Antibodies to cyclic citrulline peptide (Anti CCP)

Rheumatoid Arthritis (RA) Is a systemic autoimmune disease that affects approximately 0,5-1% of the adult population. Characterized by inflammation, synovial hyperplasia, autoantibody production, cartilage and bone destruction, progressive functional impotence with joint deformities and possible external manifestations (cardiovascular, pulmonary, cutaneous, neurological). Early therapeutic intervention is vital to prevent irreversible damage to the joints and it is therefore very important that this disease be diagnosed at an early stage.

The 1987 American College of Rheumatology (ACR) classification is widely used in the diagnostics of RA; However, it has many limitations, mainly based on clinical symptoms that are often not found in the early stages of the disease. For this reason, it is necessary to use specific serological markers to identify patients who may benefit from aggressive methods of treatment.

The first described antibody associated with rheumatoid arthritis was rheumatoid factor (FR), although it has significant diagnostic limitations. The discovery of citrulline protein autoantibodies (ACPA) even substantially improved the diagnostics of rheumatoid arthritis in the early stages of the disease.

Citrulline Is a widely used, non-essential amino acid that is an intermediate product in urea metabolism. The enzyme peptidyl-arginine deaminase (PAD), which is found in large amounts in synovial fluid during inflammation (in the form of PAD2 and PAD4 isoforms), catalyzes the conversion of arginine contained in synovial fluid proteins to citrulline. PAD2 and PAD4 isoenzymes citrulline synovial proteins, including vimentin. next time Cyclic citrulline peptides Activate T-lymphocytes and bind to HLA-DR4 (human leukocyte antigen) on the surface of its presenting cells. Cyclic citrulline peptide antibodies (anti-CCP antibodies) It is detected in 76% of patients with rheumatoid arthritis. The diagnostic sensitivity of these antibodies to RA is 78%, specificity - 96%. The study of these antibodies is used for early diagnostics of the disease, since the frequency of their detection is higher in patients with a short history of the disease compared to other antibodies. The presence of A-CCP in the body may be a prognostic indicator of the development of erosive rheumatoid arthritis.

When should we take the test?

• Diagnosis of RA in the early stages;
• Differential diagnostics of inflammatory processes in the joints;
• Defining therapeutic strategies.

How to prepare for the test?

No special preparation is required for the test. The results are not affected by food, drink or other products.

Research material

Venous blood

Possible interpretation of the results

Concentrations of antibodies against cyclic citrulline peptide increase:

• მაevmatoid arthritis;
• Other connective tissue diseases (especially systemic lupus erythematosus).

Resources

https://www.synevo.bg/revmatoiden-artrit/
https://spravochnik.synevo.ua/ru/revmatoidnaia-panel/id1028.html