About Rheumatoid ArthritisRheumatoid Arthritis (RA) is a common, systematic autoimmune disease affecting between 0.5-1% of the adult population. RA is characterised by inflammation of the synovial joints. This can lead to progressive joint destruction and consequently impair the quality of life. It is generally accepted that early intervention is vital in preventing irreversible joint damage and therefore it is important to diagnose RA as early in the disease course as possible. The 1987 American College of Rheumatology (ACR) classification is widely used in the diagnosis of RA, despite the fact they are not well suited for the diagnosis of early Rheumatoid Arthritis (RA). This is due to the fact that the ACR criteria rely heavily on the expression of clinical symptoms and these are often not manifest in early RA. Ideally a highly specific and sensitive serological marker in RA is required so that rheumatologists can identify those patients who would benefit as candidates for aggressive therapeutic regimes. Presently, the Rheumatoid Factor (RF) test is commonly used as a serological marker for RA, although it is accepted that the test lacks specificity and is also often absent in the disease (seronegative RA). Over the last few years a novel antibody has been described and which is reported to have high very specificity (>95%) and sensitivity (80%) for RA. Antibodies to cyclic citrullinated peptides (Anti-CCP1) were first described in 1998 and following the introduction of commercial ELISA products employing the so-called second generation peptides (CCP2), there has been a plethora of publications in the last 2 years on the utility of this marker in the diagnosis of early RA. The key points emerging from the Anti-CCP literature are as follows: Anti-CCP Utilities Accurate diagnosis of RA in early synovitis patients Differentiation of RA from other inflammatory arthritides Differential diagnosis of RA from other connective tissue disease such as erosive SLE Confirmation of diagnosis in seronegative Rheumatoid Arthritis (RA)
Anti-CCP in Pre-clinical Disease Antibodies are detected in serum from individuals up to 14 years before the first clinical symptoms of RA Patients with high Anti-CCP titres appear to correlate strongly with erosive disease Can be used in clinical practice to assist in planning therapeutic strategy
Role of Anti-CCP in Pathogenesis of RA Strong correlation between HLA-DR4 (shared epitope) and Anti-CCP positivity Citrullinated antigens are present in inflamed synovia Anti-CCP antibodies also produced locally in the synovium Anti-CCP producing plasma cells isolated from synovium of RA (Rheumatoid Arthritis) patients
DIASTAT Anti-CCP The Axis-Shield DIASTAT Anti-CCP is a simple ELISA based test. Sufficient reagents, calibrators, controls are supplied for 96 individual determinations. All assay protocols are carried out at room temperature and the kit shelf-life is over 18 months. The kit offers both qualitative and quantitative protocols and can be automated readily. The DIASTAT Anti-CCP test is CE marked and US FDA (510K) cleared. For more details, including a comprehensive literature pack please contact: anti-ccp@uk.axis-shield.com.
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