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Anti‐citrullinated protein antibodies and their clinical utility in rheumatoid arthritis
Author(s) -
Farid Sima Sh.,
Azizi Gholamreza,
Mirshafiey Abbas
Publication year - 2013
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12129
Subject(s) - medicine , rheumatoid factor , rheumatoid arthritis , serology , citrulline , antibody , immunology , rheumatology , autoantibody , epitope , disease , arthritis , amino acid , arginine , biology , biochemistry
One of the most important serological discoveries in rheumatology in recent years has been the characterization of autoantigens in rheumatoid arthritis ( RA ) containing the amino acid citrulline. There are many citrullinated proteins in the inflamed RA synovium. Rheumatoid factor ( RF ), which is the immunologic hallmark of RA , is not specific for RA , as it is found in 5% of healthy individuals and in 10–20% of those over the age of 65 years. RF s are of low titer in early disease stages when a clear diagnosis is often not yet possible; But anti‐citrullinated protein antibodies ( ACPA s) can be found early in the disease course of RA , even years before the onset of clinical symptoms. The identification of citrullinated epitopes led to the development of the first and later second generation anti‐cyclic citrullinated peptide (anti‐ CCP ) antibody assays. Anti‐ CCP 2 antibody has shown a specificity of 98% in sera from patients with established RA and 96% in sera from subjects with early RA . Anti‐ CCP can predict erosive disease, therefore could be a good serological marker for RA diagnosis.