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The Role of the Laboratory in the Diagnosis of Rheumatoid Arthritis

Development of Clinical Assays for Anti-Citrullinated Protein Antibodies

Slide 12

August 2011

As a result of the initial studies, development of clinical assays for anti-citrullinated protein antibodies focused on improving assay sensitivity while maintaining the high specificity.

This was accomplished through optimization of the protein or proteins used as the target antigen.

During the course of this work, it was discovered that formation of a cyclic peptide improved the sensitivity of the assays.

To form these circularized structures, cysteine residues were placed on either end of the peptide. When a disulfide bond is formed between the 2 cysteine residues, a cyclic peptide results. This is where the term “anti-cyclic citrullinated peptide antibody” or “anti-CCP antibody” come from. It is thought that the cyclic structure allows for maximum exposure of the citrullinated residue.

Development of Clinical Assays


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