Anti-CCP hs (high sensitive)
Citrulline is a ubiquitous amino acid that is not part of proteins, which is an intermediate product of urea metabolism. In many proteins of the synovial fluid, arginine residues are found. The enzyme peptidyl arginine deziminaza (PAD), which is found in large amounts in the synovial fluid in inflammation (as isoforms PAD2 and PAD4), catalyzes the conversion process of arginine to citrulline. Isoferments PAD2 and PAD4 citrulline many synovial proteins, including vimentin. CCPs activate T-lymphocytes and bind to HLA-DR4 on the surface of antigen-presentingcells. ACCPs are detected in 76% of RA patients. The diagnostic sensitivity of these antibodies for RA is 78%, specificity is 96%. The study of these antibodies should be used for early diagnosis, as the frequency of their detection is higher in patients with a short history of the disease compared with other antibodies. The presence of ATSPP can serve as a prognostic indicator of the development of erosive rheumatoid arthritis.