In a comparative study, various detection kits had a sensitivity between 69.6% and 77.5% and a specificity between 87.8% and 96.4%. Despite the excellent performance of these immunoassays, for example CCP-assays, they only provide a sensitivity comparable with that of rheumatoid factor (RF). Moreover, analysis of the correlation of anti-CCP antibody titre with RA disease activity yielded conflicting results. Unfortunately, these artificial antigens are not expressed in the affected tissue, and therefore are probably not directly involved in the pathogenesis of RA.
In the more recent time novel test systems utilizing ACPA have been developed. Citrullinated vimentin is a very promising autoantigen in RA, and more importantly a very suitable tool for studying this systemic autoimmune disease. Vimentin is secreted and citrullinated by macrophages in response to apoptosis, or by pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha). A newly developed ELISA system utilises genetically modified citrullinated vimentin (MCV), a naturally occurring isoform of vimentin to optimize the performance of the test. Noteworthy are the findings of a recently published study that highly valuates anti-MCV test systems for diagnosing rheumatoid arthritis in anti-CCP-negative patients.
Given that ACPA are more specific than rheumatoid factor, they are used to distinguish various causes of arthritis. Notably novel assays may be useful for monitoring disease activity and effects of RA therapy.
Adapted from the Wikipedia article Anti-citrullinated protein antibody, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki
Anti-citrullinated protein antibody – Clinical significance
In a comparative study, various detection kits had a sensitivity between 69.6% and 77.5% and a specificity between 87.8% and 96.4%. Despite the excellent performance of these immunoassays, for example CCP-assays, they only provide a sensitivity comparable with that of rheumatoid factor (RF).
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