, F., Castelli, R., & Gualtierotti, R. (2013). Rheumatoid factors: clinical applications. Disease markers, 35(6), 727-734.
Mori, S., Hirose, J., & Yonemura, K. (2010). Contribution of HLA-DRB1* 04 alleles and anti-cyclic citrullinated antibodies to development of resistance to disease-modifying antirheumatic drugs in early rheumatoid arthritis. Clinical rheumatology, 29(12), 1357-1366.
Murdock, R. C., Shen, L., Griffin, D. K., Kelley-Loughnane, N., Papautsky, I., & Hagen, J. A. (2013). Optimization of a paper-based ELISA for a human performance biomarker. Analytical chemistry, 85(23), 11634-11642.
Rissin, D. M., Kan, C. W., Campbell, T. G., Howes, S. C., Fournier, D. R., Song, L., … & Ferrell, E. P. (2010). Single-molecule enzyme-linked immunosorbent assay detects serum proteins at subfemtomolar concentrations. Nature biotechnology, 28(6), 595.
Taylor, C. R. (2014). Predictive Biomarkers and Companion Diagnostics. The Future of Immunohistochemistry–‘in situ proteomics’, or just a ‘stain’?. Applied immunohistochemistry & molecular morphology: AIMM/official publication of the Society for Applied Immunohistochemistry, 22(8), 555.
Vashist, S. K., & Luong, J. H. (2018). Enzyme-Linked Immunoassays. In Handbook of Immunoassay Technologies (pp. 97-127). Academic Press.
Vashist, S. K., Venkatesh, A. G., Schneider, E. M., Beaudoin, C., Luppa, P. B., & Luong, J. H. (2016). Bioanalytical advances in assays for C-reactive protein. Biotechnology advances, 34(3), 272-290.
Waritani, T., Chang, J., McKinney, B., & Terato, K. (2017). An ELISA protocol to improve the accuracy and reliability of serological antibody assays. MethodsX, 4, 153-165.
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