New Test Available
Anti Cyclic Citrullinated Peptide
As an aid in diagnosis of Rheumatoid Arthritis (RA)
RA is one of the most common systemic autoimmune diseases. The etiology of the disease is unknown. It is characterized by chronic polyarthritis. Being highly variable and of unpredictable disease course are the underlying reasons for the search for diagnostic and prognostic factors.
RA is diagnosed primarily according to clinical manifestations. The serological support is restricted to the determination of IgM rheumatoid factor (RF), which has low specificity as it may be found in healthy elderly individuals, healthy immunized persons and patients with other autoimmune diseases or chronic infections.
Despite decades of study and the development of series of classification criteria, the diagnosis of RA remains empirical and imprecise, particularly early in the course of the disease. The ability to identify the patients who will have progressive erosive disease remains objective, because this subset may benefit most with early aggressive treatment. Because the potentially toxic second - line drugs can cause serious side effects, diagnostic tests with high specificity for RA are desirable.
Anti-CCP as a new diagnostic test has been reported to be of excellent specificity (95%-100%) which is even increased by combining the test with RF. The predictive value of anti CCP is better than RF IgM; it is useful for diagnostic and therapeutic strategies in patients with recent onset arthritis and is useful if performed concomitantly with RF assay to diagnose patients with suspected RA.
Anti CCP is present in about 96% of RA sera and a recent study found these antibodies in the joints of RA patients. The presence of anti CCP in high specificity, combined with their presence early in the disease even before the disease is manifest, suggests a role for these auto antibodies in the pathogenesis of RA.
It is recommended for the rheumatologists to use anti CCP for better prediction of the early diagnosis and prognosis of RA patients, these allowing better therapeutic decision-making, and hence influence the long term outcome of the disease.