Anti-CCP hs (high sensitive)®: a new biomarker for the serological diagnosis of early rheumatoid arthritis
Timely diagnosis is of critical importance to the progression of rheumatoid arthritis (RA) because the rapid implementation of intensive treatment can inhibit damage to the joints and maintain function. In conjunction with medical history, clinical examination, and imaging procedures, serological tests form the foundation for an early diagnosis.
In addition to rheumatoid factors, autoantibodies against citrullinated antigens (ACPA) have proven to be valuable tools for the serological diagnosis of early RA. They have become a critical component of the new 2010 ACR criteria for the classification of RA, and account for three of the six points required to verify a diagnosis of RA.
Anti-CCP hs (high sensitive)® – higher sensitivity, earlier diagnosis, successful treatment
The new Anti-CCP hs (high sensitive)® test from ORGENTEC Diagnostika is the most recent addition to the ACPA family. It combines the many advantages of the detection of autoantibodies against the native autoantigen, mutated citrullinated vimentin (MCV), which have been demonstrated in many publications, with the strengths of modern peptide synthesis. Anti-CCP hs (high sensitive)® is based on specific optimized peptide epitopes from the body’s own MCV protein. This tailored antigen profile gives the test the highest sensitivity while maintaining high specificity. It is positioned as an effective tool for rapid and precise routine diagnosis and favours the rapid selection and implementation of treatment.
Anti-MCV – diagnosis and differentiation
The target antigen MCV, produced by the body, is found in the synovial tissues and synovial fluid of RA patients. MCV plays a central role in the pathogenesis of RA and is involved in the initiation of ACPA production. MCV antibodies correlate with an erosive course of disease with severe joint damage, extra-articular manifestations, and cardiovascular symptoms. A correlation between disease activity and stratification of RA with ACPA has thus far only been proven for Anti-MCV antibodies.
H. Bang, K. Egerer, A. Gauliard, K. Luthke, P. E. Rudolph, G. Fredenhagen, W. Berg, E. Feist, and G. R. Burmester. Mutation and citrullination modifies vimentin to a novel autoantigen for rheumatoid arthritis. Arthritis Rheum. 56 (8):2503-2511, 2007 (Link to full text article)
D. Coenen, P. Verschueren, R. Westhovens, and X. Bossuyt. Technical and diagnostic performance of 6 assays for the measurement of citrullinated protein/peptide antibodies in the diagnosis of rheumatoid arthritis. Clin.Chem. 53 (3):498-504, 2007. (Link to full text article)
S. W. Syversen, G. L. Goll, D. van der Heijde, R. Landewe, B. A. Lie, S. Odegard, T. Uhlig, P. I. Gaarder, and T. K. Kvien. Prediction of radiographic progression in rheumatoid arthritis and the role of antibodies against mutated citrullinated vimentin: results from a ten-year prospective study. Ann. Rheum. Dis. 69 (2):345-351, 2009 (Link to abstract on journal homepage)
El-Barbary, A.M. et al. Association of Anti-Modified Citrullinated Vimentin with Subclinical Atherosclerosis in Early Rheumatoid Arthritis Compared with Anti-Cyclic Citrullinated Peptide J. Rheumatology 138 (5) 828-834 2011 (Link to abstract on journal homepage);
The discovery of ACPAs and the biology of citrullination have led to important advances in the understanding of the pathophysiology and development of RA. Going forward, research into autoimmunity to citrullinated proteins may help identify the specific etiology of RA and provide approaches for the prediction of future risk of disease, and ultimately prevention of RA.