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Test Code:
CCP

Order Name:
Anti CCP

 
Useful For:
Determination of the IgG class of autoantibodies specific to cyclic citrullinated peptide (CCP) in human serum.

Detection of anti-CCP antibodies is used as an aid in the diagnosis of Rheumatoid Arthritis (RA) and should be used in conjunction with other clinical information. Autoantibody levels represent one parameter in a multicriterion
diagnostic process, encompassing both clinical and laboratory-based assessments.
 
Methodology:
Chemiluminescent Microparticle Immuno Assay (CMIA)
 
AliasesName:
Anti-Cyclic Citrullinated Peptide
Citrullinated Antibody
 
 
 
Test Code:
CCP

Order Name:
Anti CCP

 
Collection Specimen Or Container:
Blood/ Plain Blood (Red Top) 6 mL, 1 tube
 
Specimen Testing Type:
Serum, minimum volume 1 mL
 
Sub Mission Container:
Plastic vial
 
Rejection Criteria:
Hemolysis: 4+ reject
 
Specimen Stabillity:
Specimen Type Temperature Time
Serum (keep in original tube) Refrigerated, 2oC to 8oC 8 hours
Serum Refrigerated, 2oC to 8oC 7 days
Frozen, -20oC 14 days
 
 
 
Test Code:
CCP

Order Name:
Anti CCP

 
Schedule:
Tested daily (24 hours)
 
Turnaround Time:
Specimen collected to reported within 2:00 hours (120 mins)
 
 
Performing Location:
Immunology, Laboratory Department Tel. 13227
 
Specimen Retention Time:
5 days
 
 
 
Test Code:
CCP

Order Name:
Anti CCP

 
 
Clinical Information:
Rheumatoid Arthritis (RA) is a common, systemic autoimmune disease affecting 0.5-1% of the population. It is characterized by chronic inflammation of the synovium, which commonly leads to progressive joint
destruction and in most cases, to disability and reduction of quality of life. Evidence gained over the last few years suggests that aggressive therapy given early in the disease has the greatest therapeutic potential.

The serum of RA patients contains a variety of antibodies directed against self-antigens. The most widely known of these autoantibodies is the rheumatoid factor (RF) antibody directed against the constant domain of
IgG molecules. The presence of RF is one of the American College of Rheumatology’s (ACR) criteria for the classification of RA. Although the RF test has good sensitivity for RA, it is not very specific for the disease
as it can also be detected in the serum of patients with other rheumatic or inflammatory diseases and even in a substantial percentage of the healthy (elderly) population. For several years it has been recognized
that antibodies to anti-perinuclear factor (APF) and anti-keratin (AKA) are highly specific for RA. It was subsequently reported that both of these antibodies reacted with native filaggrin and are now referred to as
anti-filaggrin antibodies (AFA). More recently it has been shown that all of these antibodies are directed to citrulline-containing epitopes. Citrulline is a non-standard amino acid, as it is not incorporated into proteins during protein synthesis. It can, however, be generated via post-translational modification of arginine residues by the enzyme peptidyl arginine deiminase (PAD). In 1998, Schellekens and colleagues reported that linear peptides containing citrulline (CP) were very specific for RA antibodies (96%) in an ELISA based assay. Subsequent work demonstrated that cyclic variants of these peptides, termed cyclic citrullinated peptides (CCP), were equally specific for RA, but with a higher sensitivity than linear peptides.  To improve the sensitivity of the CCP test further, several dedicated libraries of citrulline-containing peptides were screened with RA sera and a new set of peptides (CCP2) were discovered which gave superior performance compared to the CCP1 test. Over the last few years, many independent studies have confirmed the diagnostic performance of the CCP2 test.

In 2007, the European League against Rheumatism (EULAR) published guidelines for the diagnosis of early RA, and the measurement of antibodies to anti-CCP was included as a serology marker.
 
Reference Value:
< 5.0 U/mL
 
Clinical Reference:
Manufacturer’s Reagent package insert, Anti-CCP, November 2015, Abbott Max-Planck-Ring 2, 65205
Wiesbaden, Germany.