Cyclic Citrullinated Peptide (CCP) Antibody

Immunology

---

Description

Rheumatoid arthritis ( RA ) is the most common form of inflammatory joint disease, but its diagnosis remains principally a clinical one. The major challenge lies in differentiating RA from the many other forms of arthritis that share several presenting symptoms but vary widely both in outcomes and therapeutic options. With a growing body of evidence indicating that joint destruction and functional decline in RA are improved by early, aggressive therapeutic intervention, the need for an unequivocal early diagnosis has become critical [3]. NICE guidance for the management of rheumatoid athritis ( RA ) in adults recommends that the initial investigation carried out should be rheumatoid factor ( RF ). If RF is negative and it is still suspected that a patient has RA, a referral to a specialist should be made who can utilise Cyclic citrullinated peptide antibodies ( CCP ) as part of the clinical assessment [1]. CCP antibodies have been shown to be highly specific for RA and appear early in the disease process when diagnosis is most difficult and intervention most effective. CCP antibody measurement is of value in confirming the diagnosis of RA in patients with atypical presentation, excluding a diagnosis of RA in patients where the RF is positive but the clinical features are equivocal and also as an indicator of early RA [2,3].

---

Indications

Rheumatoid Arthritis.

---

Sample Type

2mL Serum (Gel 5mL Yellow tube or 6mL Red tube) or 2mL Plasma (EDTA, Citrate or Heparin).
Requests from outside Sheffield: transport at ambient temperature via Royal Mail or Courier.

---

Reference Range

0 - 10 U/mL Negative.

Reference range established by manufacturer and in house verification.

---

Turnaround Time

Within 3 days

---

Testing Frequency

Daily

---

References

Aletaha D, et al. 2010 Rheumatoid Arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis and Rheumatism. 2010. 62( 9 ):2569-2581.
NICE clinical guideline 79. Rheumatoid arthritis: The management of rheumatoid arthritis in adults. 2009. [Ref 1]
PRU handbook of autoimmunity. 4th Edition. 2007. [Ref 2]
Pruijn G, et al. Anti-CCP detection facilitates early diagnosis and prognosis of rheumatoid arthritis. Cur Rhem Rev. 2005. 1:1-7. [Ref 3]
Mimori T. Clinical significance of CCP antibodies in rheumatoid arthritis. Internal Med. 44( 11 ):1122-1126.

---

See Also

Rheumatoid factor

Please note: the above information is subject to change and we endeavour to keep this website up to date wherever necessary.