The diagnosis of rheumatoid arthritis (RA) is best made utilizing the clinical, laboratory and radiologic criteria as specified in the American College of Rheumatology (ACR) Classification criteria for RA of 1987. While rheumatoid factor (RF) is a criterion, the diagnosis of RA can be made in its absence, as its sensitivity/specificity is not 100%/100%. Research for other markers has resulted in the discovery of an antibody to cyclic citrullinated peptides (anti-CCP) that proves to be a better marker. Anti-CCP is more specific than RF in the diagnosis of RA and provides better information on prognosis with regard to erosive joint disease. The pathogenic role of the anti-CCP is not known. However, B-cells from synovial fluid of RA cells are able to spontaneously secrete anti-CCP. Rheumatoid arthritis has a significant genetic predisposition and an association with the HLA complex, in particular the HLA-DRBI shared epitope (SE) alleles. There is a notable association between SE and anti-CCP positivity.
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)