Anticyclic citrullinated peptide antibodies in patients with mixed connective tissue disease

Abstract

The clinical significance of anticyclic citrullinated peptide (CCP) antibodies in patients with mixed connective tissue disease (MCTD) was assessed. Altogether, 86 sera from MCTD patients, 96 from rheumatoid arthritis (RA) patients, 42 from systemic lupus erythematosus (SLE) patients, 23 from systemic sclerosis (SSc) patients, 21 from polymyositis/dermatomyositis (PM/DM) patients, and 17 from those with Sjögren's syndrome (SjS) were tested for anti-CCP antibodies using an enzyme-lined immunosorbent assay. Among the 96 RA patients, anti-CCP antibodies were detected in 85%, with the frequency being significantly higher than in MCTD, SLE, SSc, PM/DM, and SjS patients (9%, 14%, 13%, 14%, and 18%, respectively; P < 0.001). Among eight MCTD patients who fulfilled the diagnostic criteria for RA, only 50% had anti-CCP antibodies, and the prevalence was significantly lower than for all RA patients (p < 0.01). All eight patients who fulfilled the criteria for RA had overlap of SLE and SSc, except one patient, whereas the four anti-CCP-positive patients who did not fulfill the criteria for RA had SjS without overlapping features of SLE and SSc; moreover, most of their antibody titers were low. These results suggested that anti-CCP antibodies are associated with RA in MCTD patients, but careful diagnosis of RA is required if patients with low titers of anti-CCP antibodies lack overlapping SLE and SSc.

Clinical significance of anti-cyclic citrullinated peptide antibodies in Egyptian patients with chronic hepatitis C virus genotype IV infection

“…This suggests that this process is inflammationdependent rather than disease-dependent (22,23). Moreover, the presence of anti-CCP antibody has been reported, in low prevalence, in association with systemic lupus erythematosus, systemic sclerosis, polymyositis (24), Sjö gren syndrome (25) and psoriasis (26,27). Recently, a relatively high percentage (9%) of patients with anti-CCP antibody was detected in a large group of individuals with autoimmune hepatitis, but without apparent overlap with RA (28).…”

Diagnostic Performance of Anti-Cyclic Citrullinated Peptide Antibodies in Rheumatoid Arthritis and Other Rheumatological Disorders

“…Previous studies have shown that anti-CCP antibodies can also be detected in a small percentage of patients with immune diseases other than RA like SLE, psoariatic arthritis, ankylosing spondylitis, systemic sclerosis and Sjogren's syndrome (Alenius et al, 2006, Takasaki et al, 2004and Zhao et al, 2009. The specificity and sensitivity of test was 79.9% and 94.2% respectively and the PPV was 98.9% and NPV was 41.5%.…”

The Prevalence of Anticitrullinated Protein Antibodies in Older Poles—Results from a Population-Based PolSenior Study

“…Anti-CCP antibodies cannot be considered as pathognomonic for RA, as they are also detected in other disease entities such as palindromic rheumatism, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren’s syndrome, polymyositis, dermatomyositis, ulcerative colitis, HCV seropositive patients with arthralgia and also in some infectious diseases [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Furthermore, anti-CCP antibodies are detected in apparently healthy individuals and blood donors with a frequency of about 1% [ 23 ].…”