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The Anticyclic Citrullinated Peptide (CCP) test is a specific blood test used to diagnose and predict the likelihood of developing rheumatoid arthritis (RA), based on the presence of anti-cyclic citrullinated peptide antibodies. It can detect RA before symptoms appear and may allow for earlier treatment. The test is more reliable than the rheumatoid factor blood test, which can be negative in people with RA and positive in those who don’t have it.
The Anticyclic Citrullinated Peptide (CCP) test is a highly specific blood test for diagnosing rheumatoid arthritis (RA). It is also used to predict the likelihood of developing rheumatoid arthritis, even before rheumatoid arthritis symptoms have been observed. Diagnosis of RA is typically based on symptoms consistent with this form of arthritis and blood test results for anti-CCP and rheumatoid factor, another less specific blood marker for RA.
RA is an autoimmune disease during which the body’s immune system gets confused and starts attacking the body inwardly. One of the main symptoms of RA is swollen and painful joints. Inflammation in the body produces arginine, a part of the amino acid, which is sometimes converted into a different amino acid called citrulline. People with RA make antibodies against these citrullin chains of amino acids called anti-cyclic citrullinated peptide antibodies. The anti-CCP blood test detects the presence of these antibodies.
This test is valuable for many reasons. First, anti-CCP testing can confirm a diagnosis when symptoms of RA are present. The second is its ability to detect cyclic citrullinated peptide antibodies in people’s blood before symptoms develop. Third, the presence of high concentrations of anti-cyclic citrullinated peptide antibodies in the blood before symptoms appear strongly suggests a more aggressive form of RA. This type of information may allow for earlier initiation of treatment, perhaps by warding off joint damage, and help rheumatologists determine how strongly to treat the disease.
Prior to the development of the anti-CCP test, the diagnosis of RA relied heavily on a blood test for rheumatoid factor (RF). This test is sometimes negative in people with RA and sometimes positive in people who don’t have RA or never develop this form of arthritis. The diagnosis of RA is now typically based on symptoms, as well as RF and anti-CCP blood test results.
If symptoms of RA are observed and RF and anti-CCP blood tests are both positive, a diagnosis of RA is made. When a patient has a positive RF and a negative anti-CCP test, the doctor will typically order more tests and make a decision based on the results of those tests as well as the symptoms and their severity. If the anti-CCP test is positive, the RF test is negative, and symptoms are present, the diagnosis is RA. When the anti-CCP test is positive, the RF test is negative, and no symptoms are present, it is assumed that RA has a strong likelihood of developing in the future. If both blood tests are negative but symptoms of RA are present, an alternative reason for the symptoms may be sought, and the diagnosis of RA may be delayed or abandoned.
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