Autoimmune disorder Biomarker
Collection Type: Blood
Related System: Autoimmune disorder
Anti‑CCP (anti‑cyclic citrullinated peptide) antibodies are autoantibodies directed against citrullinated proteins produced when arginine residues are post‑translationally modified. The anti‑CCP blood test measures the presence and titer of these antibodies, most often IgG, and is used primarily to detect and help predict rheumatoid arthritis (RA). It can be positive years before clinical symptoms appear. Testing is indicated for patients with persistent joint pain, swelling, morning stiffness, or symmetrical polyarthritis. Anti‑CCP positivity is more common in adults, especially women, and is associated with genetic factors (HLA‑DRB1 “shared epitope”), smoking, and worse/progressive joint damage; older age and smoking increase likelihood of positivity.
Run our symptom checker to see if this test is right for you
Symptom Checker<20 U/mL
Q: What is anti-CCP positive?
A: Anti-CCP positive means a blood test detects anti–cyclic citrullinated peptide (anti-CCP) antibodies. These antibodies are highly specific for rheumatoid arthritis and often appear before symptoms. A positive result supports RA diagnosis, indicates a higher likelihood of more aggressive, erosive disease, and helps guide early treatment decisions. Results are interpreted alongside symptoms, exam findings, and other tests like rheumatoid factor and imaging.
Q: How to reduce anti-CCP?
A: Anti-CCP antibodies often fall with early, aggressive control of rheumatoid arthritis: start disease‑modifying therapy (methotrexate, other DMARDs; biologics if needed) and suppress inflammation. Stop smoking, treat periodontal disease, maintain healthy weight, follow an anti‑inflammatory (Mediterranean) diet, and exercise regularly. Regular rheumatology follow‑up and adherence to prescribed therapy are key; antibody levels may not normalize in all patients.
Q: What is a normal Ccp level for rheumatoid arthritis?
A: Normal (negative) anti‑CCP is usually below about 20 U/mL. Results of roughly 20–39 U/mL are often considered borderline or low‑positive; values ≥40 U/mL are typically reported as positive and increase the likelihood of rheumatoid arthritis, with higher titres linked to greater disease probability and severity. Lab-specific cutoffs can vary—review your lab report and discuss results with your clinician.
Q: What diseases are high in anti-CCP?
A: Anti-CCP antibodies are most strongly associated with rheumatoid arthritis (including early and erosive RA). They can also be positive in related conditions such as palindromic rheumatism and juvenile idiopathic arthritis, and occasionally in other inflammatory arthritides like psoriatic arthritis, systemic lupus erythematosus, and Sjögren’s syndrome, though much less commonly than in RA.
Q: What diseases can cause a positive ANA?
A: Antinuclear antibodies (ANA) can be positive in autoimmune connective-tissue diseases such as systemic lupus erythematosus, systemic sclerosis (scleroderma), Sjögren’s syndrome, mixed connective-tissue disease, polymyositis/dermatomyositis and rheumatoid arthritis. They also occur in autoimmune hepatitis, drug-induced lupus, some infections and in a portion of healthy people. A positive ANA is nonspecific and requires clinical correlation and further testing.
Q: What causes high rheumatoid factor?
A: Rheumatoid factor is an autoantibody (usually IgM against IgG) produced in autoimmune and chronic inflammatory states. High RF is most commonly seen in rheumatoid arthritis but also occurs with other autoimmune diseases (Sjögren’s, systemic lupus, systemic sclerosis), chronic infections (hepatitis C, endocarditis, tuberculosis), some malignancies, chronic liver disease, and even in older healthy adults. Elevated RF is nonspecific and needs clinical correlation.