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Anti Cyclic Citrullinated Peptide

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This test looks for anti cyclic citrullinated peptide (CCP) antibodies in the blood, which are a type of autoantibodies that can cause disease by attacking the body's healthy cells. If CCP antibodies are found in your blood, it can be a sign of rheumatoid arthritis (RA). This test is advised if you show symptoms of rheumatoid arthritis-like joint pain, low-grade fever, joint swelling, and fatigue.

CCP antibodies are found in more than 75% of people who have rheumatoid arthritis. As rheumatoid arthritis can be difficult to diagnose, especially in its early stages, other tests such as X-ray and C reactive protein tests are also recommended.

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What does Anti Cyclic Citrullinated Peptide measure?

Anti cyclic citrullinated peptide antibodies are autoantibodies which are produced by the immune system that attack against the cyclic citrullinated peptide. Due to these attacks, inflammatory symptoms are produced in the body which is most commonly seen in rheumatoid arthritis. The Anti CCP antibodies can be present in patients prior to the start of symptoms of rheumatoid arthritis. The presence of positive Anti CCP antibodies in rheumatoid arthritis patients is said to be due to the combination of genetics and environmental factors. These patients have a common sequence of amino acids which is called as shared epitope that is encoded in specific genetic markers called human leukocyte antigens (HLA) which are responsible for producing proteins to control immune responses. The shared epitope attaches to these proteins to produce Anti CCP antibodies.

FAQs related to Anti Cyclic Citrullinated Peptide

Is there any preparation required before the test?

Inform the doctor about the medications you may be taking. No other specific preparations are usually required before this test.

Is there any risk associated with this test?

There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.

What is Citrulline?

During inflammation, arginine amino acid residues can be enzymatically converted into citrulline residues in proteins, such as vimentin, by a process called citrullination. Its production occurs during the metabolism of the amino acid arginine. It will change the structure of the protein which can trigger an immune response that produces autoantibodies against proteins in the joints.

What is Rheumatoid arthritis?

Rheumatoid arthritis is a systemic autoimmune disease which is chronic (from a long time). It causes inflammation, stiffness, pain and disastrous changes in joints of the body. It can occur at any age but the usual age is after 40 years. As compared to men, women are more affected. It can progress slow or fast. But, if untreated can cause disability of the joints.

What are other tests advised for rheumatoid arthritis?

Apart from anti CCP antibody test, rheumatoid factor (RF) test, joint X rays, and blood tests are advised. If a patient has positive anti CCP antibody test as well as RF test it indicates that the patient has rheumatoid arthritis. If the patient has a positive anti CCP antibody test but negative RF test it means that the patient is likely to develop rheumatoid arthritis in the future. If anti CCP antibody test is negative but RF test is positive, it can indicate that the patient should be analyzed for other inflammatory conditions as well.

Is Anti CCP antibody test screening test for Rheumatoid arthritis?

No, the screening test for rheumatoid arthritis is the rheumatoid factor. But, once the RF is positive, anti CCP antibody test should be done to differentiate rheumatoid arthritis from other arthritis.

Content created by

Dr. Swati Gupta (Anand)

MBBS, MD Lab Medicine

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Last Updated

25th Oct 2023