Cyclic Citrullinated Peptide CCP Antibody
Also known as
CCP Antibody, Citrulline Antibody, Anti-citrulline Antibody, Antic-cyclic Citrullinated Peptide, Anti-CCP, and ACPA
This test is ordered to detect and diagnose rheumatoid arthritis and help differentiate it from other types of arthritis. It helps in evaluating the prognosis of a patient with rheumatoid arthritis.
The CCP Antibody test is ordered when your doctor suspects you have rheumatoid arthritis. A patient may have joint inflammation with additional symptoms like limited motion, stiffness, pain, and swelling of different joints.
This is a blood test. The blood test requires a sample drawn from a vein in your arm.
The patient must inform his or her doctor about any medication they are on or any supplements they are taking. Doctors may instruct them to stop taking multivitamins or dietary supplements with biotin in them at least eight hours before the blood is drawn.
Cyclic citrullinated peptide antibodies are autoantibodies. They are produced by the immune system in response to cyclic citrullinated peptides. This test is used to identify and measure the amount of anti-CCP antibodies present in the blood. Citrulline is a natural product of the body. It is formed in the metabolic process of the amino acid arginine. In people with rheumatoid arthritis, this conversion occurs at a higher rate. The substance citrulline changes the configuration of the protein, which triggers an immune response leading to the production of autoantibodies against joint proteins. The CCP antibody not only helps in the diagnosis of the disease but is also useful in identifying patients with a more rapidly erosive form of the disease. Rheumatoid arthritis is a chronic disease. This systemic autoimmune condition can lead to discomfort in the form of pain, inflammation, stiffness in the hands, feet, and other joints in the body. It may also cause heavier, destructive changes in them. The disease is not limited to an age bracket; however, it usually develops between the ages of 40 and 60. Furthermore, the disease is more common amongst women. The way the disease progresses and its prognosis varies from person to person. It may develop very quickly or proceed slowly. Sometimes, people may go into remission, and for some, it may go away. If the disease is left untreated, however, it can significantly shorten a person’s lifespan and may leave people that are affected unable to work in a span of a few years. Breaking down the test Making an accurate diagnosis of rheumatoid arthritis and beginning the appropriate treatment plan before the onset of irreversible joint damage is essential. Previously, rheumatoid factor was the main blood test used to detect RA and to differentiate it from other categories of arthritis and additional inflammatory conditions. But, the rheumatoid factor test is not ideal in terms of its specificity and sensitivity. The test may be negative in people that have signs of clinical rheumatoid arthritis and positive in people that do not have those signs. The sensitivity of the cyclic citrullinated antibody test is the same as that of rheumatoid factor, but it has a specificity of 95 to 98%. It is also likely to be positive with the early onset of RA. However, ACR includes CCP antibody testing with rheumatoid factor as part of the criteria for diagnosing the disease. The American College of Rheumatology argues that CCP antibodies can be detected in nearly 60% of people with early onset of RA – as early as 3 to 6 months after the development of symptoms. This early detection and diagnosis are imperative because doctors can be aggressive in their treatment of the disease, minimizing the risk, complications, and damage.
The test is ordered alongside or after the rheumatoid factor test in order to aid in the diagnosis of rheumatoid arthritis. It also assesses how severe the disease is and what course it may take. On the other hand, the cyclic citrullinated peptide antibody test may be ordered by the doctor to help in evaluating the likelihood of rheumatoid arthritis in people that have undifferentiated arthritis.
The CCP antibody test may be ordered by your practitioner alongside a rheumatoid factor test if you have symptoms that may occur due to undifferentiated arthritis or previously undiagnosed inflammatory arthritis. The test may also be ordered as a follow-up to the rheumatoid factor test, which came back negative despite clinical signs and symptoms that indicate otherwise to the doctor. Rheumatoid arthritis tends to impact a variety of joints in a symmetrical fashion. The symptoms include:
- Painful, warm, swollen joints of the hands and wrists most commonly
- Pain sometimes affecting elbows, neck, shoulders, hips, knees, and/or feet
- Stiffness of affected joints in the morning that improves during the course of the day
- Fatigue
- Fever
- Development of nodules under the skin, especially at the elbows
- A general feeling of being unwell (malaise)
If patients with symptoms of arthritis test positive for CCP antibody and RF, it is likely that they have rheumatoid arthritis. The progression of the disease may be quick and severe. If people test positive for CCP antibody but not RA, or have lower levels of both, and have symptoms that suggest rheumatoid arthritis, they may have RA or might develop it in the near future. In people that have a negative CCP antibody test result but a positive RF, symptoms play a pivotal role in the diagnosis of rheumatoid arthritis. In case the result is negative for both tests, RA is unlikely. But, it must be noted that rheumatoid arthritis is a clinical diagnosis and can be made in the absence of positive tests in either case.
