Anti-citrullinated protein antibodies in rheumatoid arthritis

As good as it gets?

Z. Szekanecz, Lilla Soós, Z. Szabó, Andrea Fekete, A. Kapitány, A. Végvári, S. Sipka, G. Szűcs, S. Szántó, Gabriella Lakos

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Anti-citrullinated protein antibodies (ACPAs) have recently emerged as sensitive and specific serological markers of rheumatoid arthritis (RA), providing superior alternative of the rheumatoid factor (RF) test in the laboratory diagnostics of RA. The first members of this autoantibody family were anti-perinuclear factor (APF) and anti-keratin antibodies (AKA). It became evident that both APF and AKA recognize citrullinated epitopes of filaggrin. Citrullination is a post-translational modification of arginine by deimination, physiologically occurring during apoptosis, inflammation or keratinization. The presence of several citrullinated proteins has been demonstrated in the RA synovium. The identification of citrullinated epitopes as targets for anti-filaggrin antibodies led to the development of the first and later second generation anti-cyclic citrullinated peptide (anti-CCP) antibody assays. The widely used anti-CCP2 assays have high diagnostic sensitivity and specificity, and they also show important predictive and prognostic value in RA. The anti-Sa antibody has been identified a decade ago; however, recent studies confirmed that anti-Sa is directed against citrullinated vimentin, hence it is a new member of the family of ACPAs. The newly developed anti-mutated citrullinated vimentin (anti-MCV) assay has similar diagnostic performance than the anti-CCP2 ELISA; however, the diagnostic spectrum of the anti-MCV test is somewhat different from that of anti-CCP2. It's especially useful in the diagnosis of RA in RF and anti-CCP2 seronegative patients. The combined application of anti-CCP2 and anti-MCV assays can improve the laboratory diagnostics of RA. The family of ACPAs is expected to expand; there is an increasing need for developing new diagnostic strategies after careful evaluation of the characteristics of the available assays.

Original languageEnglish
Pages (from-to)26-31
Number of pages6
JournalClinical Reviews in Allergy and Immunology
Volume34
Issue number1
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Rheumatoid Arthritis
Vimentin
Antibodies
Anti-Idiotypic Antibodies
Proteins
Rheumatoid Factor
Keratins
Epitopes
Synovial Membrane
Post Translational Protein Processing
Autoantibodies
Arginine
Enzyme-Linked Immunosorbent Assay
Apoptosis
Inflammation
Sensitivity and Specificity
filaggrin

Keywords

  • Anti-CCP2
  • Anti-mutated citrullinated vimentin
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Anti-citrullinated protein antibodies in rheumatoid arthritis : As good as it gets? / Szekanecz, Z.; Soós, Lilla; Szabó, Z.; Fekete, Andrea; Kapitány, A.; Végvári, A.; Sipka, S.; Szűcs, G.; Szántó, S.; Lakos, Gabriella.

In: Clinical Reviews in Allergy and Immunology, Vol. 34, No. 1, 02.2008, p. 26-31.

Research output: Contribution to journalArticle

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