Mehmet AĞILLI, Şafak EKİNCİ, Fevzi Nuri AYDIN, İrfan ŞENER, Adem PARLAK, Halil YAMAN

Anti-siklik Sitrüllinlenmiş Peptid/Protein (Anti-CCP) ve Romatoid Artrit Tanısındaki Değeri

Romatoid artrit (RA); etyolojisi belli olmayan, kronik eroziv sinovit ile karakterize, inflamatuvar multisistemik bir hastalıktır. Dünya genelinde prevelansı %1 civarındadır. RA tanısında bir takım klinik durumlar ile beraber serolojik belirteçlerin de önemi büyüktür. Günümüzde RA şüphesi olan hastalarda en yaygın kullanılan laboratuvar testi romatoid faktör (RF)'dür. RF, RA tanısında duyarlı ancak özgül olmayan bir parametredir. RA'nın erken tanısı, ilerleyici eklem hasarının önüne geçilebilmesi açısından önemli yer teşkil etmektedir. Antisiklik sitrulin peptid/protein (anti-CCP) son yıllarda erken tanı amacıyla kullanılan dikkate değer bir belirteç olarak göze çarpmaktadır. Sitrüllinlenmiş peptid/protein antikorları (ACPA) ailesinin en önemli üyesi olan anti-CCP, RA tanısında oldukça tatmin edici özgüllük değerleri göstermiştir. ACPA varlığının 2010 RA tanı kriterlerine dâhil edilmesiyle anti-CCP'nin önemi bir anlamda tescillenmiştir

Anti-cyclic Citrullinated Peptide Antibody (Anti-CCP) and Diagnostic Value for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an inflammatory multisystem disease of unknown etiology characterized by chronic destructive synovitis. It's prevalence is about 1% all over the world. Serologic markers are also important beside some clinical situations upon RA diagnosis. Today, the most commonly used laboratory test is rheumatoid factor (RF) in patients with suspected RA. RF is sensitive but not a specific biomarker for diagnosing RA. Early diagnosis of RA is essential to prevent of progressive joint damage. In recent years, anticyclic citrullinated peptide/protein antibody (anti-CCP) attracts the attention as a remarkable biomarker for early diagnosis. Anti-CCP which is a family of anti-citrullinated protein antibodies (ACPA) family, showed quite satisfactory specificity in the diagnosis of RA. Due to the prescence of ACPA was included to 2010 RA diagnostic criteria, in a manner of speaking, importance of anti-CCP was registered

PDF

___

1.Scott D, Symmons D, Coulton B, Popert A. Long-term outcome of treating rheumatoid arthritis: results after 20 years. Lancet 1987;1(8542):1108.
2.Feldmann M, Brennan FM, Maini RN. Role of cytokines in rheumatoid arthritis. Annual review of immunology 1996;14(1):397-440.
3.Sharp JT, Lidsky MD, Collins LC, Moreland J. Methods of scoring the progression of radiologic changes in rheumatoid arthritis. Correlation of radiologic, clinical and laboratory abnormalities. Arthritis & Rheumatism 2005;14(6):706-720.
4.Girbal-Neuhauser E, Durieux JJ, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritis-associated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
5.Schellekens GA, De Jong B, Van Den Hoogen F, Van de Putte L, van Venrooij WJ. Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies. Journal of Clinical Investigation 1998;101(1):273.
6.Van Boekel M, Vossenaar ER, Van Den Hoogen F, Van Venrooij WJ. Autoantibody systems in rheumatoid arthritis: specificity, sensitivity and diagnostic value. Arthritis research 2002;4(2):87-93.
7.Girbal-Neuhauser E, Durieux J-J, Arnaud M, et al. The epitopes targeted by the rheumatoid arthritis-associated antifilaggrin autoantibodies are posttranslationally generated on various sites of (pro) filaggrin by deimination of arginine residues. The Journal of Immunology 1999;162(1):585-594.
8.Vossenaar ER, Van Venrooij WJ. Citrullinated proteins: sparks that may ignite the fire in rheumatoid arthritis. Arthritis Research and Therapy 2004;6(3):107-111.
9.Machold K, Stamm T, Nell V, et al. Very recent onset rheumatoid arthritis: clinical and serological patient characteristics associated with radiographic progression over the first years of disease. Rheumatology 2007;46(2):342-349.
10.SchellekensGA, Visser H, de Jong BA, et al. The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide. Arthritis Rheum 2000;43(1):155-63.
11.van Gaalen FA, Visser H, Huizinga TWJ. A comparison of the diagnostic accuracyand prognostic value of the first and second anti-cyclic citrullinated peptides (CCP1 and CCP2) autoantibody tests for rheumatoid arthritis. Annals of the rheumatic diseases 2005;64(10):1510-1512.
12.Lee D, Schur P. Clinical utility of the anti-CCP assayin patients with rheumatic diseases. Annals of the rheumatic diseases 2003;62(9):870-874.
13.Bizzaro N, Tonutti E, Tozzoli R, Villalta D. Analytical and diagnostic characteristics of 11 2nd-and 3rd-generation immunoenzymatic methods for the detection of antibodies to citrullinated proteins. Clinical chemistry 2007;53(8):1527-1533.
14.Lutteri L, Malaise M, Chapelle JP. Comparison of second-and third-generation anti-cyclic citrullinated peptide antibodies assays for detecting rheumatoid arthritis. Clinica Chimica Acta 2007;386(1):76-81.
15.Correia ML, Carvalho S, Fortuna J, Pereira MH. Comparison of three anti-CCP antibody tests and rheumatoid factor in RA and control patients. Clinical Reviews in Allergy and Immunology 2008;34(1):21-25.
16.Enriconi dos Anjos LM, Pereira IA, d 'Orsi E, Seaman AP, Burlingame RW, Morato EF. A comparative study of IgG second-and third-generation anti-cyclic citrullinated peptide (CCP) ELISAs and their combination with IgA third-generation CCP ELISA for the diagnosis of rheumatoid arthritis. Clinical rheumatology 2009;28(2):153-158.
17.Innala L, Kokkonen H, Eriksson C, Jidell E, Berglin E, RANTAPÄÄ-DAHLQVIST S. Antibodies against mutated citrullinated vimentin are a better predictor of disease activity at 24 months in early rheumatoid arthritis than antibodies against cyclic citrullinated peptides. The Journal of Rheumatology 2008;35(6):1002-1008.
18.Vander Cruyssen B, Nogueira L, Van Praet J, et al. Do all anti-citrullinated protein/peptide antibody tests measure the same? Evaluation of discrepancy between anti-citrullinated protein/peptide antibody tests in patients with and without rheumatoid arthritis. Annals of the rheumatic diseases 2008;67(4):542-546.
19.Pruijn G, Wiik A, van Venrooij W. The use of citrullinated peptides and proteins for the diagnosis of rheumatoid arthritis. Arthritis Research and Therapy 2010;12(1):203.
20.Avouac J, Gossec L, Dougados M. Diagnostic and predictive value of anti-cyclic citrullinated protein antibodies in rheumatoid arthritis: a systematic literature review. Annals of the rheumatic diseases 2006;65(7):845-851.
21.Niewold T, Harrison M, Paget S. Anti-CCP antibody testing as a diagnostic and prognostic tool in rheumatoid arthritis. QJM 2007;100(4):193-201.
22.Turesson C, Jacobsson L, Sturfelt G, Matteson E, Mathsson L, Rönnelid J. Rheumatoid factor and antibodies to cyclic citrullinated peptides are associated with severe extra-articular manifestations in rheumatoid arthritis. Annals of the rheumatic diseases 2007;66(1):59-64.
23.Bizzaro N, Pregnolato F, van Boekel MAM, et al. Preliminary evaluation of the first international reference preparation for anticitrullinated peptide antibodies. Annals of the rheumatic diseases 2012;71(8):1388-1392.
24.Luis Caro-Oleas J, Fernández-Suárez A, Reneses Cesteros S, Porrino C, Núñez-Roldán A, Wichmann Schlipf I. Diagnostic usefulness of a third-generation anti-cyclic citrulline antibody test in patients with recent-onset polyarthritis. Clinical Chemical Laboratory Medicine 2007;45(10):1396-1401.
25.İyidir ÖT, Erten Ş. Bağ Dokusu Hastalıklarında Otoantikorların Klinikte Kullanımı. Turkiye Klinikleri J Med Sci 2007;27:236-246.
26.Kawano S, Saigo K, Morinobu A, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 2007;146:797-808.
27.Jørgensen KT, Wiik A, Pedersen M, et al. Cytokines, autoantibodies and viral antibodies in premorbid and postdiagnostic sera from patients with rheumatoid arthritis: case-control study nested in a cohort of Norwegian blood donors. Annals of the rheumatic diseases 2008;67(6):860-866.
28.Nielen MMJ, van Schaardenburg D, Reesink HW, et al. Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serialmeasurements in blood donors. Arthritis & Rheumatism 2004;50(2):380-386.
29.Rantapää-Dahlqvist S, de Jong BAW, Berglin E, et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis & Rheumatism 2003;48(10):2741-2749.
30.van der Helm-vanMil AHM, le Cessie S, van Dongen H, Breedveld FC, Toes REM, Huizinga TWJ. A prediction rule for disease outcome in patients with Recent-onset undifferentiated arthritis: How to guide individual treatment decisions. Arthritis & Rheumatism 2007;56(2):433-440.
31.Van Gaalen F, Linn-Rasker S, Van Venrooij W, et al. Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: a prospective cohort study. Arthritis & Rheumatism 2004;50(3):709-715.
32.Pruijn GJM, Vossenaar ER, Drijfhout JW, van Venrooij WJ, Zendman AJW. Anti-CCP antibody detection facilitates early diagnosis and prognosis of rheumatoid arthritis. Current Rheumatology Reviews 2005;1(1):1-7.
33.Söderlin M, Kastbom A, Kautiainen H, Leirisalo-Repo M, Strandberg G, Skogh T. Antibodies against cyclic citrullinated peptide (CCP) and levels of cartilage oligomeric matrix protein (COMP) in very early arthritis: relation to diagnosis and disease activity. Scandinavian journal of rheumatology 2004;33(3):185-188.
34.Majka DS, Deane KD, Parrish LA, et al. Duration of preclinical rheumatoid arthritis-related autoantibody positivity increases in subjects with older age at time of disease diagnosis. Annals of the rheumatic diseases 2008;67(6):801-807.
35.Syversen SW, Goll GL, van der Heijde D, et al. Prediction of radiographic progression in rheumatoid arthritis and the role of antibodies against mutated citrullinated vimentin: results from a 10-year prospective study. Annals of the rheumatic diseases 2010;69(2):345-351.
36.López-Longo FJ, Oliver-Miñarro D, de la Torre I, et al. Association between anti-cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis. Arthritis Care & Research 2009;61(4):419-424.
37.Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborativeinitiative. Arthritis & Rheumatism 2010;62(9):2569-2581.
38.Dejaco C, Duftner C, Klotz W, Schirmer M, Herold M. Third generation anti-cyclic citrullinated peptide antibodies do not predict anti-TNF-? treatment response in rheumatoid arthritis. Rheumatology international 2010;30(4):451-454.
39.Zendman A, Van Venrooij W, Pruijn G. Use and significance of anti-CCP autoantibodies in rheumatoid arthritis. Rheumatology 2006;45(1):20-25.
40.Roland PN, Mignot SG, Bruns A, et al. Antibodies to mutated citrullinated vimentin for diagnosing rheumatoid arthritis in anti-CCP-negative patients and for monitoring infliximab therapy. Arthritis Research and Therapy 2008;10(6):142.