14.3.3 ETA, Rheum. Arthritis

Optimal Result: 0 - 0.2 Units.

14-3-3 eta is a protein released from inflamed joint tissue. It acts as a pro-inflammatory mediator and is implicated in the erosive joint damage seen in rheumatoid arthritis (RA). Levels can be elevated in both early and established RA.

Why 14-3-3 eta is tested

RA can be challenging to diagnose early. Traditional markers like Rheumatoid Factor (RF) and Anti-CCP (Cyclic Citrullinated Peptide) antibodies help—but they’re not positive in everyone, especially early on. Serum 14-3-3 eta adds diagnostic sensitivity, helping identify patients who might otherwise be missed.

  • Diagnostic value: 14-3-3 eta is highly specific for RA. In early disease, it can provide about a 15% incremental detection benefit on top of RF and Anti-CCP—meaning ~15% more early RA patients may be identified when this marker is included alongside those tests.

  • Disease activity & prognosis: Positive 14-3-3 eta is associated with higher rates of radiographic joint damage (e.g., Sharp/van der Heijde scoring). Levels ≥ 0.50 ng/mL have been linked to more rapid radiographic progression, even in patients who appear clinically quiet (e.g., in SDAI remission).

How to interpret results for 14-3-3 eta

  • Within reference (< 0.20 ng/mL):
    This is considered negative. A value in range does not rule out RA, especially if symptoms (joint pain, morning stiffness, swelling) persist. Your clinician will weigh this result with symptoms, exam, imaging, and other labs (RF, Anti-CCP, CRP, ESR).

  • Elevated (≥ 0.20 ng/mL):
    Supports an RA diagnosis when considered with clinical findings.

    • ≥ 0.50 ng/mL: Signals higher risk for faster joint damage progression on imaging, even if you’re feeling relatively well. This level may prompt closer monitoring and a discussion about earlier or more targeted therapy.

What affects the result of 14-3-3 eta

14-3-3 eta reflects joint-derived inflammation and erosive activity. Levels may shift with disease activity and treatment response. Your provider may trend this marker over time together with clinical scores (e.g., SDAI, DAS28) and imaging.

What to do next

  • If elevated:

    • Discuss results promptly with your rheumatologist.

    • Ask whether your current treatment plan adequately addresses progression risk, especially if ≥ 0.50 ng/mL.

    • Consider combining this marker with RF, Anti-CCP, CRP, ESR, and (when appropriate) ultrasound or X-ray to establish a baseline and monitor change.

  • If in range but symptoms persist:

    • A negative result doesn’t exclude RA. Keep a symptom diary (duration of morning stiffness, swollen joints, fatigue).

    • Follow up for a full work-up: exam, imaging, and complementary labs.

Related tests

  • RF and Anti-CCP antibodies: Core RA serologies.

  • CRP and ESR: Systemic inflammation/activity.

  • Imaging: Ultrasound, X-ray/MRI for erosions and synovitis.

  • Composite indices: SDAI, DAS28 to track control over time.

Key evidence

  • Early detection benefit: Adding 14-3-3 eta to RF and Anti-CCP improves early RA detection by ~15%.

  • Radiographic risk: Positive 14-3-3 eta correlates with higher radiographic damage; ≥ 0.50 ng/mL predicts faster progression, even in SDAI remission.

Notes: This test was developed and analytically validated by the performing laboratory (e.g., Labcorp) and may not be FDA-cleared; it is used for clinical decision-making under applicable regulations. Results should be interpreted by a qualified clinician.

References

  1. Carrier N, et al. Arthritis Res Ther. 2016;18:37.

  2. Maksymowych WP, et al. Arthritis Res Ther. 2014;16:R99.

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