The case for measuring antibodies to specific citrullinated antigens

摘要: Anti-citrullinated protein/peptide antibodies (ACPA) are the principal autoantibody system associated with rheumatoid arthritis (RA), diagnostic sensitivity of 70% and specificity 95%. Current testing for ACPA uses anti-cyclic citrullinated peptide assay (anti-CCP) which measures a generalized reactivity citrulline-containing peptides, thus giving no insight into to specific RA antigens. Of these, best characterized are, α-enolase, fibrinogen/fibrin, vimentin, Type 2 collagen filaggrin, each found in approximately 30-60% cases. Given reports cross-reactivity between antigens, we discuss whether or not measuring these could aid: clinical diagnosis, identification subsets drug responses, provide pathogenic mechanisms etiology RA.