REVIEW - Anti-CCP antibodies and RA

[Guest guest]

Rinsho Byori. 2010 May;58(5):466-79.

[Anti-cyclic citrullinated peptide antibodies and rheumatoid arthritis]

[Article in Japanese]

Hayashi N, Kumagai S.

The Center for Rheumatic Diseases, Shinko Hospital, Kobe 651-0072, Japan.

Abstract

Rheumatoid arthritis (RA) is a severe, progressive, systemic

inflammatory disease of unknown etiology. Early diagnosis of RA is

important to identify individuals who will develop severe destructive

disease, so that effective treatment can be initiated before

irreversible damage occurs. Rheumatoid factor (RF) has been commonly

used as a serological marker for RA, although RF had a tolerable

sensitivity of 75.9% for RA, but low specificity of 78.7% and 75.4%

for patients with other rheumatic diseases and chronic inflammatory

disease, respectively. Antibodies to citrullinated protein/peptide

antigens, i.e., to peptides post-translationally modified by the

conversion of arginine to cilrulline (ACPA), are specific serological

markers for RA. Not only did anti-cyclic citrullinated peptide

antibody (anti-CCP) demonstrate a higher sensitivity of 78.5% when

compared to RF, but anti-CCP also had a much higher specificity of

95.9% and 97.9% for other rheumatic diseases and chronic inflammatory

disease patients, respectively. Moreover, meta-analysis revealed that

pooled sensitivity and pooled specificity were 67% and 95% for

anti-CCP, 69% and 85% for RF, respectively, and that anti-CCP was more

specific than RF for diagnosing RA. In 2009, ACPA (anti-CCP) was

included in the new Criteria for RA from the American College of

Rheumatology and the European League Against Rheumatism. Anti-CCP

testing is particularly useful in the diagnosis of RA, being present

early in the disease process, and able to predict severe disease and

irreversible damage. In addition, the titers might be early predictors

of the efficacy of anti-TNF therapy. In this review, we discuss the

historical background of anti-CCP as well as its diagnostic

performance, usefulness for early diagnosis, prognostic capability,

and pathogenesis of RA.

PMID: 20560456

http://www.ncbi.nlm.nih.gov/pubmed/20560456

Not an MD