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For example, RF has limited sensitivity and specificity for the diagnosis of RA, and autoantibodies detected by the CCP test (anti-CCP antibodies) have a specificity of up to 98% but a sensitivity of only ∼68%. 2 Further, current tests cannot differentiate subtypes of ACPA-positive (ACPA+) RA.
ACPA are often detected using the so-called cyclic citrullinated peptide, or CCP test [ 5].
A positive cyclic citrullinated peptide (CCP) test in these patients should therefore be interpreted with care, and preferably followed by a control ELISA with a non-citrullinated antigen.
The ACPA profiles we identified with our array had comparable specificity and greater sensitivity than the commercial CCP test in diagnosing RA.
Due to unawareness of its advantages or lack of funding for it, the anti-cyclic citrullinated peptide (CCP) test is not performed routinely in primary care.
The majority of published studies in which the presence of ACPA in RA patients was investigated have used the second-generation CCP test (termed the CCP2 test).
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It is found that when strong P-waves are propagating in soil layers, VCP tests are more appropriate for the simulation of in situ stress fields than the conventional cyclic triaxial tests with a constant confining pressure (CCP tests).
Next-generation CCP tests are being developed, and recently the CCP3 and anti-modified citrullinated vimentin (MCV) tests were described.
Blood was taken for serum analysis (rheumatoid factor (RF), C-reactive protein (CRP) and anti-cyclic citrinulated peptide (CCP) testing) and DNA extraction.
Limitations include the lack of data on CCP antibody status, as most cases were diagnosed prior to the widespread usage of this test, and absence of plasma samples for CCP testing in about half the cases.
After the first generation of anti-CCP test (CCP1) [ 4, 5] a second generation of anti-CCP test (CCP2) has been introduced.
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