CCP抗环状胍氨酸肽抗体课件.ppt

1、 Morning stiffness早晨僵硬 1 hourArthritis of 3 of 14 joints/joint groupsArthritis of hand jointsSymmetric swelling of jointRheumatoid nodules in specific locationsPositive rheumatoid factor(RF)Radiographic changes suggestion joint erosionAnti-CCP 1Anti-CCP 2Used peptides derived from filaggrin纤聚蛋白(fila

2、ment aggregating protein聚角蛋白微丝蛋白)To improve sensitivity,citrulline peptides were synthesized to optimize their use in immunoassays为了改善敏感性，合成了环瓜氨酸多肽以优化其在免疫检测中的应用This test had about 48%sensitivity,and 98%specificity该检测有48的敏感性和98的特异性These peptides were screened against RA sera,and the best ones were se

3、lected for use in the assay用RA的血清来筛选这些多肽，选其中最好的用于免疫检测Sensitivity was not comparable to RF(80%).敏感性不如RF好Improved sensitivity(equivalent to RF,80%);better specificity(95%for anti-CCP vs.80%for RF)由此敏感性得到改善，和RF相同，而且特异性更好了Anti-CCP 1 assays are no longer available when reading papers,be careful to notice

4、 what version of anti-CCP assay was usedAnti-CCP1已不再应用，阅读文献时注意检测中使用的是哪种Anti-CCP020406080100Anti-CCP2RF(IgM)Percent(%)RA(sensitivity)Non-RA(specificity)CCP2(%)IgM-RF(%)类风湿关节炎7774非类风湿关节炎97770%10%20%30%40%50%60%70%80%0246810years before first symptomsCCP-2 positive研究研究Forslind et al(2004)Kastbom et al(

5、2004)Berglin et al(2005)人群379例早期RA242 例早期RA138 例早期RACCP阳性%556475跟踪时期(年)232对于对于Anti-CCP的评的评价价较之较之X光更有效预测光更有效预测关节损坏程度关节损坏程度能预测疾病活动性能预测疾病活动性与关节损坏程度相与关节损坏程度相关关FeatureBenefit灵活的样本类型容易进行实验室常规检测检测方法/检测步骤MEIA定量检测/两步法随机检测、快速急诊检测 19分钟内出结果定标稳定期长降低实验室成本1:10 自动稀释 降低手动干扰 减少工作量和人为误差 随时可用的试剂和定标品操作简便、降低变异系数AxSYM 分析仪平台 应用在很多实验室