The Role of the Laboratory in the Diagnosis of Rheumatoid Arthritis
Development of Clinical Assays for Anti-Citrullinated Protein Antibodies
August 2011
There have been several generations of anti-CCP antibody assays.
The first generation assay used a cyclic peptide that had been derived from the human fillagrin protein. Although this assay had improved sensitivity over the initial indirect immunofluorescence 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 used a panel of citrullinated peptides that had been identified through screening of peptide libraries using sera from patients with rheumatoid arthritis. The second generation assays are still widely used as a clinical test.
The third generation assays are relatively new, and use a synthetic form of a 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.
Development of Clinical Assays |
Jump to section:
- Introduction
- Introduction to Rheumatoid Arthritis
- Risk Factors Associated with Development of Rheumatoid Arthritis
- Clinical Symptoms of Rheumatoid Arthritis
- 1987 Classification Criteria for Rheumatoid Arthritis
- 2010 Classification Criteria for Rheumatoid Arthritis
- Laboratory Evaluation of Patient with RA
- 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
- Summary
- Questions?
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