Antibodies Against Citrullinated Peptides

Development of Clinical Assays for Anti-Citrullinated Protein Antibodies

September 2008

There have been several generations of anti-CCP assays. The first generation assay uses a cyclic peptide that happens to derive from the human filaggrin protein. Although this assay had improved sensitivity over the initial indirect immunofluorescent assays, the sensitivity was still poor in comparison to Rheumatoid factor. This type of assay was never widely used in most clinical laboratories.

The second generation anti-CCP antibody assay had significantly improved sensitivity primarily because these assays use a panel of citrullinated peptides that had been identified through screening of peptide libraries using serum from patients with Rheumatoid Arthritis. The second generation assays are still widely used as a clinical assay.

The third generation assays are relatively new and use a synthetic form of cyclic citrullinated peptide. The third generation assays are generally quite comparable to the second generation assays, although some studies have demonstrated a small improvement in sensitivity, primarily in patients with early disease.

< Previous Slide

Development of Clinical Assays

Next Slide >

 

Jump to section:

• Introduction
• Introduction to Connective Tissue Diseases
• Clinical Symptoms of Rheumatoid Arthritis
• Epidemiologic Features of Rheumatoid Arthritis
• Diagnostic Criteria for Rheumatoid Arthritis
• Utility of Rheumatoid Factor
• Discovery of Anti-Citrulline Antibodies
• Enzymatic Process of Citrullination
• Diagnostic Performance of Anti-Citrulline Antibodies
• Development of Clinical Assays for Anti-Citrullinated Protein Antibodies
• Development of Clinical Assays for Anti-Citrullinated Protein Antibodies
• Sensitivity and Specificity Comparison Anti-CCP and RF
• Diagnostic Algorithm for CTDs
• Summary
• Questions?