RESEARCH - The use of citrullinated peptides and proteins for the diagnosis of RA

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Arthritis Res Ther. 2010; 12(1): 203.

Published online 2010 February 15. doi: 10.1186/ar2903.

The use of citrullinated peptides and proteins for the diagnosis of

rheumatoid arthritis

Ger JM Pruijn,1 Allan Wiik,2 and Walther J van Venrooij1

1Department of Biomolecular Chemistry 271, Nijmegen Center for

Molecular Life Sciences, Institute for Molecules and Materials,

Radboud University Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, the

Netherlands

2Digesmuttevej 10, DK-2970 Hoersholm, Denmark

Abstract

The presence or absence of antibodies to citrullinated

peptides/proteins (ACPA) is an important parameter that helps a

clinician set a diagnosis of early rheumatoid arthritis and, hence,

initiate treatment. There are several commercial tests available to

measure ACPA levels, although it can be difficult to decide what the

best test for a given clinical question is. We analyzed literature

data in which the diagnostic and other properties of various ACPA

tests are compared. The results show that for diagnostic purposes the

CCP2 test has the highest specificity, the highest sensitivity in

stratified studies and the highest positive predictive value. For the

prediction of future joint destruction the CCP2, MCV, and CCP3 tests

may be used. The ability to predict the likelihood of not achieving

sustained disease-modifying antirheumatic drug-free remission was

highest for the CCP2 test. Finally, the levels of anti-CCP2 and

anti-CCP3 (and possibly anti-mutated citrullinated vimentin) in

rheumatoid arthritis patients are not significantly influenced by TNFα

blocking agents.

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Read the full article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875630/

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