Cyclic citrulline to peptide, antibodies (Anti-CCP)

Why this test? 

For the diagnosis of rheumatoid arthritis at a very early stage (duration of the disease)

In what cases is it prescribed?

In some rheumatic diseases, there is a joint syndrome (pain, swelling in the joints, morning stiffness, local redness of the skin), which can make it difficult to make a correct diagnosis, especially in the early stages of the disease. 

In this case, the analysis helps to make a differential diagnosis, as it has a high specificity (up to 98%) and sensitivity (up to 70%) for detecting rheumatoid arthritis even in the earliest stages of the disease, when only a few symptoms are present. 

When planning the therapy of rheumatoid arthritis. 

A more aggressive course of the disease with a rapid progression of erosion in the joints is characteristic of patients whose blood contains ACCPs, therefore, in the early stages of the disease, it is necessary to prescribe adequate therapy to prevent the development of irreversible changes in the joints (deformations, ankylosis). 

Information about the test 

Antibodies to cyclic citrulline peptide, IgG, are currently one of the most informative markers of early rheumatoid arthritis. ACCPs belong mainly to the IgG class and are detected in the blood at the earliest stages of rheumatoid arthritis (1-2 years before the first symptoms appear). 

Rheumatoid arthritis is the most common chronic autoimmune disease characterized by damage to peripheral joints with the development of erosive-destructive changes in them and a wide range of extra-articular manifestations. 

A characteristic feature of rheumatoid arthritis is symmetrical damage to the joints of the hands, feet, wrist, elbow, shoulder, knee and ankle joints. There is soreness, swelling, redness of the skin over the affected joints, restriction of movement and, as a result, impaired joint function. One of the important symptoms of rheumatoid arthritis is morning stiffness in the joints lasting more than one hour. Progressive inflammation of the joints leads to a significant limitation of their mobility with the development of joint abnormalities. Initially, when the joints are affected in the form of arthritis, there is a need for differential diagnosis. 

At the same time, it is necessary to pay attention to the typical signs of rheumatoid arthritis, the development of an erosive process in the joints of the hands, the rheumatoid factor, and especially to CDL antibodies. 

Rheumatoid factor is not specific enough and can be detected in other autoimmune diseases and chronic infections, while antibodies to cyclic citrulline peptide have a higher specificity (98%) and are diagnostically significant for the detection of rheumatoid arthritis. The test also makes it possible to differentiate erosive and non-erosive forms of the disease. 

Patients with elevated levels of CDL antibodies have a greater degree of joint cartilage damage compared to patients whose blood does not contain these antibodies. This can be used to predict the rate of joint destruction at the stage of early rheumatoid arthritis, which allows considering the detection of ACCP as one of the factors of the unfavorable prognosis of this disease. Joint determination of rheumatoid factor and ACCP allows to diagnose rheumatoid arthritis at an early stage, prescribe therapy in a timely manner and prevent severe destructive changes in the joints.