BackSignificance of the analysis of antibodies to cyclic citrullinated peptide (ACCP, anti-CCP) in the early diagnosis of rheumatoid arthritis
The determination of antibodies to cyclic citrulline peptide (ACCP) is of the greatest importance among new immunological methods. This method has now become the second standard immunological test after the determination of rheumatoid factor for the diagnosis of rheumatoid arthritis (RA). The first representatives of this family, antikeratin antibodies and antiperinuclear factor, were described back in the 60s of the last century. However, they became widely used precisely after the development of ELISA methods for the determination of antibodies to cyclic citrulline peptide (ACCP).
The importance of this test is determined by:
· the appearance of antibodies to cyclic citrulline peptide in the blood serum 1 year before the onset of the disease (its sensitivity at an early stage of the disease reaches 75%);
· sufficient specificity for rheumatoid arthritis (75-90%);
· determination of ACCP in patients with seronegative rheumatoid factor;
· use for predicting the development of rheumatoid arthritis - a high titer of ACCP is associated with a more severe course of the disease (in particular, with a faster progression of erosive changes in joints), as well as with persistently high activity of RA.
The definition of ACCP allows for a more reliable diagnosis of such a serious disease as Rheumatoid arthritis.
The earlier the cause of joint inflammation is determined, the more likely it is to stop the progression of the disease and prevent disability.
ACCP are Antibodies to cyclic citrullinated peptide, which are highly specific for Rheumatoid arthritis. ACCP appear already at the earliest stage of the disease and even 1 year before the onset of clinical manifestations of arthritis (pain, swelling, stiffness in the joints, etc.).
In addition, the test makes it possible to differentiate erosive and non–erosive forms of RA (sensitivity – 67-78%, specificity - 57-82%). ACCP positive patients have a greater degree of cartilage damage compared to anti-CCP negative patients. It is useful for the diagnosis of seronegative RA. The prognostic value of the method increases if it is used in combination with the Russian Federation. This test makes it possible to differentiate RA from other connective tissue diseases.
Rheumatoid arthritis affects about 2% of the population. This is the most common autoimmune disease in which inflammation in the joints leads to damage, destruction and loss of joint function. Unfortunately, without treatment, joint deformities develop rapidly and damage to internal organs is added. Rheumatologists are engaged in the treatment of such patients, to whom patients usually come in advanced stages.
It is especially important to determine the ACCP in case of a negative result for Rheumatoid factor and a persistent unclear cause of arthritis.
Early diagnosis of Rheumatoid arthritis and the immediate start of proper treatment is the key to preventing joint destruction and prolonging active longevity.
Indications:
· Early diagnosis of rheumatoid arthritis (preferably in combination with rheumatoid factor
· Diagnosis of seronegative (rheumatoid factor) forms of rheumatoid arthritis.
· For prognostic purposes, with recently developed rheumatoid arthritis.
Increasing values:
Rheumatoid arthritis (clinical sensitivity – 70.6%, general specificity – 98.2%);
In some cases of other connective tissue diseases, especially SLE (systemic lupus erythematosus).
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