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Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown etiology. We studied the diagnostic performances of anti-cyclic citrullinated peptides antibody (anti-CCP) assay and recombinant anti-citrullinated filaggrin antibody (AFA) assay by enzyme linked immunosorbent assay (ELISA) in patients with RA in Korea. Diagnostic performances of...
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Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases. The presence of antibodies to cyclic citrullinated peptide (CCP) is better at discriminating RA patients and is also associated with significantly more disease activity compared to serum rheumatoid factor. In this study, we assessed two new automated second generation...
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... In this study, anti-CCP test achieved higher specificity (95.4% Vs. 80%) and sensitivity (76.9% Vs. 64.6%) compared with RF. These findings agree with other's finding that demonstrated higher specificity of anti-CCP antibodies in patients with RA (Choi et al., 2005). The specificity of a test is the probability that a test will produce a true negative result when used in control group while sensitivity is the probability that the test will produce a true positive result when used in patients test group. ...
The SJUST, Scientific Journal of University of Science and Technology has three major issues: Medical, Engineering and Administrative Sciences. The current one is the Medical Sciences Issue No. 1 of Vol 1 of the Six Issue from the University Scientific Journal Issue No, 6
... Anti-CCP is considered as a sensitive and specific rheumatoid arthritis biomarker, and its detection is widely used for the diagnosis of the disease. The cut-off value is calculated as the maximal point of area under the curve by receiver-operator characteristics (ROC) curve [54,55]. ROC curve is a plot of the true positive rate against the false positive rate, in other words, it shows the relationship between sensitivity and specificity. ...
... Anti-CCP is considered as a sensitive and specific rheumatoid arthritis biomarker, and its detection is widely used for the diagnosis of the disease. The cut-off value is calculated as the maximal point of area under the curve by receiver-operator characteristics (ROC) curve [54,55]. ROC curve is a plot of the true positive rate against the false positive rate, in other words, it shows the relationship between sensitivity and specificity. ...
Anti-cyclic citrullinated peptide IgG antibodies (anti-CCP) are produced as an immune response in the presence of post-translational modified peptides known as cyclic citrullinated peptides (CCP). Anti-CCP have been considered as specific biomarkers for the diagnosis of rheumatoid arthritis (RA), and due to their high specificity, it is possible to make a differential diagnosis of other rheumatic diseases. These autoantibodies can be detected in the early stages of RA and even up to 10 years before presenting the first symptoms of the disease opening a window of opportunity for timely treatment. In this work, a simple straight channel microdevice and CCP conjugated magnetic nanoparticles (MNPs-CCP) as solid support was developed for quantifying anti-CCP. An additional microdevice with an optical flow Z cell design coupled with optical fibers was used to perform the spectrophotometric detection. The dynamic range of concentrations was determined between 0.70 and 2000 U mL − 1 with a limit of detection of 0.70 U mL − 1. The developed microdevice immunoassay was probed using a positive control and a negative control of plasma employing only 6 μL of both samples and reagents. The results showed that the proposed microdevice was almost nine times faster than using a commercial anti-CCP ELISA kit obtaining equivalent results and being 16 times more sensitive. The microdevice immunoassay, with conjugated MNPs-CCP is a simple method for anti-CCP quantification being cheaper, faster, and more sensitive than the ELISA kit.
... Although there is a correlation between RF and anti-CCP in RA patients and it has been used mostly in the diagnosis of RA, anti-CCP can be helpful in the diagnosis of other rheumatological disorders such as SLE [8]. It was reported that anti-CCP test might result in positive up to 8% in Behcet's disease, fibromyalgia, gout, juvenile rheumatoid arthritis, reactive arthritis, and SLE [9,10]. ...
Aim: Anti-cyclic citrullinated peptide antibodies (Anti-CCP) is considered as a novel marker in the assessment of rheumatoid disorders. Some studies have emphasized the importance of anti-CCP in indicating erosive arthropathy in Systemic Lupus Erythematosus (SLE), like Rheumatoid Arthritis (RA). These studies have reported that the chance of erosive arthritis development is significantly increased in anti-CCP-positive patients. This study aimed to investigate the relationship between anti-CCP and arthritis along with other clinical and laboratory parameters in patients with SLE.Methods: A total of 147 SLE patients who had been admitted to Kocaeli University Medical Faculty, Department of Internal Medicine, Division of Rheumatology between January 2001 and October 2015 were included in this retrospective study. SLE diagnosis was verified according to American College of Rheumatology (ACR) and/or The Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) criteria. Patients whose diagnosis was not definite and not having anti-CCP were excluded.Results: Female/male ratio was found as 5.6, and the mean age was calculated as 43.9±11.85 years. The mean follow-up period was 73.3±44.97 months. Anti-CCP was found to be positive in ten patients whereas arthritis was found to be present in 100 patients. Anti-CCP was positive in seven patients with arthritis. RF (Rheumatoid Factor) was found as positive in 50 patients of whom 40 had arthritis. A relationship was found between Anti-CCP and RF. There was no relationship between anti-CCP and arthritis. Conclusions: Anti-CCP has been reported to be significantly related to arthritis and other characteristics of rheumatoid disorders, particularly RA in several studies. There are conflicting results about the relationship between anti-CCP and arthritis in patients with SLE. These conflicting results may be derived from different subtypes of anti-CCP (citrulline-dependent), different cut-off values, and characteristics of the patient population. We did not observe any relationship between the Anti-CCP and arthritis.
... The initial anti-CCP levels appear to be of great importance in predicting the interval time to disease onset, since a delay in RA diagnosis could occur in subjects with low antibody levels at symptom onset (Gerli et al., 2008). It has been suggested that anti-CCP has an important role in grading clinical activity (Choi et al., 2005;Pinheiro et al., 2003). It was proved that anti-CCP titer correlated with disease activity in RA (Kastbom et al., 2004;. ...
... Available data indicate variations in the sensitivity and specificity of anti-CCP across different studies [16][17][18][19][20]. ...
... The sensitivity of the RF test has been reported to be from 70% to 75% [16][17][18], and its specificity has been reported to be between 80% and 85% [16,17]. However, the RF antibody is reported not to be found in all RA patients [17][18][19]. Therefore, the specificity of the RF test has been limited. ...
... The anti-CCP test shows high specificity (between 88% and 99%), and its sensitivity has been shown to range from 45% to 91% [18,20]. In case of Korean patients, the sensitivity of anti-CCP test has been reported between 72.0% and 82.3%, and its specificity has been reported to be from 92.0% to 96.0% [19,23,24]. The current disadvantage of the anti-CCP test is its lower specificity for RA diagnosis compared to other arthritis or autoimmune diseases [16]. ...
... The sensitivity was 6% lower than that of the CCP assay, whereas its specificity was 11% higher. The sensitivity of anti-CCP test has been reported to be between 45% and 91%, and its specificity has been reported to be from 88% to 99% [18][19][20]. Comparing with those results, CCP11A assay showed high level of both sensitivity and specificity. From these results, we selected CCP11A as a valuable specific marker peptide for RA diagnosis. ...
A specific peptide marker for diagnosing rheumatoid arthritis (RA) was found based on cyclic citrullinated peptide (CCP) using the following three steps: (1) analysis of the binding epitope of autoimmune antibodies using ϵ-aminocaproic acid-modified peptides; (2) RA diagnosis using sequence-modified peptides; and (3) evaluation of the peptides' diagnostic performance for RA diagnosis. Ninety-five serum samples were analyzed by ELISA and compared using MedCalc (version 15.2.1). Microplate binding ϵ-aminocaproic acid was added to the N- or C-terminal of the CCP sequence. The N-terminal anchoring peptide assay showed 15% higher specificity compared with the C-terminal anchoring peptide assay. Based on this result, the hydrophilic C-terminal sequence of CCP was substituted with a hydrophobic amino acid. Among the sequence-modified peptides, CCP11A (in which alanine was substituted for the 11th amino acid of CCP) assay showed the highest sensitivity (87%) and specificity (100%) for RA diagnosis. Thus, CCP11A was selected as a possible specific marker peptide for RA diagnosis and further analyzed. The results of this analysis indicated that CCP11A showed better specificity than the CCP assay in both healthy individuals (11% better) and OA cohort (20% better). From these results, CCP11A was evaluated as a specific marker for diagnosing RA with higher diagnostic performance.
Copyright © 2015 Z. Published by Elsevier B.V. All rights reserved.
... Several studies have shown that anti-CCP is moderately sensitive but highly specific for RA, with specificity higher than that of RF. 13,17,18,[28][29][30][31][32] In previous studies and meta-analyses, the reported sensitivity of anti-CCP for the diagnosis of RA ranged from 60% to 83%, and the reported specificity ranged from 90% to 98%. [11][12][13]19,[33][34][35][36][37][38] Odds ratios (OR) for the diagnosis of RA varied from 17.0 to 64.5. 11,12,19,33 Important differences were seen in the characteristics of patients evaluated as well as the cutoff value used to define a positive test. ...
To compare the diagnostic performance of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP) in the diagnosis of patients with rheumatoid arthritis (RA) in Taiwan.
Serum concentrations of RF and anti-CCP were measured in 246 cases, including 39 patients with RA and 207 patients with other rheumatic diseases (non-RA). The age, sex, clinical presentation, RF, anti-CCP results and the final diagnoses were recorded and analyzed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated.
Among all 246 patients, 39 (15.9%) were diagnosed with RA and 207 (84.1%) were diagnosed with other rheumatic diseases (non-RA). In the diagnosis of RA, the sensitivity, specificity, PPV, NPV, LR+ and LR- of the RF test were 67%, 79%, 37%, 93%, 3.12, and 0.42, respectively. The corresponding data for the anti-CCP test were 79%, 98%, 86%, 96%, 32.91 and 0.21, respectively. The presence of either anti-CCP or RF increased the sensitivity to 85%, and when they both were present, the specificity increased to 98%. Among the 39 RA patients, 26 (66.7%) tested positive for RF, and 31 (79.5%) tested positive for anti-CCP. RF was positive in two of eight anti-CCP-negative patients with RA, and anti-CCP was positive in seven of 13 RF-negative patients with RA.
The RF and anti-CCP tests are complementary, and the co-detection of these antibodies can increase the detection rate and provide important clinical value in the diagnosis of RA. Both anti-CCP and RF positivity are useful for the diagnosis of RA, and use of both tests together improves the diagnostic sensitivity.
© 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
... In case of RA factor, it was found that 92% of the patients had values above the threshold level while 8% had lower values. When compared to data of other populations, it was found that in case of the Korean population, 80.56% of the RA patients were found to be RF positive while 19.44 were RF negative [17]. In a similar study conducted on the Iranian population, it was found that 66.5% of the RA patients were RF positive while 33.5 were negative [18]. ...
Rheumatoid Arthritis (RA) is a chronic inflammatory condition affecting the joints causing swelling, stiffness and pain which finally leads to substantial loss of functioning and mobility in its advanced stages. In the present study we have monitored important serological parameters of fifty RA patients and also have discussed the justification of using rat as a model for human RA researches by comparing their respective serological parameters. We have also evaluated the anti-arthritic roles of raw Aloe vera gel and its effects in rat model where arthritis was induced by using Freund’s Complete Adjuvant (FCA). Three essential conclusive statements were derived from the study. Firstly, the six clinical parameters that we have selected for the study namely, RA factor, CRP, ASO, ESR, ceruloplasmin and serum creatinine were all essential for the differential diagnosis of Rheumatoid Arthritis during its early and later stages, RA factor being the most sensitive of all parameters (92% sensitivity). Secondly, this study has supported the use of the rat as a model for designing therapeutic strategies against RA. Lastly, as evident from our study, Aloe vera extracts can be beneficial for the reduction of inflammatory edema and also for the reduction of ceruloplasmin in RA condition in rat model. However, further investigations are necessary for more refined therapeutic usage of Aloe vera for the treatment of RA in human.
... The sensitivity and specificity of RF were 30% and 70% respectively. Our results did not match with the results of Choi at all and Greiner et al. [20,21]. This can be attributed to the different methods used for RF measurement, selection of cases, disease durations and administration of different drugs. ...
Background:
Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease, with a worldwide prevalence of 0.5% to 1%. Anti-cyclic citrullinated peptide antibody (anti-CCP-2 Ab) is a marker of choice for diagnosing early and late RA. Anti-oxidant enzymes activity decreases in RA patients. Till now, the relationship between the rheumatoid factor (RF) and anti-CCP-2 Ab, anti-oxidant activity and polymorphism of paraoxenase-1 (PON-1) 192 Q/R in patients with RA has not been investigated. In this study, we aimed to determine the serum level of RF and anti-CCP-2 Ab, PON-1 activity and 192 Q/R polymorphism and arylesterase (ARE) activity in patients with RA. Also, we studied RA markers in different genotypes of PON-1 of RA patients.
Methods:
A total of 120 RA patients and 90 healthy persons were subjected to full clinical examinations and routine laboratory tests. PON-1 and ARE activities were determined using an enzymatic spectrophotometric method. PON-1 192 gene polymorphism was determined using polymerase chain reaction based restriction fragment analysis. RF was measured by immunoturbidimetry method and anti-CCP-2 Ab was assayed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS for windows 20.0.
Results:
The sensitivity and specificity of anti-CCP-2 Ab for the diagnosis of RA were 76.2% and 100% respectively. PON-1 and ARE activities were statistically lower (P <0.001) in the RA group compared to the control group. A negative correlation between RF and anti-CCP-2 Ab levels and PON-1 and ARE activities was found. No significant difference in the genotype distribution between RA patients and healthy persons was detected. RF and anti-CCP-2 Ab levels were higher in RA patients carried RR genotype than in those carried QQ genotype.
Conclusion:
High RF and anti-CCP-2 antibody serum levels were found to be associated with decreased PON-1 and ARE activities with no correlation between PON-1 polymorphism and serum levels of RF and anti-CCP-2 Ab in patients with RA. These results may indicate an implication between antioxidant enzymes activity and serum levels of RF and anti-CCP-2 Ab.
