van Venrooij Walther J, van Beers Joyce J B C, Pruijn Ger J M
Department of Biomolecular Chemistry, Radboud University, Nijmegen, The Netherlands.
Ann N Y Acad Sci. 2008 Nov;1143:268-85. doi: 10.1196/annals.1443.013.
Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronic inflammation of synovial joints. In most cases this will lead to the formation of pannus tissue, ultimately leading to joint destruction. Early diagnosis, coupled with aggressive use of disease-modifying antirheumatic drugs, has been shown to have a favorable effect on the course of the disease. Therefore, early and accurate diagnosis has become increasingly important. Several sets of criteria have been published to achieve such an early diagnosis, and all of them include measurement of antibodies directed to citrullinated peptides or proteins. This review summarizes our present knowledge about the most well-known and established test to measure these antibodies, the anti-CCP test, which measures antibodies directed to cyclic citrullinated peptides. We describe the current views on how these antibodies are generated and how genetic and environmental parameters are important in this process. The anti-CCP test is more specific than the commonly used RF test (95% versus less than 90%) and has a comparable sensitivity (more than 70%). These antibodies are detectable very early in the disease and are reported to predict the development of erosive RA. Increasing evidence supports a role for these antibodies in the pathology of the disease. In conclusion, testing for anti-CCP autoantibodies is widely accepted as an indispensable tool for diagnosis and early treatment in the management of rheumatoid arthritis patients.
类风湿关节炎（RA）是一种常见的自身免疫性疾病，其特征为滑膜关节的慢性炎症。在大多数情况下，这会导致血管翳组织的形成，最终导致关节破坏。早期诊断，再加上积极使用改善病情的抗风湿药物，已被证明对疾病进程有积极影响。因此，早期准确诊断变得越来越重要。已经发布了几套标准以实现这种早期诊断，并且所有标准都包括对瓜氨酸化肽或蛋白质的抗体检测。本综述总结了我们目前对用于检测这些抗体的最知名且成熟的检测方法——抗环瓜氨酸肽（CCP）检测的认识，该检测方法用于检测针对环瓜氨酸化肽的抗体。我们描述了目前关于这些抗体如何产生以及基因和环境参数在此过程中的重要性的观点。抗CCP检测比常用的类风湿因子（RF）检测更具特异性（95% 对低于90%），且具有相当的敏感性（超过70%）。这些抗体在疾病早期即可检测到，并且据报道可预测侵蚀性RA的发展。越来越多的证据支持这些抗体在疾病病理学中的作用。总之，检测抗CCP自身抗体已被广泛接受为类风湿关节炎患者诊断和早期治疗中不可或缺的工具。
