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Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibody in Patients with Rheumatoid Arthritis
XIAOFENG ZENG, MAIXING AI, XINPING TIAN, XIAODAN GAN, YANPING SHI, QINFANG SONG, and FULIN TANG
ABSTRACT. Methods. The synthesized cyclic citrullinated peptide was used as substrate for ELISA. Anti-CCP antibody was detected by ELISA in 191 patients with RA, 132 with rheumatic diseases other than RA, and 98 with nonrheumatic diseases. The antiperinuclear factor (APF), anti-keratin antibody (AKA), rheumatoid factor (RF), and HLA-DR4 gene complex were also tested in each RA patient. The results of these tests were compared with anti-CCP antibody to examine the correlation between them. Results. Ninety (47.1%) patients with RA, 4 (3.0%) with other rheumatic diseases, and 2 (2.0%) with nonrheumatic diseases were found to be anti-CCP antibody positive by ELISA. The sensitivity of anti-CCP antibody was 47.1%, with a high specificity (97.4%) in RA. Anti-CCP antibody correlated with APF, AKA, RF, and HLA-DR4 gene complex. Conclusion. A new modified anti-CCP antibody test had a moderate sensitivity (47.1%) but a high specificity (97.4%) in patients with RA and was found as a valuable supplement to diagnosis of RA. Anti-CCP correlated with APF, AKA, RF, and HLA-DR4 gene complex, but did not completely overlap with them. Anti-CCP antibody could be regarded as a new diagnostic marker for RA. (J Rheumatol 2003;30:1451-5) Key Indexing Terms:
CYCLIC CITRULLINATED PEPTIDE ANTIBODY
From the Department of Rheumatology, Chinese Academy of Medical Science, Peking Union Medical College Hospital; and Department of Rheumatology, Capital University of Medical Science, Beijing Friendship Hospital, Beijing, China. X.F. Zeng, MD, Professor of Medicine; F.L. Tang, MD, Professor of Medicine; X.P. Tian, MD, Associate Professor of Medicine; X.D. Gan, BA, Research Associate; Y.P. Shi, Research Assistant; Q.F. Song, Research Associate, Department of Rheumatology, Chinese Academy of Medical Science, Peking Union Medical College Hospital; M.X. Ai, MD, Assistant Professor of Medicine, Department of Rheumatology, Capital University of Medical Science, Beijing Friendship Hospital. Address reprint requests to Dr. X.F. Zeng, Department of Rheumatology, Chinese Academy of Medical Science, Peking Union Medical College Hospital, Beijing, China. Submitted May 29, 2002; revision accepted December 19, 2002. |