Zusammenfassung
Antikörper gegen citrullinierte Peptide (CCP-Antikörper) sind hoch spezifisch für
die rheumatoide Arthritis. Mit ELISA-Verfahren der 2. Generation weisen CCP-Antikörper
eine Spezifität von > 96 % und eine Sensitivität von 68 % auf. Auch können CCP-Antikörper
oft schon Jahre vor dem ersten Auftreten von Symptomen nachgewiesen werden. Sie eignen
sich daher ausgezeichnet für die Differentialdiagnose zwischen frühen Formen einer
rheumatoiden Arthritis und anderen entzündlichen Gelenkerkrankungen. Da CCP-Antikörper
mit aggressiven und therapierefraktären Verläufen einer rheumatoiden Arthritis assoziiert
sind, kann dies für Entscheidungen zu einer frühzeitigen und intensiven Therapie herangezogen
werden, um die Entstehung knöcherner Erosionen zu verhindern. Im Gegensatz zu dieser
wichtigen differentialdiagnostischen Bedeutung spielen CCP-Antikörper keine Rolle
für das Therapiemonitoring, da sie meist im Langzeitverlauf keine nennenswerten Veränderungen
aufweisen.
Summary
Antibodies against citrullinated peptides are highly specific for rheumatoid arthritis.
With second generation ELISA-kits, CCP-antibodies have a specificity of > 96 % and
a sensitivity of 68 %. CCP-antibodies can be detected several years before the onset
of clinical symptoms. They are, thus, ideally suited for the differential diagnosis
between early forms of rheumatoid arthritis and other inflammatory arthritides. As
CCP-antibodies are associated with aggressive and treatment resistant courses of rheumatoid
arthritis, their high predictive value can be useful in therapeutic strategy decisions
in order to verify early treatment with disease modifying drugs or biologicals in
line with modern treatment approaches to start aggressive therapy early to prevent
bone erosions. In contrast to their role in differential diagnosis and prediction
of aggressive disease, however, CCP-antibodies are of no value in monitoring treatment
as they do not change essentially over prolonged periods of time.
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Prof. Dr. med. Bernhard Manger
Medizinische Klinik III
Krankenhausstraße 12
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